Search

Idiopathic sudden sensorineural hearing loss (SSNHL) is typically treated with systematic or intratympanic corticosteroids. Current ENT-UK guidelines suggest treatment with a dose of oral prednisolone 1mg/kg/day for 7 days then tapered over a further 5 days. However, there is no consensus on the effectiveness of corticosteroids for idiopathic SSNHL and no universally accepted optimal regime. The objective of this systematic review was to examine the effect of high dose versus standard dose corticosteroids in the management of idiopathic SSNHL. A systematic review was performed of all published data related to patients with idiopathic SSNHL who were treated acutely with high dose corticosteroid therapy. Articles were included that reported data on high dose, or comparing standard dose to high dose, oral or intravenous corticosteroid therapy for the treatment of patients with idiopathic sudden sensorineural hearing loss. Articles where patients received only combination treatment with intra-tympanic steroid were excluded. Risk of bias was assessed using the ROBINS-I tool and the ROB-2 tool. Six studies were included in the analysis, representing 919 patients. Two prospective single-arm studies of patients with SSNHL treated with a high dose steroid regime found mean hearing level improved (79.5dB to 42.3dB) and 45.8% of idiopathic patients had complete recovery of hearing. Three retrospective case-series comparing high dose to standard dose regimes found a significantly greater improvement in hearing level (38.3dB vs. 48.8dB, P = 0.042), a greater mean absolute hearing gain (44.4dB vs. 15.1dB) and a significantly higher rate of functionally relevant recovery (35.7% vs. 7.4%, P = 0.035) in patients treated with high dose regimes. The single included prospective randomised trial found no statistically significant difference in mean hearing level or speech discrimination score between patients treated with high dose pulse steroids or a standard dose regime. Our systematic review found the reported outcomes in the literature in this area to be mixed, with some studies suggesting a greater degree of hearing recovery with a high dose regime but others suggesting no difference. The overall quality of the available evidence was deemed to be low, with the studies at moderate risk of bias. [ABSTRACT FROM AUTHOR]

Lodi et al.'s Cochrane review demonstrated that topical treatments in the context of oral LP have only low certainty evidence for their efficacy.[10] Systemic therapies for otic LP have remained largely unexplored. Our series' demographics are similar to the demographics found in oral LP patients.[4] Unlike oral LP however, biopsy of the external auditory canal was not necessary to establish diagnosis. The diagnosis of otic lichen planus should be considered in patients with recalcitrant otorrhoea and/or canal stenosis, particularly in those with known extra-otic lichen planus. Keywords: canal stenosis; lichen planus; management; otology EN canal stenosis lichen planus management otology 79 82 4 12/16/22 20230101 NES 230101 Key Points This case series represents the largest in the United Kingdom and helps confirm otic lichen planus as a rare but important cause of chronic stenosing inflammation of the ear canal. [Extracted from the article]

BACKGROUND: To assess compliance with guidance produced by the UK body representing all ENT Surgeons (ENT UK) and the British Society of Otology (BSO) on restarting otological surgery after the first wave of the COVID-19 pandemic. Safety was assessed by recording surgical complications and transmission of SARS-CoV-2 transmission during this period. METHODS: A prospective multicenter audit of otological surgery was conducted over a 12-week period, from June 15, 2020, to September 6, 2020. RESULTS: One thousand one hundred thirty cases from 79 hospital sites across Great Britain were involved in the study; 91.1% were tested for SARS-CoV-2 pre-operatively, none of whom tested positive; 70.4% were isolated for 7-14 days prior to surgery; 28.2% of surgeons wore full personal protective equipment, compared with 66.6% of anesthetists and 68.2% of scrub staff. The endoscope was used in 75 (6.7%) of all procedures, operations were changed to be performed under local rather than a general anesthetic in 3 cases (0.3%) and the "double drape" to protect against aerosol was used in 321 (27.4%) of cases. Trainees were present in 80.3% of cases. Complications occurred in 4% of cases. No patients or staff contracted SARS-CoV-2 during the audit. CONCLUSION: ENT UK and BSO guidance was variably followed, with the highest compliance for the use of an FFP3 mask, a negative SARS-CoV-2 swab, and trainee presence in theater. Surgeons did not use full personal protective equipment as frequently as their anesthetic and scrub team colleagues. There were only minimal changes in surgical and anesthetic techniques. Otological operation after the first wave of the SARSCoV-2 pandemic was performed safely with no reported COVID transmission or increase in major complications despite changes in operating practice. [ABSTRACT FROM AUTHOR]

The Bulldog is a popular companion breed in the UK despite widely reported disease predispositions. This study aimed to characterise the demography, mortality and common disorders of Bulldogs under veterinary care in the UK during 2013. VetCompass collates anonymised clinical data from UK primary-care veterinary practices for epidemiological research. The clinical records of all Bulldogs available in the VetCompass study dataset were reviewed manually in detail to extract the most definitive diagnoses recorded for all disorders that existed during 2013 and for all deaths. Bulldogs comprised 1621 (0.36%) of 445,557 study dogs. Bulldogs increased from 0.35% of the 2009 birth cohort to 0.60% in 2013. Median longevity was 7.2 years, which was lower in males (6.7 years) than females (7.9 years) (P = 0.021). The most prevalent fine-level precision disorders recorded were otitis externa (n = 206, prevalence 12.7%, 95% CI: 11.1–14.4), pyoderma (142, 8.8%, 95% CI: 7.4–10.2) and overweight/obesity (141, 8.7%, 95% CI: 7.4–10.2). The most prevalent disorder groups were cutaneous (n = 463, prevalence: 28.6%, 95% CI: 26.4–30.8), ophthalmological (292, 18.0%, 95% CI: 16.2–20.0), aural (211, 13.0%, 95% CI: 11.4–14.8), enteropathy (188, 11.6%, 95% CI: 10.1–13.3) and upper respiratory tract (171, 10.5%, 95% CI: 9.1–12.1). Provision of an evidence base on the most common disorders and causes of mortality within breeds can support owners, breeders and the veterinary profession to improve health and welfare within these breed. [ABSTRACT FROM AUTHOR]

Introduction: Benign paroxysmal positional vertigo (BPPV) is the most common cause of dizziness in the elderly. This has been identified as a risk factor in falls. Falls are the leading cause of disability and the leading cause of death from injury among people over 75 in the UK. Methods: We assessed the effect of BPPV treatment on falls in an elderly population by retrospectively reviewing one unit's experience of BPPV management over an 8-year period from June 2008 to June 2016. We specifically assessed patients who were referred for the primary reason of falls and were aged over 65 years. These patients were evaluated and treated with particle repositioning maneuvers if their positional tests were positive. The frequency of falls prior to their visit and at 6-month clinic follow-up were reviewed. Results: The total number of falls in the cohort reduced significantly (P < .0001) after the procedure, from 128 to 46 falls (64% reduction). Associated comorbidities were also evaluated in this group. Conclusion: A prompt and effective treatment of BPPV is prudent to prevent devastating falls in older people in our communities. [ABSTRACT FROM AUTHOR]

Objective: The impact of dietary factors on tinnitus has received limited research attention, despite being a considerable concern among people with tinnitus and clinicians. The objective was to examine the link between dietary factors and presence and severity of tinnitus. Design: This study used the UK Biobank resource, a large cross-sectional study of adults aged 40–69. 171,722 eligible participants were asked questions specific to tinnitus (defined as noises such as ringing or buzzing in the head or ears). Dietary factors included portions of fruit and vegetables per day, weekly fish consumption (oily and non-oily), bread type, cups of caffeinated coffee per day, and avoidance of dairy, eggs, wheat and sugar. We controlled for lifestyle, noise exposure, hearing, personality and comorbidity factors. Results: Persistent tinnitus, defined as present at least a lot of the time, was elevated with increased: (i) fruit/vegetable intake (OR = 1.01 per portion/day), (ii) bread (wholemeal/wholegrain, OR = 1.07; other bread, 1.20) and (iii) dairy avoidance (OR = 1.27). Persistent tinnitus was reduced with: (i) fish consumption (non-oily, OR = 0.91; oily, 0.95), (ii) egg avoidance (OR = 0.87) and (iii) caffeinated coffee consumption (OR = 0.99 per cup/day). Reports of “bothersome” tinnitus (moderate-severe handicap) increased with wholemeal/wholegrain bread intake (OR = 0.86). Reports of less frequent transient tinnitus increased with dairy avoidance (OR = 1.18) and decreased with caffeinated coffee (OR = 0.98 per cup/day) and brown bread (OR = 0.94). Conclusions: This is the first population study to report the association between dietary factors and tinnitus. Although individually dietary associations are mostly modest, particular changes in diet, such as switching between foodstuffs, may result in stronger associations. These findings offer insights into possible dietary associations with tinnitus, and this may be useful when discussing management options in combination with other lifestyle changes and therapies. [ABSTRACT FROM AUTHOR]

The use of acupuncture among US adults was estimated at nearly 40% in 2012. A study from the United Kingdom in 2010 found 60% of otolaryngologic patients had used a form of complementary or integrative medicine, with greater than a third in the last year alone. Acupuncture, a therapeutic modality of traditional Chinese medicine, has been used for millennia in Asian countries. Within otolaryngology, acupuncture has been used for a variety of conditions encompassing otology, laryngology, rhinology, and pediatrics. Herein, we review the current literature on the applications of acupuncture for a range of ENT disorders., Competing Interests: Disclosure The authors have no relevant financial interests pertaining to this article., (Copyright © 2022 Elsevier Inc. All rights reserved.)

The article provides information on the hearing impairment disability, an illness that affects about 20 percent of the population in Great Britain. It is characterized by the average hearing level in one ear over the lower frequencies which is worse by 25 decibels. Otological services are directed towards diagnosis and treatment of organic pathology to break the stages of the illnesses at an earlier stage.

Malignant atrophic papulosis occurring in mother and son is described. Hitherto this condition has not been described in 2 members of the same family nor, to our knowledge, have there been previously reported cases from the U.K. Genetic and environmental factors involved in the pathogenesis of this disease are discussed. [ABSTRACT FROM AUTHOR]

A calendar of events related to continuing medical education in the Great Britain for 2007 is presented. The 6th Copenhagen-Nottingham Nose and Throat Dissection Course will be held on June 13 to July 16 at Copenhagen, Denmark. The 11th Surgical Course on Tympanoplasty and Mastoidectomy will be held on July 12-15 at Ipswich, England. The West Midlands symposium on otology and neurology will be held on October 9 at Wolverhampton, England.

The article discusses the opportunities and threats facing otology and audiology in Great Britain. It has cited the delivery of sophisticated and high quality care to hearing and balance impaired patients in multidisciplinary teams characterized by respect and integration of purpose.

The article offers information on several conferences related to continuing medical education to be held in Great Britain during 2010, including the British Society of Otology Annual Meeting in London on February 4, 2010, the One-Day Symposium on Lacrimal Surgery in Ipswich on February 12, 2010, and a conference of The Otorhinolaryngological Research Society in Oxford on March 19, 2010.

A calendar of continuing medical education events in Great Britain is presented including the General Ear, Nose, and Throat (ENT) Courses, Otology/Neurotology, and Paediatric ENT.

A calendar of continuing medical education events for the Great Britain area is presented including the Head and Neck and Otology.

The article reports on developments related to otology and otolaryngology. In otology, the endoscope is increasingly considered as a vital aid to diagnosis, teaching, monitoring, and management. Its first three roles are mainly due to its ability to freeze pictures of and photograph the ear consistently without any effort. The quality of the otolaryngology audits carried out by the Clinical Effectiveness Units in Great Britain keep getting better.