Predictors of trigeminal neuropathy in patients receiving Gamma Knife stereotactic radiosurgery for vestibular schwannoma.

Objective: The authors' objective was to validate dosimetric and clinical predictors of the development of trigeminal neuropathy (Tn) in patients treated with stereotactic radiosurgery (SRS) for a diagnosis of vestibular schwannoma (VS).

Methods: In total, 301 patients were treated with SRS for VS at the authors' center between April 2013 and June 2020, with a median prescription dose of 12.5 Gy.

Case Report: Recurrent pediatric cavernous malformation of the trigeminal nerve.

Background: Most cavernous malformations (CM) usually involve the parenchyma and rarely occur in cranial nerves. Recurrence of CM associated with cranial nerves after surgical resection has not been previously reported.

Case Description: This paper describes the case of an 11-year-old girl who presented with left otalgia and headache because of a left trigeminal cavernous malformation.

The potential effect of the updated national criteria on adult cochlear implantation in England and Wales.

Objectives: Following an update of 'old' TA166 guidance (March 2019), the National Institute for Health and Care Excellence (NICE) predicted a 70% increase in cochlear implantation (CI). We investigated the effect of the 'new' TA566 criteria on adult CI at our regional centre.

Methods: Adult CI assessments between 1st January 2015 and 31st December 2018 (before new criteria) and between 7th March 2019 and 31st August 2019 (after new criteria) were retrospectively examined.

The Effect of Different Round Window Sealants on Cochlear Mechanics Over Time.

Background: This project investigated the effects of round window membrane (RWM) sealants after surgical incision, with a focus on audiological thresholds, ossicular mechanics, and the impact upon cochlear function and pathology.

Methods: Twenty-eight guinea pigs were randomly allocated to one of three sealant groups (muscle, n = 7; fascia, n = 7, Tisseel, n = 8) or an unsealed control group (n = 6). Preoperative hearing was measured using auditory brainstem responses (ABRs).

Factors associated with the development of paediatric chronic otitis media by age nine: a prospective longitudinal cohort study of 6560 children.

Objective: This study aimed to analyse social, health and environmental factors associated with the development of chronic otitis media by age nine.

Method: This was a prospective, longitudinal, birth cohort study of 6560 children, reviewed at age nine. Chronic otitis media defined as previous surgical history or video-otoscopic changes of tympanic membrane retraction, perforation or cholesteatoma.

Phantosmia as the first presentation of a cavernous sinus - clinoidal meningioma.

Cavernous sinus meningiomas (CSM) are complex skull base lesions that, due to their particular anatomical location, render surgical management difficult. Their symptomatology is versatile, and the clinical outcome is difficult to predict. We present the case of a 57-year old female patient who experienced phantosmia - an abnormal, persistent, olfactory sensation of cigarette smell for 18 months.

The challenge of performing mastoidectomy using the operating microscope with coronavirus disease 2019 personal protective equipment (PPE).

Objective: Mastoidectomy is considered an aerosol-generating procedure. This study examined the effect of wearing personal protective equipment on the view achieved using the operating microscope.

Methods: ENT surgeons assessed the area of a calibrated target visible through an operating microscope whilst wearing a range of personal protective equipment, with prescription glasses when required.

Giant Juvenile Ectopic Schwannoma of the Temporal Bone.

Background: Ectopic intracranial schwannomas (those that do not arise from a named cranial nerve) are rare. They account for <2% of surgically resected central nervous system schwannomas.

Case Description: We report the case of a 14-year-old boy presenting with a left conductive hearing loss and temporal bone deformity.

A Systematic Review of Interventions for Balance Dysfunction in Patients With Vestibular Schwannoma.

Objective: Dizziness is a major contributing factor to poor quality of life for patients with vestibular schwannoma (acoustic neuroma). We wished to review the literature on interventions for balance dysfunction in these patients.

Data Sources: A systematic literature review was performed identifying studies that measured balance function before and after treatment for vestibular schwannoma.

Smartphone speech-to-text applications for communication with profoundly deaf patients.

Objective: Visual communication aids, such as handwriting or typing, are often used to communicate with deaf patients in the clinic. This study aimed to establish the feasibility of communicating through smartphone speech recognition software compared with writing or typing.

Method: Thirty doctors and medical students were timed writing, typing and dictating a standard set of six sentences appropriate for a post-operative consultation, and the results were assessed for accuracy and legibility.

The Cochlear Baha 4 Attract System - design concepts, surgical technique and early clinical results.

Bone conduction implant systems utilize osseointegrated fixtures to transmit sound through the bones of the skull. They allow patients with hearing loss to receive acoustic signals directly to the inner ear, bypassing the outer and middle ear. The new Cochlear™ Baha(®) Attract System (Cochlear Bone Anchored Solutions AB, Mölnlycke, Sweden) has been designed as a non-skin penetration hearing implant.

The role of post-operative imaging in cochlear implant surgery: a review of 220 adult cases.

Objectives: To determine the incidence of abnormal radiological findings after cochlear implantation and their effect on clinical outcomes.

Methods: Retrospective review of 220 adult cochlear implants. Clinical records and post-operative plain X-rays were reviewed and compared with pre-operative and 6-month post-operative City University of New York (CUNY) speech scores.

What factors influence patient and parent choice of cochlear implant model for children?

Objectives: The West of England Cochlear Implant Programme purchases two makes of cochlear implant (CI) for paediatric use (MED-EL and Cochlear). If the CI team has no preference, the decision regarding which implant to use is made by the patient and family. Families are provided with information about the devices and allowed time to handle dummy implants and ask questions.

Systematic review of intralesional cidofovir dosing regimens in the treatment of recurrent respiratory papillomatosis.

Objective: Surgical management of recurrent respiratory papillomatosis (RRP) usually involves resection via microlaryngoscopy. Intralesional injection of cidofovir has been shown to be an effective adjuvant treatment, but remains unlicensed. United Kingdom General Medical Council guidelines recommend the prescribing doctor should "be satisfied that there is a sufficient evidence base and/or experience of using the medicine to demonstrate its safety and efficacy".

Draping for neck surgery requiring endotracheal tube manipulation.

During airway surgery, the anaesthetist may be required to manipulate or withdraw the endotracheal tube. Traditional surgical head drapes often make access to the tube difficult, therefore limiting control of the airway and risking de-sterilisation of the surgical field. We report a new method of draping for major neck operations that permits easy access to the endotracheal tube while maintaining sterility of the operative field.

Mastoiditis secondary to metastatic lung carcinoma: case report and literature review.

Objective: We present a case report and systematic review of acute mastoiditis caused by metastatic lung cancer.

Case Report: A 62-year-old woman developed acute mastoiditis as a complication of otitis media. Cortical mastoidectomy revealed deposits of metastatic non-small cell lung carcinoma around the sigmoid sinus.

How private is your consultation? Acoustic and audiological measures of speech privacy in the otolaryngology clinic.

The right to confidentiality is a central tenet of the doctor-patient relationship. In the United Kingdom this right to confidentiality is recognised in published GMC guidance. In USA the Healthcare Insurance Portability and Accountability Act of 1996 (HIPAA) strengthened the legal requirement to protect patient information in all forms and failure to do so now constitutes a federal offence.

Patients' perceptions of doctors' clothing: should we really be 'bare below the elbow'?

Introduction: In September 2007, the Department of Health published Uniforms and Workwear: an Evidence Base for Guiding Local Policy. Following this, most National Health Service trusts imposed a 'bare below the elbow' dress code policy, with clinical staff asked to remove ties, wristwatches and hand jewellery and to wear short-sleeved tops. There is currently no evidence linking dress code to the transmission of hospital-acquired infection.

Readability of out-patient letters copied to patients: can patients understand what is written about them?

Unlabelled: The National Health Service Plan of 2000 proposed that patients should receive a copy of all correspondence regarding their care. There is concern that the readability of patients' letters may not be appropriate for many patients.

Materials And Methods: This study determined readability scores for sequential letters written to general practitioners and copied to patients, following ENT consultations at the Royal United Hospital in Bath.