Nasopharyngeal amyloidosis: an unusual cause of unilateral hearing loss.

Amyloidosis is typically a systemic depositional disease, diagnosed on clinical symptoms and signs in conjunction with histopathology. When occurring on a localized basis in the head and neck, the lesion is most commonly observed in the larynx. Primary localized nasal amyloidosis however is an uncommon finding, with 25 reported cases in the literature to date.

National Institute for Clinical Excellence guidelines on the surgical management of otitis media with effusion: are they being followed and have they changed practice?

Objective: UK National Institute of Clinical Excellence (NICE) guidelines on surgical management of otitis media with effusion (OME) in children call for an initial 3 month period of observation, with ventilation tube (VT) insertion considered for children with persistent bilateral OME with a hearing level in better ear of 25-30 dB HL or worse ("core criteria"), or for children not meeting those audiologic criteria but when OME has significant impact on developmental, social or educational status (exceptional circumstances). We aimed to establish whether guidelines are followed and whether they have changed clinical practice.

Methods: Retrospective case-notes review in five different centres, analysing practice in accordance with guidelines in all children having first VT insertion before (July-December 06) and after (July-December 08) guidelines introduction.

Primary care for tinnitus: practice and opinion among GPs in England.

Rationale, Aim And Objective: Effective tinnitus management starts with appropriate general practitioner (GP) triage, which in England can be guided by the Department of Health's Good Practice Guide (GPG). Despite the prevalence of the condition, there has never been a systematic survey of its management in primary care in England. We aimed to evaluate how people with tinnitus are assessed and managed in general practice, noting variation in practice across GPs and health authorities, and evaluating how closely typical practice aligns to the GPG for tinnitus.