To systematically review the literature on the occurrence of psychiatric diagnoses in a tinnitus-affected population, and correlate the presence of psychiatric disorders with tinnitus-related annoyance and severity.

A systematic review of the literature published between January 2000 and December 2012 was performed using PubMed, ISI Web of Science and SciELO databases. Original articles in English and Portuguese that focused on the diagnosis of mental disorders associated with tinnitus, especially anxiety and depression, were identified.

A total of 153 articles were found and 16 were selected. Fifteen articles showed a high prevalence of psychiatric disorders in tinnitus-affected patients, and nine showed a high correlation between the presence of a psychiatric disorder and tinnitus-related annoyance and severity.

The prevalence of psychiatric disorders, especially anxiety and depression, is high in tinnitus patients, and the presence of these disorders correlates with tinnitus-related annoyance and severity.

To evaluate the long-term stability of intratympanic steroids and investigate the ‘real’ impact of sudden sensorineural hearing loss on patients.

A total of 14 patients treated with intratympanic steroids were evaluated by audiometric and vestibular examinations. The modified Glasgow Benefit Inventory was used to evaluate quality of life changes after intratympanic steroid treatment.

There was no significant difference between pure tone average post-intratympanic steroids and at follow up. The general Glasgow Benefit Inventory score was not significantly associated with the presence of tinnitus or dizziness, or with patient age. The change in pure tone average after intratympanic steroid treatment did not correlate with social or physical scores, but correlated strongly with the general Glasgow Benefit Inventory score (p = 0.0023). Intratympanic steroid administration led to a stable improvement in hearing. Quality of life assessment showed that patients can feel satisfaction regardless of the hearing outcome. Patients who regained a social hearing level expressed greater satisfaction than patients without serviceable hearing. Overall, quality of life improvement was not related to hearing improvement.

Sudden sensorineural hearing loss is devastating. Considering the audiological effects alone ignores the ‘human’ perspective. Audiological success can correlate with poor quality of life outcome.

This study describes the clinical features of up-beating vertical nystagmus observed during the seated–supine positional (straight head-hanging) test in patients with benign paroxysmal positional vertigo.

A total of 190 patients with benign paroxysmal positional vertigo symptoms who had presented between 2009 and 2012 were enrolled for this retrospective case series. Twelve patients with positional up-beating vertical nystagmus, as confirmed by video-nystagmography during the seated–supine positional test, were selected.

The incidence and duration of symptoms of multiple canal benign paroxysmal positional vertigo were significantly lower compared with the other types of benign paroxysmal positional vertigo (p = 0.029 and p = 0.048 respectively). Trauma was the leading aetiological factor in those patients (p = 0.012). The average number of therapeutic manoeuvres required for the relief of symptoms in patients with multiple canal involvement was significantly higher than in the other groups (p = 0.041).

In patients with benign paroxysmal positional vertigo, the presence of vertical up-beating nystagmus while lying down is a unique peripheral sign and could indicate multiple canal involvement. Therefore, the seated–supine positional test should always be included in the test battery.

To study the interactive influence of implanted nano platinum black electrodes (as compared with pure platinum electrodes) on rabbit orbicularis oculi muscle morphology and function.

The influence of the two types of electrode on the orbicularis oculi muscle was monitored in a rabbit model of facial paralysis. Biological electric current and exciting current were administered to biological tissue, and morphological and functional changes were identified. Changes in orbicularis oculi muscle contraction, electrode configuration and performance associated with long-term electrical stimulation were observed over 28 days of implantation.

The nano platinum black electrode was superior to the pure platinum electrode in the following aspects: morphology and functionality, electrical excitation function of the orbicularis oculi muscle (as assessed by electromyography), muscle contraction function and biological tissue changes. Furthermore, the nano platinum black electrode features had good stability.

Microelectrode surface modification with nano platinum black can effectively increase the microelectrode surface area and improve electrode performance, and is associated with good tissue compatibility.

To determine the effectiveness of biocements in rebridging isolated incudostapedial erosion.

A review of the use of biocements for isolated incudostapedial joint erosion was performed on publications from 1998 to 2012 available from Medline, Embase and Pubmed. Inclusion criteria were papers published in English, case series or comparative studies with more than 10 patients, isolated incudostapedial erosion through chronic ear disease, minimal air-bone gap less than 20 dB (or air-bone gap less than 10 dB) and follow up for at least one year.

In 108 patients, rebridging ossiculoplasty was performed using hydroxyapatite cement. Closure of air-bone gaps less than 20 dB and less than 10 dB was achieved in 80–94.4 per cent and 29–75 per cent, respectively. Glass ionomer cement was used in 318 patients. Closure of air-bone gaps less than 20 dB and less than 10 dB was achieved in 74–94 per cent and 40–76 per cent, respectively.

Biocements can be successfully used to close isolated incudostapedial erosions. Larger comparative prospective studies documenting the length of eroded incus and types of reformation of the incudostapedial joint, with standardised reporting, are needed in the future.

This study aimed to determine the characteristics of hearing loss in patients with Behçet's disease.

Twenty-six consecutive patients with Behçet's disease and a control group consisting of 25 age-matched healthy subjects were prospectively included in this study. Pure tone and speech audiometry, tympanometry, distortion product otoacoustic emission testing, and auditory brainstem-evoked response assessment were performed in the patients and controls.

The pure tone audiograms and the results of distortion product otoacoustic emission testing showed statistically significant hearing loss in the Behçet's disease patients (p < 0.05). Auditory brainstem-evoked response results were not significantly different between the patients and controls (p > 0.05).

The findings of the present study demonstrated that audiological involvement is more frequent in patients with Behçet's disease than in healthy controls. Therefore, all patients with Behçet's disease should be regularly monitored by an otolaryngologist and be given information about the possibility of inner-ear involvement.

To investigate the frequency of demodex species in the external acoustic meatus in patients with an itchy ear canal.

Patients were assigned to one of three groups. Group one consisted of 54 patients with an itchy ear canal who were using a local agent, while group two was composed of 51 patients with an itchy ear canal who were not using a local agent. Group three consisted of 50 healthy individuals without an itchy ear canal.

Demodex species test results were positive in nine (5.8 per cent) of the cases. Six of these positive cases were in group one, two in group two and one in group three. The frequency of demodex species in the external acoustic meatus was similar between those patients with an itchy ear canal who did not use a local agent and the healthy individuals (p = 0.571), but it was significantly higher in those using a local steroid compared with those not using a local agent (p = 0.046).

Although demodex species was not significantly higher in patients with an itchy ear canal compared with the control group, use of a local steroid increased the parasite frequency in the external ear canal of affected patients.

This study aimed to present the histopathological and audiological effects of mechanical trauma associated with the placement of a model electrode in the scala tympani in rats, and the effects of continuous topical corticosteroid application.

The study comprised three groups of rats. The round window membrane was perforated in all three groups and a model electrode was inserted in the round window. Group one received no further treatments. Groups two and three also had an intrathecal microcatheter compatible with a mini-osmotic pump inserted; in group two this was used to release normal saline and in group three the pump released 400 µg/ml dexamethasone.

Dexamethasone infusion given after implantation of the intracochlear model electrode was more effective for preventing hearing loss than the administration of just one dose of dexamethasone.

The findings suggest that continuous dexamethasone infusion is beneficial for preventing the loss of hair cells and neurons associated with early and late periods of intracochlear electrode trauma.

Haemorrhage is the most common major complication of endoscopic sinus surgery. Post-operative absorbable or non-absorbable nasal packing can cause pain and blockage. Haemostatic powders or gels may prevent this problem. However, when based on factors in the clotting cascade, they induce an inflammatory reaction and can cause post-operative synechiae. Oxidised cellulose powder produces haemostasis without inducing synechiae formation, but has not been trialled for sinus surgery.

A randomised clinical trial was performed to compare cellulose powder to non-absorbable packing following sinus surgery. Participants were 50 consecutive patients undergoing sinus surgery, 47 of whom completed the study. The main outcome measures were post-operative bleeding, pain scores and synechiae formation.

Cellulose powder was effective at stopping bleeding, and was associated with less pain than nasal packing, with no evidence of increased synechiae formation.

Cellulose powder appears to be a good haemostatic agent following sinus surgery. A larger trial would allow more accurate quantification of its effectiveness.

The main purpose of this study was to evaluate the effect of the pectoralis major myofascial flap on pharyngocutaneous fistula formation and time to oral feeding.

This retrospective study reviewed 155 total laryngectomies. Patients were divided into two main groups. Group 1 included 110 patients who were treated primarily by total laryngectomy and group 2 comprised 45 patients who were treated by salvage laryngectomy with or without a pectoralis major myofascial flap.

The use of a pectoralis major myofascial flap did not have a significant effect on pharyngocutaneous fistula formation in the salvage group (p = 0.376). When comparing the oral feeding day of patients with pharyngocutaneous fistula, a significant difference was observed between the salvage group with pectoralis major myofascial flap reinforcement and the salvage group without pectoralis major myofascial flap reinforcement (p = 0.004).

Our study demonstrated that pectoralis major myofascial flap reinforcement did not decrease the rate of pharyngocutaneous fistula formation. Instead, it prevented the formation of large fistulas that would require surgical management, and showed a similar time to oral feeding and length of hospital stay to primary laryngectomy.

To analyse trends in two-week rule referrals for head and neck cancer over 10 years.

Data from two-week referrals received by the Wirral University Hospital NHS Trust between 1 January and 30 June 2012 were compared with similar data from 2002.

A total of 357 referrals were received during the 6-month audit period, compared with 149 during the whole of 2002. Cancer pick-up rates were 9 per cent and 5 per cent in the first and second cycles, respectively.

The annual number of two-week referrals made to our department increased by over 450 per cent in 10 years, but the resulting cancer pick-up rate fell by nearly 50 per cent. Whilst cancer patients need to be seen quickly, the current system is inefficient in parts. Modifications to the treatment pathway should be considered to improve patient care quality and reduce pressure on ENT departments.

To determine the prevalence of laryngeal sensory neuropathy in patients with type 2 diabetes mellitus.

A cross-sectional study was performed, comprising 50 patients diagnosed with type 2 diabetes mellitus and 36 healthy controls. In the diabetic group, glycaemic control level, disease duration and presence of neuropathy were assessed. Participants were diagnosed with laryngeal sensory neuropathy if they had a cough, globus pharyngeus or throat clearing lasting for more than six weeks, in the absence of laryngopharyngeal reflux disease, allergies, asthma, angiotensin-converting enzyme inhibitor intake or psychogenic disorders.

In the diabetic group, the mean age ± standard deviation was 44.66 ± 10.07 years. Sixty per cent of patients were male, 42 per cent had had diabetes for more than five years and 52 per cent had average to poor glycaemic control. The prevalence of laryngeal sensory neuropathy was 42 per cent in the diabetic group, compared with 13.9 per cent in controls; this difference was statistically significant (p = 0.005). There was no association between the prevalence of laryngeal sensory neuropathy and glycaemic control level, disease duration or presence of neuropathy.

Laryngeal sensory neuropathy is more common in patients with type 2 diabetes mellitus than in controls.

Granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis) is a primary systemic vasculitis that affects medium to small sized vessels throughout the body. It often presents with symptoms and signs involving the ear, nose, and head and neck area.

To highlight salient features of ENT-related issues in granulomatosis with polyangiitis, and raise awareness of the condition.

A case report of a patient with limited disease and an insidious onset is presented, along with a review of the current literature. In addition, basic initial management is described.

Eighty-six publications were used to describe salient features of ENT-related issues in granulomatosis with polyangiitis.

The time to diagnosis has not reduced significantly in the last 10 years in the UK. A high index of suspicion is required for an earlier diagnosis of granulomatosis with polyangiitis.

Thyroglossal duct cysts and obstructive sleep apnoea are commonly occurring medical conditions which appear to present independently in patients. However, we noted three cases where the thyroglossal duct cysts influenced the development and/or therapy of obstructive sleep apnoea. In this article, these three case studies are presented, as is a study of the association between thyroglossal duct cysts and obstructive sleep apnoea, preceded by a literature review.

The patient in the first case study underwent hyoidthyroidpexia for obstructive sleep apnoea, which revealed an unexpected thyroglossal duct cyst. The second patient had previously undergone Sistrunk surgery for the removal of a thyroglossal duct cyst and subsequently presented with obstructive sleep apnoea. Finally, the third patient, who had previously undergone Sistrunk surgery, presented with obstructive sleep apnoea and underwent alternative surgery as hyoidthyroidpexia was no longer possible.

To our knowledge, the association between thyroglossal duct cysts and obstructive sleep apnoea has not been addressed previously. The results indicate that the relationship is much stronger than previously thought, and further research is required to investigate the extent of the association and possible causal relations.