It's that time of year again. The weather is turning colder and multi-coloured leaves cover the ground. The selection of articles for this October issue of The Journal of Laryngology & Otology is sure to further invigorate your senses.
‘Itchy ears’ are one of the most frequently encountered symptoms in the ENT clinic. In this month's issue, old remedies are revived with a study by Babakurban et al.Reference Babakurban, Topal, Aydin, Hizal, Copur and Ekici 1 Castellani's paint, formulated in 1905 by Aldo Castellani (Italian physician, 1877–1971), has long been used in dermatological practice. One of its active ingredients, basic fuchsin, which has local anaesthetic, bactericidal and fungicidal properties, is also responsible for imparting a bright magenta red colour to the compound. In this study, the authors found that Castellani's paint is an effective treatment for itchy ears, and does not affect the normal microbial flora of the external auditory canal, unlike topical steroids.Reference Cevik, Kaya, Akbay, Yula, Yengil and Gulmez 2
ENT training is currently a topical issue. An online general practitioner trainee survey conducted by Easto and Reddy, with a response rate of 60.5 per cent, found that nearly 60 per cent of general practitioner trainees spent no time in ENT posts in post-graduate training, and 65 per cent of general practitioner trainees received no formal ENT teaching after medical school.Reference Easto and Reddy 3 However, 93.4 per cent of trainees were keen to attend a 1-day ENT course if provided locally. Locally available courses for general practitioner trainees made up of local experts is therefore encouraged, especially given that within primary care 15–20 per cent of adult presentations and up to 50 per cent of paediatric presentations are ENT-related.
Part of such training may include the use of simulation. Previous studies have shown that simulation provides an opportunity for doctors to learn and practice important ENT skills in a safe environment.Reference Chin, Chin, Roth, Rotenberg and Fung 4 , Reference Johnston, Selimi, Chang and Smith 5 In a related series of articles in this month's issue, Isaacson et al. demonstrate the effectiveness of an ex vivo ovine model for suspension microlaryngoscopy training, Clark et al. report the development and validation of a low-cost microsurgery ear trainer, and Avnstorp et al. show that the introduction of emergency cricothyroidotomy simulation training in Zimbabwe saves lives.Reference Isaacson, Ianacone and Soliman 6 – Reference Avnstorp, Jensen, Dzongodza, Matinhira, Chidziva and Melchiors 8 This current series of articles is noteworthy in terms of simulator development and highlights the importance of simulation training in low-income settings.
Hyperbaric oxygen for the treatment of idiopathic sudden sensorineural hearing loss is revisited in a study by Alimoglu and Inci.Reference Alimoglu and Inci 9 The authors conclude that hyperbaric oxygen therapy may be effective as a salvage treatment following failed corticosteroid therapy. However, the limited availability, cost and lack of high-level evidence probably make it impractical at present.Reference Cekin, Cincik, Ulubil and Gungor 10
Historically, there has been a dichotomy among ENT surgeons between soft versus unrestricted diets following tonsillectomy. A systematic review in this month's issue of the best available evidence concludes no statistical difference in morbidity between the two diets; the authors recommend an unrestricted diet to encourage adequate nutrition and hydration.Reference Millington, Gaunt and Phillips 11
Looking to the future, a study by Nishio et al. demonstrates the efficacy and safety of adipose-derived stem cells in a vocal fold paralysis model in pigs.Reference Nishio, Fujimoto, Suga, Iwata, Toriyama and Takanari 12 Although the sample size is small, it demonstrates a proof-of-principle of the utilisation of such cells in regenerative medicine approaches in the future.Reference Wormald, Fishman, Juniat, Tolley and Birchall 13
