TYM smartphone otoscope for imaging and videoing the external ear canal and eardrum [MIB134]

New:  Medtech innovation briefing

The TYM smartphone otoscope (Cupris) uses an iOS smartphone to let users capture images and videos of the external ear canal and eardrum. These can then be reviewed and shared securely with other healthcare professionals through the Cupris app.

The TYM smartphone otoscope package consists of 5 specula (4.25 mm), a proprietary smartphone case and an otoscope attachment.

Should we consider devolution of “head and neck” surgery from the specialties of oral and maxillofacial surgery; ear, nose, and throat surgery; and plastic surgery?

Br J Oral Maxillofac Surg. 2017 Jun;55(5):566. doi: 10.1016/j.bjoms.2016.12.019. Epub 2017 Feb 14.
Editorial published in the British Journal of Oral and Maxillofacial Surgery

In the United Kingdom the practice of vascular surgery has now become recognised as the tenth independent surgical specialty by the Royal College of Surgeons of England and the General Medical Council (GMC). Traditionally, surgical trainees developed their subspecialty vascular interest within the parameters of obtaining a certificate of completion of training (CCT) in General Surgery. The process of devolution of areas of subspecialty may also apply to other surgical specialties.

 

UHCW Research: Elledge R, Walton G, Sandhu R, Prasad S, Howe D

Sinusitis (acute): antimicrobial prescribing [NG 79]

New Guidance from NICE:

This guideline sets out an antimicrobial prescribing strategy for acute sinusitis.  It aims to limit antibiotic use and reduce antimicrobial resistance. Acute sinusitis is usually caused by a virus, lasts for about 2 to 3 weeks, and most people get better without antibiotics. Withholding antibiotics rarely leads to complications.

This guideline includes recommendations on:

• managing symptoms, including advice when an antibiotic is not needed and the use of corticosteroids and nasal sprays
• choice of antibiotic when a back-up or immediate prescription is needed
• self-care

Action plan on hearing loss: what works guides

The Action plan on hearing loss, produced in 2015, identified ways that services for people with hearing loss could be improved.

This series of guides aims to support employers and service providers in delivering on the recommendations outlined in the plan.

Most common ear infections should not be treated with antibiotics, says NICE

The draft guidance advises GPs and healthcare professionals how they should treat acute otitis media, a middle ear infection that is common in children and young people.

Estimates suggest one in four children experience a middle ear infection before they are 10 years old, and that 60% show signs of improvement (for example being in less pain) within 24 hours, even if they are not given antibiotics.

In light of this, NICE says children and young people should be cared for with pain relief rather than antibiotics.

Surveillance Audiometry

This document replaces all previous versions. Its purpose is to describe a standard procedure, and to provide recommendations, for effective pure-tone surveillance audiometry primarily on those exposed to noise at work. It also includes the recommended format for audiogram forms. This document is not intended to provide guidance on specific circumstances or on interpretation of results

Balloon Eustachian tuboplasty treatment of longstanding Eustachian tube dysfunction

The Journal of Laryngology & Otology, DOI: https://doi.org/10.1017/S0022215117000974. Published online: 15 May 2017

To evaluate the subjective and objective outcomes of balloon dilation Eustachian tuboplasty in patients with recurrent, previously treated chronic Eustachian tube dysfunction.

UHCW Research: T Singh, V Taneja, K Kulendra, M Farr, J Robinson and D Rejali 

Review of emerging technologies for hearing loss

The NIHR Horizon Scanning Research and Intelligence Centre has completed a horizon scanning review of emerging health technologies for the management and reduction of the negative consequences of hearing loss.

Migalastat for treating Fabry disease

Highly specialised technologies guidance from NICE in using migalastat (Galafold) for treating Fabry disease in people over 16.

Re: Should we consider devolution of "head and neck" surgery from the specialties of oral and maxillofacial surgery; ear, nose and throat surgery; and plastic surgery?

Br J Oral Maxillofac Surg. 2017 Feb 14. pii: S0266-4356(17)30042-6. doi: 10.1016/j.bjoms.2016.12.019. [Epub ahead of print]

We were interested in Islam’s editorial regarding the devolution of head and neck surgery from the parent specialties that feed into it.1 We have had a devolved arrangement of practice at University Hospitals Coventry and Warwickshire Hospitals NHS Trust since 2003. To the best of our knowledge this is the only service in the country in which this is the case, and it is recognised as such within the clinical and management structure of the hospital. The service has a separate clinical lead, QIPS (Quality, Improvement, and Patient Safety), business, and departmental meetings

UHCW Research: Elledge R, Walton G, Sandhu R, Prasad S and Howe D.

Tranexamic acid in epistaxis - who bloody nose?

New from BestBETs

In [adults without a bleeding disorder who have uncomplicated epistaxis] is [tranexamic acid] effective at [stopping bleeding and/or preventing rebleeding]?

The evidence is not sufficient to advise the routine use of tranexamic acid for patients attending ED with epistaxis. The evidence available is conflicting and there is a lack of sufficiently robust, well-designed trials on the topic to allow a recommendation to change current practice to include tranexamic acid. However, it is important to note that there is no evidence of tranexamic acid for epistaxis causing an increase in adverse events and the most robust study available currently shows a potential benefit. As such it is an area where more research would be beneficial. From the evidence available, it would seem that using the injectable form of tranexamic acid as a topical treatment would be the most likely to be beneficial and should be the starting point for future research. It may also be reasonable from the evidence currently available to offer topical tranexamic acid to patients such as the one in the clinical scenario above where the standard treatment of nasal packing is unacceptable to the patient.

XprESS multi sinus dilation system for treating chronic sinusitis

NICE medical technologies guidance on the XprESS multi-sinus dilation system for treating chronic sinusitis after medical treatment has failed.

Ear examination

New recommended procedure for ear examination from the British Society of Audiology.

Basic Audiometry & Tympanometry – Minimum Training Guidelines

This document is one of a family of BSA Training Guidelines, which includes Industrial Audiometry, Otoscopy & Impression Taking, Aural Care, Ear Examination and Basic Audiometry & Tympanometry – all of which allow the awarding of BSA Certificates.

Flushing your nose with salt water may be moderately useful for symptoms of sinusitis

Nasal irrigation seems moderately effective for symptoms of sinusitis. People using nasal irrigation showed greater improvement in their sinus-related quality of life compared to people who didn’t use irrigation. They were also less likely to use over-the-counter medicines, and to have spent fewer days unwell with symptoms by six months.

From the NIHR Dissemination Centre

Improving Access To Cochlear Implantation: Change Lives And Save Society Money

This report from the Ear Foundation calls for a review of the NICE guidelines on cochlear implants as new research shows that the UK has the most restrictive guidelines in Western Europe. It also shows that people with serious hearing loss often cost the NHS and other care services more by being denied an implant because of the greater risks of suffering from dementia and mental health problems when hearing loss is not addressed.

Common Principles of Rehabilitation for Adults in Audiology Services

New practice guidance from the British Society of Radiology on common principles of rehabilitation for adults in audiology services.

Betahistine may be worth trying for people with undiagnosed vertigo

Taking the drug betahistine could reduce the feeling of vertigo, even when the cause hasn't been found. Vertigo is a feeling that the environment is moving around when it is not. It can be caused by problems in the ear or the brain. Regardless of the cause, this study found that if 100 people with vertigo are treated with betahistine, 60 will report improvement.

Side effects reported in this Cochrane review were uncommon and usually mild.

From the NIHR Dissemination Centre

New National Commissioning Framework for Hearing Loss Services launched

A new guide to help organisations responsible for planning and commissioning local hearing services for deaf people and those with diminishing hearing is launched by NHS England.

The Commissioning Services for People with Hearing Loss – a Framework for Clinical Commissioning Groups establishes what effective commissioning looks like for CCGs by:

• Ensuring CCGS are supported when choosing good value services for their local populations
• The needs of local people are met by high quality integrated care
• Addressing access and outcome inequalities
• Improving patient choice when it comes to selecting services
• Contracting and monitoring outcomes and referrals from all providers to ensure consistency

Making an important space for hearing loss

The Ear Foundation has launched a website which brings together a wide range of practical resources and information available on hearing loss in one place.

SoundSpace Online aims to gather accessible information for people of all ages with hearing loss, their families, professionals ,policy makers and funders of services in the sector - or anyone interested in learning more about hearing loss.