This month's issue of The Journal of Laryngology & Otology provides much room for thought. The economic impact of recurrent respiratory papilloma, a benign disease with a natural history that is relapsing and remitting over several years, has not previously been estimated in the UK. Harrison et al. have now done so and the costs are significant.Reference Harrison, Montgomery and Macgregor1 The case for prevention and combined concurrent adjunctive treatment remains strong and holds promise.Reference Kim and Baizhumanova2
The hypothesis that the age of onset of Ménière's disease is increasing as the elderly take to work with its attendant stressReference Shojaku, Watanabe, Fujisaka, Tsubota, Kobayashi and Yasumura3 has not been corroborated by Van Esch and colleagues' epidemiological study from the Netherlands.Reference van Esch, van Benthem, van der Zaag-Loonen and Bruintjes4 Ménière's disease has a peak incidence between 40 and 69 years in the Netherlands, as in most other countries.Reference Lüscher, Theilgaard and Edholm5
The age for closure of a child's perforated eardrum has been a controversial matter.Reference Carr, Strachan and Raine6 Singh et al. show that the comparative outcomes of tympanoplasty in younger children are no different from those in older children.Reference Singh, Arora, Garg, Kumar and Kumar7 In cases of small vestibular schwannomas with serviceable hearing, Peng and Wilkinson's systematic review on the outcomes of microsurgery in relation to observation and stereotactic radiation shows that, for patients under the age of 65 years, microsurgery via the middle fossa offers durable preservation of hearing.Reference Peng and Wilkinson8 One of the vicissitudes that occasionally occurs in thyroid surgery is incidental parathyroidectomy. Hone et al. report that concurrent neck dissection is an independent predictor of incidental parathyroidectomy and increases the risk by a factor of four.Reference Hone, Tikka, Kaleva, Hoey, Alexander and Balfour9
