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        The future of British otorhinolaryngology is in safe hands
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        The future of British otorhinolaryngology is in safe hands
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One of the most exciting developments in British otorhinolaryngology is the setting up of trainee networks to enhance research and audit. Mehta and colleagues have asked themselves whether they can design and deliver a national audit of how epistaxis is managed, given the perceived wide variations and lack of data. 1 They confirm that they can and that there is variation in the management of epistaxis. Regional trainee collectives have been mobilised towards national projects, and high-quality data have been recorded through web-based interfaces. This work, along with a previous collaboration on peritonsillar abscess management, 2 across the UK, confirms the viability of the endeavour. The future of British otorhinolaryngology is in safe hands.

Mindfulness is all the rage in today's world. An excellent randomised controlled study of mindfulness meditation versus relaxation therapy in the management of tinnitus, by Arif and colleagues from the Welsh Hearing Institute and University Hospital of Wales, shows an improvement in outcomes for both these modalities, and reveals that mindfulness mediation performed better as compared to relaxation therapy. 3 This is likely to lead to a change in therapy for patients who are appropriate for this modality and it adds to the armamentarium of therapies for tinnitus. 4

The long-held notion that the fascia graft used for tympanoplasty ought to be dry and parchment-like is brought into question by Jiang and Lou. 5 These authors report that using dry or wet temporalis fascia graft does not affect the outcome of a type I underlay graft, and suggest that a wet graft may shorten the duration of surgery for tympanoplasty. This adds to the earlier report from Shanker et al., which reported that the success rate for type I tympanoplasty is the same in wet and dry mucosal otitis media. 6

The question of race as a factor in thyroid cancer has been considered by Keane and colleagues, in a retrospective analysis of 8 studies involving over 600 000 adult patients. 7 They show that variations exist in racial groups, which are also dependent on gender. Black and white people have a higher proportion of follicular cancer. This is in contrast to papillary thyroid cancer; Megwalu and Saini previously reported that black patients had significantly worse overall survival after adjusting for sex, marital status, age, year of diagnosis, multifocal disease and type of surgery. 8

References

1 Mehta, N, Williams, RJ, Smith, ME, Hall, A, Hardman, JC, Cheung, L et al. Can trainees design and deliver a national audit of epistaxis management? A pilot of a secure web-based audit tool and research trainee collaboratives. J Laryngol Otol 2017;131:518–22
2 ENT Trainee Research Collaborative – West Midlands. National prospective cohort study of peritonsillar abscess management and outcomes: the Multicentre Audit of Quinsies (MAQ) study. J Laryngol Otol 2016;130:768–76
3 Arif, M, Sadler, M, Rajenderkumar, D, James, J, Tahir, T. A randomised controlled study of mindfulness meditation versus relaxation therapy in the management of tinnitus. J Laryngol Otol 2017;131:501–7
4 Gewal, R, Spielmann, PM, Jones, SE, Hussain, SS. Clinical efficacy of tinnitus retraining therapy and cognitive behavioural therapy in the treatment of subjective tinnitus: a systematic review. J Laryngol Otol 2014;128:1028–33
5 Jiang, Z, Lou, Z. Impact of the nature of the temporalis fascia graft on the outcome of type I underlay tympanoplasty. J Laryngol Otol 2017;131:472–5
6 Shankar, R, Virk, RS, Gupta, K, Gupta, AK, Bal, A, Bansal, S. Evaluation and comparison of type I tympanoplasty efficacy and histopathological changes to the tympanic membrane in dry and wet ear: a prospective study. J Laryngol Otol 2015;129:945–9
7 Keane, E, Francis, EC, Catháin, ÉÓ, Rowley, H. The role of race in thyroid cancer: systematic review. J Laryngol Otol 2017;131:480–6
8 Megwalu, UC, Saini, AT. Racial disparities in papillary thyroid microcarcinoma survival. J Laryngol Otol 2017;131:83–7