There is increasing evidence that PDE-5 inhibitors may induce sensorineural hearing loss via plausible physiological mechanisms. There needs to be more awareness of this disabling side effect among healthcare professionals responsible for prescribing this drug.

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Irregular symptoms in benign diverticula should raise suspicion of malignancy. Management consists of surgical excision ± PORT. © 2014 Wiley Periodicals, Inc. Head Neck 36: 1368-1375, 2014.

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patients, mostly by surgical interventions (n¼6). 35 patients had previously had a failed diagnostic bronchoscopy. Of these patients, the addition of ENB allowed a diagnosis in 14 cases. 8 underwent an ENB directly upon assessment of the clinical data. The anatomical positioning of the lesion was without consequence for the diagnostic yield. The diagnostic yield increased significantly with the size of the lesion (<2 cm: 15%, 2e3 cm: 37%, >3 cm: 50%, p<0.001). Conclusions ENB is a useful diagnostic method in the hands of a skilled interventional respiratory physician, particularly where conventional bronchoscopy has failed. Although the anatomical location does not affect the accuracy of the results, lesions over 2 cm in size are more likely to be amenable to this procedure. The overall diagnostic yield lies lower than those quoted in previous studies, so that selective use of this procedure should be considered.

A 47-year-old man presented to hospital with a 1 day history of acute left-sided abdominal pain. He was initially treated for renal colic but the pain continued to worsen. Surgical review elicited left iliac fossa tenderness with guarding. Observations were within normal limits but serology revealed a raised C reactive protein.