Objectives Admission of patients with necrotising otitis externa (NOE) has been rising steadily over the last five years and mortality and morbidity associated with the disease is high. Our objective is to assess the value of adjuvant hyperbaric oxygen therapy in patients with necrotising otitis externa. Design and setting A retrospective, observational, case-control study was conducted by examining patients’ records over a four-and-a-half-year period at two secondary care sites in the UK. The (Non-HBO) control group treated conventionally and the (HBO) group treated with additional adjuvant HBO in a multiple occupancy therapy chamber at the James Paget University Hospital. The primary outcome measure was death. Secondary outcomes measures were resolution of pain and recovery from otalgia, facial nerve palsy and other cranial nerve palsies. Results There were 10 patients in the HBO group and 20 in the non-HBO group; mean age was 82.3 years and 88.3 years respectively. The mortality rate was 30% in the HBO group compared to 55% in the non-HBO group. Patients tolerated HBO well, had greater resolution of pain (90% vs 64%) and resolution of facial nerve palsy (67% vs 31%) than the non-HBO group. Resolution of other cranial neuropathies was similar. Conclusion Our case series suggests that HBO is potentially a life-saving intervention. It also suggests that patients treated with HBO therapy for NOE appear to improve both in terms of pain and facial nerve palsies compared with conventional treatment and sets the precedent for a trial to formally compare the adjunctive intervention of HBO.

Introduction The UK Medical Licensing Assessment (UKMLA) curriculum represents a consensus on core content including ENT-related content for newly qualified doctors. However, there is no similar consensus as to how ENT content should be taught at medical school. Design A virtual consensus forum was held at the 2nd East of England ENT Conference in April 2021 to ascertain views of medical students and junior doctors on how ENT should be taught at medical school. A syllabus of ENT-related items based on the UKMLA and GMC practical procedures curricula was divided into ‘Presentations’, ‘Conditions’ and ‘Practical Procedures’. 64 participants (27 students, 11 foundation doctors, and 7 other junior doctors) voted via anonymous polling for up to three of nine teaching methods they believed were best suited to teach each syllabus item. Results For ‘Presentations’, work-based/clinical-based learning and small-group seminars were significantly more popular than other methods, a further two were of middling popularity, and the remaining five (including simulation and e-learning) were significantly less popular. ‘Conditions’ results were near-identical, with work-based/clinical-based learning and small-group seminars significantly more popular than the remaining teaching methods. For ‘Practical procedures’ the three practical teaching methods were significantly more popular than the six theoretical methods. Conclusion Students and junior doctors express clear preference for clinical-based teaching and small-group seminars when learning ENT content. E-learning is poorly favoured, despite being increasingly used by medical schools and teaching bodies. Co-design of clinical training between students and educators may ensure training better matches students’ needs and expectations.