Journal Reviews
Cuff up or cuff down; to occlude or not to occlude? What effect does tracheostomy tube modification have on swallowing outcomes?
Dysphagia is commonly seen in patients with tracheostomy. The current global pandemic has increased interest in the impact of a tracheostomy on swallowing outcomes. This systematic review is therefore a timely addition to the literature and a useful read for...
Predicting swallowing outcomes post radiotherapy for head and neck cancer
A videofluroscopic swallow study (VFSS), also known as modified barium swallow (MBS) offers a dynamic view of swallow biomechanics and associated swallowing physiology. The authors of this paper investigated whether quantitative timing and displacement measures of key structures involved in...
Is flexible nasendoscopy really aerosol generating?
Amid the COVID-19 pandemic, the safety of office-based laryngoscopy has been a source of considerable concern, speculation and debate. Flexible nasendoscopy is a key diagnostic tool in the assessment of the ENT patient, however most healthcare providers consider this to...
RCT: tongue retaining devices vs CPAP for OSA
This study compared the effect of a tongue retaining device versus the use of CPAP in 27 patients within a crossover RCT design. Tongue retaining devices (also known as tongue stabilising devices), are similar in appearance to a plastic tongue-sized...
Functional considerations in reconstruction after laryngectomy
With a plethora of different reconstructive options and techniques available after laryngectomy, it can be difficult to clearly see which give the lowest complication rates and best functional outcomes. This article aims to summarise the current evidence in swallowing and...
Multiple surgeries for RRP – does a greater number of operations result in a worse voice outcome?
Recurrent respiratory papillomatosis (RRP) of the larynx remains a challenging condition to treat, with a number of affected patients requiring multiple operations to remove recurrent disease over the course of their lifetime. At the most severe end of the spectrum,...
Dysphagia following intubation during the COVID-19 pandemic
Dysphagia is a known sequela of mechanical ventilation and intubation. About a third of patients discharged from hospital after acute respiratory distress syndrome present with dysphagia. The authors of this review have considered the implications for patients intubated due to...
Laryngopharyngeal reflux - would mucolytics help?
With laryngopharyngeal reflux (LPR) being such a common presenting complaint to ENT clinics, who would not want to have more, effective treatment options for patients suffering with this annoying condition? In their small randomised, controlled trial, Chae et al put...
Speech analysis via mobile phone – is there an app for that?
Experienced ENT surgeons will often be able to discern the likelihood of significant laryngeal pathology in a patient referred with dysphonia by the sound of their voice during the initial history-taking phase of a consultation. With the move earlier in...
Enhanced recovery following surgery for head and neck cancer – the current evidence
Enhanced recovery after surgery (ERAS) programmes are now well established in many surgical specialities as a means of reducing postoperative complications and length of stay in hospital. Whilst many head and neck teams have interventions used to aid postoperative recovery,...
Patient positioning for transnasal flexible laryngoscopy
The position of a patient’s head during flexible nasendoscopy to visualise the larynx does not usually require much consideration – adequate views are almost always obtained with a patient sitting in a neutral position. Occasionally however, there will be patients...
Laryngeal evaluation during COVID-19 using transcervical ultrasonography
In light of the COVID-19 pandemic, the authors highlight their protocol of transcutaneous laryngeal ultrasonography as an alternative to flexible fibreoptic laryngoscopy when appropriate. This is to reduce the risk of aerosolisation posed by laryngoscopy. Ultrasonography is a rapid, non-invasive...
