How effective are our two-week-wait guidelines in picking up head and neck cancer?

With a 30% increase in the incidence of head and neck cancer since 1999 in the UK, it is important that the two-week wait referral guidelines safely encompass all risk factors but also render these urgent referrals based on signs...

Salvage surgery vs. repeat stereotactic radiosurgery for progressing vestibular schwannomas

This large multicentre case series of patients treated twice with stereotactic radiosurgery (SRS) for progressing vestibular schwannomas (VS) is reported by the International Gamma Knife Radiosurgery consortium. Progression of tumour growth after primary SRS is rare but does occur. Complications...

Imaging of the parathyroid glands in primary hyperparathyroidism: where do we stand?

Primary hyperparathyroidism (PHPT) refers to an intrinsic parathyroid gland abnormality that produces excessive secretion of parathyroid hormone. PHPT is diagnosed biochemically, and surgical excision of the abnormal parathyroid tissue represents the only definitive cure. Historically, the standard operative management of...

Helicobacter pylori infection delays mucociliary clearance in the nose

Chronic rhinosinusitis is not uncommonly a difficult condition to treat and therefore any possible association of this condition with factors outside the nose and sinuses is the subject of worthwhile research. Impairment of mucociliary clearance is paramount to upper respiratory...

Hypoglossal nerve stimulation for OSA

Hypoglossal nerve stimulation has been lauded as the great new surgical treatment panacea for obstructive sleep apnoea (OSA). This meta-analysis includes 12 studies with a total of 350 patients, including the five-year follow-up data from the STAR trial which was...

Your voice and your personality

Variations of vocal effort are a normal adaptation to difficult communication situations. However, persistence of these abnormal strategies can lead to various functional dysphonias. In this experiment, the authors tested 41 females aged 18-52. The subjects were asked to instruct...

Electrodes and the stapedial reflex

This study had two main objectives: testing the efficiency of the sequential stimulation of four different electrodes versus a single electrode on the threshold of the stapedial reflex; and correlating the values with the minimum comfort level (MCL). The study...

Swallow this: management of dysphagia in progressive neurological conditions

Whether the person with the swallowing difficulty has an acquired or progressive neurological condition, understanding the aetiology will allow the speech and language therapist assessing the swallow to have a better understanding of the likely implications for future swallow management...

Is dissection of level IV necessary in patients with negative neck oral cancer?

Supraomohyoid neck dissection (SOHND) refers to the removal of lymph nodes contained in levels I-III and is currently referred to as a selective neck dissection levels I-III. This type of neck dissection has been frequently used in the management of...

Reliability of Koos classification

Vestibular schwannoma (VS) tumour size has been considered the primary determinant of hearing outcomes and facial nerve function according to several published studies. Varying methods are used to estimate the size and volume of the VS with very little consensus...

Follow-up of NF2 patients with ABRs, SDS and MRI

Hearing loss is one of the earliest manifestations in vestibular schwannomas with 60% of the patients having high frequency loss. Several metabolic and mechanical factors influencing the cochlea and cochlear nerve have been implicated in the hearing decline noted in...

Is wine blocking your nose?

Salicylates are commonly found in a wide variety of foods, such as unripe fruit, vegetables, nuts, seeds and spices. They play a role in growth and development of plants, photosynthesis, transpiration, ion uptake and transport. Non-steroidal exacerbated respiratory disease (N-ERD)...