Doing it for the people: how to do speech and language therapy

This review article distils 58 studies, collating information from people with aphasia, their families and clinical speech and language therapists summarising the seven habits of highly effective aphasia therapists. Habit 1: Effective therapists invest time in and prioritise relationships with...

Association of quality of life with type of surgical treatment in patients with differentiated thyroid cancer

Standard treatment for differentiated thyroid cancer (DTC) is surgery, which includes either a total thyroidectomy or hemithyroidectomy. Surgery may then be followed by radioactive iodine treatment and, for some, treatment with thyroid hormone to suppress thyrotropin levels. All patients undergoing...

Diagnosing complications of acute mastoiditis in emergency situations

In many cases, acute mastoiditis is manageable with intravenous antibiotics and hospitalised care. However, the decision whether to intervene surgically remains crucial and reliance is based on radiological findings – CT scans for bony changes and MRI for possible intra-cerebral...

Is posterior epistaxis really ‘posterior’?

In absence of any clear bleeding points seen on the septum, it is generally presumed that the epistaxis is posterior, especially when simple cauterisation of the septum does not help and may progress to sphenopalatine ligation. In this publication, the...

Salivary pepsin – a simple test for LPR?

A diagnosis of laryngopharyngeal reflux (LPR) can be made on the basis of characteristic symptoms and nasendoscopy findings. Objective tests exist for this condition; for example, 24-hour dual-channel pH-metry which is considered to be the gold standard. Such tests are,...

Do parents sleep better after paediatric adenotonsillectomy?

Paediatric adenotonsillectomy for sleep disordered breathing (SDB) is amongst the commonest surgical procedures performed in ENT. In the outpatient clinic, parents routinely express their concern about their child’s breathing but the impact of sleep disordered breathing on the parent is...

3D endoscopy in pituitary adenoma surgery

Endoscopic approach for pituitary adenoma surgery is well recognised. There has been recent refinement of 3D endoscopy technology which improves on the depth of vision offered and more compact delivery. This may improve visualisation of the critical structures involved in...

Does balloon tuboplasty work in the long term, and how can we measure outcomes?

There is much interest and debate at ENT conferences and within current literature about the role of balloon dilatation techniques for Eustachian tube dysfunction (ETD), a condition which we still only have limited understanding of, and which can be challenging...

How can we improve outcomes for patients with acute vestibular neuritis?

Vestibular neuritis is a common disorder that can leave up to 50% of patients with persistent vertigo symptoms for months to years following the acute insult. Often their first contact with ENT or balance specialists is many months after the...

More than words: looking at all the evidence

Evidence based practice (EBP) is a three-pillared approach whereby information on the research evidence, factors relating to the patient and clinical experience are all considered to inform a care decision. Unfortunately, there is frequently very little research evidence to inform...

Bespoke is best for children with communication difficulties

Children with communication difficulties can benefit from augmentative alternative communication (AAC) aids to support them in daily interaction, as well as in developing milestones. One of the most difficult aspects of choosing a device is not only meeting the child’s...

Modified barium swallow studies: what is the radiation risk?

A modified barium swallow study (MBSS), also called a videofluoroscopy swallowing study uses ionising radiation to assist the clinician in visualising swallowing biomechanics from the oral cavity to the oesophagus. This procedure is currently one of the best methods used...