Tell me like it is: advice for relatives of people with aphasia

More than a quarter of people who have a stroke present with aphasia immediately post-stroke (approx. 30%) and of these, around 60% experience chronic communication difficulties. Provision of information is seen as one of the top 10 best practice recommendations...

Do you really like me? Is it, Is it therapy?

Therapeutic alliance describes what happens in the interactions and relationships between the client and the therapist. There is evidence from mental health literature that a therapeutic alliance can have a significant impact on outcomes. A negative alliance can lead to...

Risks of tracheostomy in head and neck cancer

Tracheostomy is associated with several complications, with rates quoted as high as 8-45%, including: bleeding; displacement; obstruction; surgical emphysema; pneumothorax; fistulae and failure to decannulate. There are now many studies that confirm the increased length of stay and complications of...

Rib grafts for mandibular reconstruction

Reconstruction of the mandible following ablation requires good bone stock to allow optimal function and the placement of dental implants. In the developed world, vascularised bony flaps are accepted as the gold standard but these may not be widely available...

Accuracy of CT scans for cholesteatoma and its complications

Chronic ear disease with cholesteatoma generally requires active surgical management and the requirement for this needs precise assessment. A retrospective study was conducted to evaluate the accuracy of CT scan findings in terms of predicting cholesteatoma and its associated complications...

Platelet-rich plasma to reduce post-tonsillectomy haemorrhage and pain

Minimising haemorrhage and promoting healing of raw areas are cornerstones for uneventful and speedy recovery after tonsillectomy. In this single-blinded prospective experimental study, application of platelet-rich plasma to one side tonsillar bed has been compared to the other side in...

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...

Reliability of modified Dix-Hallpike test

Modifications of the Dix-Hallpike (DH) are sometimes necessary when the traditional DH is not feasible. The absence of any formal studies on modified DH was the idea behind this multicentre (three academic centres), prospective, randomised, single blinded and controlled clinical...

Does the season affect the diagnosis of vestibular disorders?

There are mixed results in the literature regarding seasonal variation in the presentation of various peripheral vestibular disorders. In this large population study involving over 20,000 patients recruited from 116 ENT practices across Germany, the authors analysed the demographic characteristics...

A voice as smooth as silk?

A number of materials currently exist for vocal fold injection medialisation. Popular options include calcium hydroxylapatite (CaHA), hyaluronic acid (HA) and polydimethylsiloxane (PDMS). The authors of this paper state that there is an unmet need for an injectable material that...

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...

Endoscopic transsphenoidal surgery versus dopamine agonist therapy for microprolactinomas

This study addresses the importance of the location of microprolactinomas in determining prognosis after surgery. Long-term dopamine agonist treatment is the current standard of treatment for microprolactinomas. However, patients often seek surgical removal. The authors of this study retrospectively analysed...