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The mark of the head and neck surgeon

Like Zorro, the head and neck surgeon leaves their mark. No more so than during parotid surgery. Various modifications have been put forward modifying the classic Blair incision. This latest modification camouflages the pre-tragal scar by running it on to...

Impact of the updated cancer staging system on HPV-positive disease

The AJCC cancer staging manual was updated in 2017 (8th edition). It is used in the MDT setting for planning treatment and assessing prognosis for individual patients, and is also widely used internationally in clinical trials. Unlike previous iterations of...

Quinsy and culture

Peritonsillar abscesses are frequently encountered in clinical practice. Standard treatment includes empirical medical treatment and drainage. This study aimed at evaluating the value of culture and sensitivity testing of the aspirate in guiding antibiotic treatment. Patients received empirically amoxycillin, amoxycillin...

Incidental thyroid nodules: should we observe or operate?

Thyroid nodules are extraordinarily prevalent, detected by physical examination in 7% and by imaging studies in 67% of the population. Although most of these nodules are benign, up to 20% are found to be malignant on excision. It’s a very...

Alcohol and the vestibulo-ocular reflex (VOR)

I was drawn to this paper initially for slightly unscientific reasons but in fact it proved a worthwhile read. It describes the effect of alcohol consumption on the VOR of eight healthy subjects as measured using video head impulse testing...

Transcutaneous vs. percutaneous bone conduction devices

Bone conduction devices (BCD) have proven to be effective options for hearing amplification in patients who are not candidates for conventional hearing aids. This study prospectively surveyed 70 patients with BCD using the COSI (Client Oriented Scale of Improvement) and...

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...

Preventing major postoperative haemorrhage following TORS

Transoral robotic surgery (TORS) has become an increasingly utilised treatment modality in the management of oropharyngeal squamous cell carcinoma (OPSCC). Postoperative haemorrhage, although uncommon, is a significant complication. To ameliorate this risk, transcervical ligation of branches of the external carotid...

The challenge of disrupting the hearing care market in the USA

Barry Freeman, an Audiology Consultant of extensive global experience, examines the business model of hearing care service delivery in America. He discusses the challenges the profession has faced, and proposes some food for thought on learning from other health care...

The effects of polypharmacy in the elderly

Another pill to cure the ill? Alec Lapira discusses the warning signs of polypharmacy in the elderly population. Polypharmacy in the elderly Polypharmacy – defined as the use of five or more medications – occurs in 20–37% of older people...

The evolution and advancements in radiological imaging of the sinuses

Computed tomography (CT) imaging is crucial in the planning of any endoscopic sinus operation; we hear from one of the pioneers of CT scanning who worked with Stammberger and Messerklinger in developing many of the technologies that we now take...

What’s the appetite for clinical risk?

The first Professor and Chair of Medical Professionalism at RCSI and BSHS, Dubhfeasa Slattery provides an overview of how a desire for better healthcare at all levels can be harnessed and nourished, leading to a potential life-long interest in reducing...