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Vocal cord dysfunction and dysfunctional breathing: an evolving clinical paradigm

Patients frequently present to the ENT department with breathing difficulties. The entity of ‘vocal cord dysfunction’ (also known as paradoxical vocal cord movement, inducible laryngeal obstruction, and many other names) is increasingly well recognised. Ravi Thevasagayam gives us an overview....

Endoscopic DCR

In this interesting article, our experienced colleagues describe their favoured technique for performing endoscopic DCR and share with us the key steps for a successful outcome. Dacrocystorhinostomy (DCR) was historically performed by ophthalmologists for nasolacrimal obstruction using external techniques. The...

Airway stenting in paediatric ENT

Although experience in the use of airway stents in adults is considerable, their use in children is more recent and more limited. Cláudia Schweiger and Michael J Rutter provide an overview of stents and their use in paediatric airway. Stenting...

Cough no more?

The challenge of the ‘unexplained chronic cough’ that just will not go away is a challenge that frustrates many of us. Often patients have seen respiratory, upper GI and eventually they see you as the last resort! Is behavioural therapy...

A move away from bony free flaps in reconstruction

Techniques for facial reconstruction have come on in leaps and bounds since the world wars. The use of titanium implants is more recent and the technology for manipulating the metal and how we use it is rapidly developing. Here the...

A modification of the crescentic flap for nasal skin reconstruction

Non-melanoma skin cancers are the most frequent skin tumours and in over 25% of cases affect the nose. Following excision, the reconstruction may be challenging. Reconstruction aims to preserve the anatomical units, nasal functions and also an aesthetic final outcome....

Preserving hearing in NF2 patients

Neurofibromatosis type 2 (NF2) is known to result in bilateral hearing loss, even when there is no significant tumour growth. The cause is postulated to be multifactorial: stretching and compression of the cochlear nerve by the tumour, impairment of labyrinthine...

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...

A soprano’s demise: a cautionary tale for the thyroid surgeon

Prior to the mid-19th century, thyroid surgery was considered excessively dangerous. The emergence of anaesthetic, antisepsis and improved instrumentation, however, increased its feasibility and frequency in Europe. The unhurried, judiciously antiseptic and haemostatic approach, advocated by Kocher, was popularised and...

Audiological and psychological consequences of single-sided deafness

The loss of sound input from one ear has a significant impact on our perception of our acoustic environment. This impact is compounded in adverse listening conditions. Rachel Knappett’s article explores the audiological impact of this hearing loss and the...

Leadership in healthcare

There is often a great deal of confusion over the words ‘management’ and ‘leadership’. Sometimes they are used interchangeably. Sometimes they are used to represent opposite ends of a spectrum. Sometimes both are used as collective nouns, or to describe an activity.

How can we actually be culturally responsive?

Now, more than ever, we need to take action to meet the needs of the students and patients we work with. Black Lives Matter only emphasised how little progress has been made in this area to date. The authors of...