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Voice change after total thyroidectomy with intact laryngeal nerves – a common but temporary problem
It has been reported that up to 87% of patients have a degree of voice dysfunction after thyroidectomy, even when the laryngeal nerves are preserved. Postoperative inflammation, laryngeal oedema due to vascular congestion, direct damage to the cricothyroid muscles and...
A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth
It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...
Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture
Placement of voice prosthesis at the time of trachea-oesophageal puncture is well described using 20-French prostheses. There is debate about the optimal size of the prosthesis with work in the 1980s and 1990s supporting larger prostheses. The rationale was that...
Can and should vestibular schwannoma surgery be carried out via the endoscopic transcanal approach?
The extent and scope of endoscopic ear surgery has rapidly progressed in recent years, and this paper, from one of the leading proponents of this technique, reports on the outcomes of a case series of patients who have had total...
Robotic insertion of electrode array in cochlear implantation
Cochlear implants (CIs) are commonly used for profound bilateral hearing loss. They have specific national guidance for their insertion, however patients with a substantial residual acoustic hearing are potential CI candidates. Preservation of this residual hearing can be sought with...Introduction to speech testing
Let’s get back to basics: Dr Schoepflin introduces the concepts behind speech testing for hearing care professionals. While pure tone threshold testing is considered the ‘gold standard’ for assessing auditory sensitivity, the results of pure tone testing provide only limited...
Role of ultrasonography-guided fine-needle aspiration in management of the neck after chemoradiotherapy
Primary chemoradiotherapy (CRT) is a well-established treatment for locally advanced head and neck squamous cell carcinoma (HNSCC). However, not every patient has a complete response to this treatment modality, necessitating eventual salvage neck dissection. Some patients with persistent adenopathy following...
Balloon dilatation is an effective adjunct
This is a good study design, sufficiently powered, comparing medical management to balloon sinus dilatation. All patients had failed medical management and were thoroughly assessed preoperatively with Lund-Mackay score confirming abnormal CT findings, SNOT 20 index score, chronic sinusitis score...Life Down Under: an overview of the Sydney Endoscopic Ear Fellowship
As we emerge from the impact of the COVID-19 pandemic on the first half of 2020, trainee colleagues will be looking to their future once again. Options may include fellowships, and we are delighted to have Dr Andrew Ma share...ENT in this issue...Wellbeing
Declan Costello, MA, MBBS, FRCS(ORL-HNS), Editor, ENT & Audiology News; Consultant Ear, Nose and Throat Surgeon, Wexham Park Hospital, Slough, Berkshire, UK. E: d.costello@nhs.net The last two years have taken an enormous toll on people’s sense of wellbeing and happiness....ENT Wallabies
Juggling the demands of elite sport, a boisterous social life on tour and medical academia would seem too much for mere mortals. All in a day’s work for your average Wallaby. Currently I am a Senior Visiting Medical officer at...
