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Gadolinium enhanced MRI and the diagnosis of Ménière’s disease

Despite various criteria applied over the years to diagnose Ménière’s disease since the concept of endolymphatic hydrops was first observed in postmortem examinations of patients in 1938, the diagnosis still remains mainly clinical. To visualise endolymphatic hydrops in MRI imaging,...

Parapharyngeal space tumours – is the transoral approach effective?

Several approaches are described to the parapharyngeal space to permit resection of tumours in this region, with the most commonly employed approach being the transcervical route. The transoral approach remains somewhat controversial as it is felt that this approach can...

Choosing instrumental assessments of swallowing for children

Swallowing disorders in children are increasingly common due to advances in medical care allowing them to survive prematurity or complex health conditions. Careful assessment of eating and drinking is necessary to ensure that children are managed both safely and with...

Intra orbital treatment to save the eye!

Invasive fungal sinusitis can be a devastating condition, and accepted management is surgical debridement of infected tissue, systemic antifungal treatment and reversal of immunosuppression. Orbital involvement is common, affecting up to 75% of cases, and in advanced disease orbital exenteration...

Not the answer yet, but it may be in the future

AI is certainly a topical issue these days and radiomics refers to techniques which allow the extraction of quantitative features from medical imaging to produce large data sets for clinical problem solving. This paper looks at CT imaging of the...

When things go wrong

The new-age, Paediatric Surgeon, Ray Clarke, (fear uasal, íseal), eloquently demands throwing off the shackles of the past and welcomes the dawning of an era of openness, transparency and candour, preferably suffused with compassion for both the patient and the...

World Congress on Thyroid Cancer 2023

The World Congress on Thyroid Cancer (WCTC) meets in London next month for the first time since 2019. More than 800 thyroid professionals will participate in a robust programme that includes the latest surgical technologies, RAI dedifferentiation advances and TKI-targeted...

Cognition and hearing – you can’t test one with the other!

Cognitive Psychologist, Boaz M Ben-David, provides insights into the import of considering cognitive factors when assessing speech perception ability to maximise intervention success. Failing to do so, he suggests, is “ageist”, a predisposition healthcare professionals must avoid. Cognitive performance is...

Clinical leadership and management: the ‘Darzi’ experience

The Fellowship in Clinical Leadership programme, more commonly known as the ‘Darzi Fellowship,’ commenced in 2009. It was designed to provide junior doctors at the registrar level with postgraduate training in clinical leadership and change management in order to develop...

Tonsillectomy in adolescents

Tonsillectomy is one of the most common operations performed across the developed world. Salil Sood and Ray Clarke discuss the special considerations that apply when performing this procedure on adolescent patients. Tonsillitis in teenagers can be exceptionally painful and disruptive....

Can we prevent chronic rhinosinusitis?

The old adage ‘prevention is better than cure’ is considered by Professor Hopkins in respect to chronic rhinosinusitis, a condition affecting around 10% of the adult population and associated with huge impact on quality of life and economic cost. A...

Acoustic shock: definitions and clinical aspects

Acoustic shock, a previously little-known and poorly understood clinical entity, came to the public’s attention in 2019 due to a high-profile legal case of a musician at the Royal Opera House. In this fascinating article, Andrew Parker and William Parker...