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Ballenger’s Otorhinolaryngology: Head and Neck Surgery, 18th Edition

One hundred and eight years after its first edition, the two-volume eighteenth edition of Ballenger’s Otorhinolaryngology is published in1300 pages set out in six sections, 114 chapters ably edited by Ashley Wackym and James Snow. Volume one very comprehensively covers...

Less pain more gain: impact of prophylactic gabapentin on swallowing outcomes in head and neck cancer patients undergoing radiation treatment

Patients planned for chemoradiation to the head and neck are usually advised to expect some pain and soreness during their treatment and that pain relief will be offered as and when it is required. Uncontrolled pain and mucositis affect oral...

Expanding the role of FNA in thyroid nodule decision-making

Papillary thyroid cancer, the commonest histological type, has been extensively reported as having BRAF proto-oncogene mutations (most commonly the V600E mutation). There is great interest in BRAF as a molecular marker, particularly as a prognostic factor that may guide the...

Is medical therapy without surgical treatment sufficient in treating peritonsillar abscess?

Standard treatment of peritonsillar abscess (PTA) has typically involved both medical therapy and surgical drainage either in the form of needle aspiration, or incision and drainage. However, is medical without surgical treatment sufficient? The authors suggest that medical therapy without...

Increasing tongue strength to reduce dysphagia: what is the potential benefit of a device driven exercise?

Weakness in tongue muscle strength and laryngeal elevation is known to have an adverse impact on swallowing function. Various swallowing exercises are often recommended to improve function of these important structures with the goal of preventing aspiration and improving swallow...

Speculating on saliva during endoscopy

It has been noted that the presence of saliva in the pharynx and larynx during flexible endoscopic evaluation of swallowing (FEES) can be an indicator of increased risk of aspiration and consequent pneumonia, as well as weight loss and malnutrition....

Take a breath between mouthfuls

Pulse oximetry provides a measure of the percentage of oxygen in the blood. The usual range of readings on pulse oximetry is 97-99%. Older people may have lower pulse oximetry readings than younger people, and young women have higher readings...

Does the appearance, texture, and flavour of food affect how we swallow?

Texture modification and the use of thickened fluids are well-known strategies used to facilitate swallowing in people with dysphagia. However, some controversy exists around thickeners and their possible negative impact on hydration and medication absorption. This paper considers other properties...

Lymph node metastases in papillary thyroid cancer

This retrospective Korean cohort study looked at the risk factors associated with bilateral lateral lymph node metastases in patients with unilateral papillary thyroid cancer. There were 11 patients who met the inclusion criteria across an 11-year period from 2009 to...

Swallowing the risk: managing dysphagia in aged care

The risk of dysphagia increases with age and the prevalence of dysphagia in aged care facilities is 41–52%. Dysphagia increases the risk of aspiration, asphyxiation, malnutrition, pneumonia and ultimately death. Modifying food and fluids, by providing mashed or pureed foods...

Swallow toxicity score (DIGEST) and its clinical utility in oncology practice

The Dynamic Imaging Grade of Swallowing Toxicity (DIGEST, graded from 0–4) was developed as a tool for clinicians to grade dysphagia from modified barium swallow studies (MBSS). The purpose is to provide a common terminology for adverse events of pharyngeal...

Preservation rhinoplasty

Hump reduction and osteotomies to close the open roof, or lowering the whole nasal dorsum? Charles East explains how preservation techniques can improve outcomes by maintaining the integral structures of the nose. What is preservation rhinoplasty? The origins of reduction...