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Treating middle ear conditions in developing countries

This month’s journal issue discussed global health in otolaryngology with this paper focusing on the management of chronic middle ear disease in the developing world. Chronic suppurative otitis media (CSOM) is more common in developing countries. The reason for this...

Doing it for the people: how to do speech and language therapy

This review article distils 58 studies, collating information from people with aphasia, their families and clinical speech and language therapists summarising the seven habits of highly effective aphasia therapists. Habit 1: Effective therapists invest time in and prioritise relationships with...

Spotlight on Africa: paediatric ENT focus

Sub-Saharan Africa (SSA) carries 24% of the global disease burden but employs only 3% of the world’s health workers [1]. Unique workforce considerations exist in SSA including a paucity of skilled health professionals and fluctuant political climates [1,2]. Shazia Peer...

ENT leadership

Challenges The first challenge is to agree what we mean by the term leadership because there are many different ways in which the term is used. What is, however, a consensus is that the key distinction between leadership and management...

Clinical leadership and management: developing world ENT

I have been asked to share some of the initiatives I have been involved with to address ENT-related challenges in Africa and the developing world. Developing countries constitute the majority of the world’s landmass (Figure 1), are home to >50%...

Management of stage IV pharyngolaryngeal lesions

This is a retrospective study of 63 patients presenting with stage four laryngeal and/or hypopharyngeal squamous cell carcinoma. The aim was to define the factors influencing the oncological and functional outcomes of the patients. All patients had T4 lesions with...

EMG and unilateral vocal fold palsy

The authors studied the diagnostic and prognostic value of laryngeal electromyography (LEMG) in adults with unilateral vocal fold palsy. The study included 61 patients who were tested on average seven months after their palsy (4-11 months). In most cases the...

eNOS and OME

The pathophysiology of otitis media with effusion (OME) is multifaceted. The authors tackled the nitrous oxide (NO) and platelet activating factor (PAF) pathways and the genetic polymorphism of endothelial nitrous oxide synthetase (eNOS). DNA analysis by PCR and restriction fragment...

Minimal or not so minimal?

Parathyroidectomy is usually a straightforward technique when the target gland has been accurately determined. Surgical excision is usually through a small midline incision. With the advent of video assisted surgery, trials have been made to use this technique in parathyroidectomy....

More is better

The authors reviewed 119 patients undergoing endoscopic sinus surgery for sinonasal polyposis. Of these, 45 patients were operated upon by a traditional functional technique preserving the middle turbinate and keeping its position. In addition, the second group underwent a partial...

Inspiratory peak flow and tracheostomy

The evaluation of the degree of laryngeal obstruction to indicate a tracheostomy has always been a subjective decision. The authors correlated the visual laryngeal obstruction by flexible nasolaryngoscopy and the peak inspiratory flow using a pocket peak inspiratory flowmeter. Twenty-two...

Your voice and your personality

Variations of vocal effort are a normal adaptation to difficult communication situations. However, persistence of these abnormal strategies can lead to various functional dysphonias. In this experiment, the authors tested 41 females aged 18-52. The subjects were asked to instruct...