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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...
Does cholesteatoma surgery affect school performance?
While much focus has been placed on short-term complications associated with cholesteatoma, a lack of knowledge remains about the impact suffering from cholesteatoma in childhood may have on educational outcome. The aim of the study was to investigate whether suffering...
Preoperative imaging for thyroid cancer according to 2015 ATA guidelines
The 2015 American Thyroid Association (ATA) management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer suggest that thyroid sonography with survey of the cervical lymph nodes should be performed in all patients with known or suspected thyroid...
Preoperative risk factors: when do you need to refer to the haematologist?
It is essential that clinicians are able to identify and assess which patients are in the high risk category for bleeding during ENT surgery. A full history, including medications, herbal remedies taken, any other medical co-morbidities and family history of...
Outcome of TORS to tongue base and epiglottis in patients with OSA intolerant of conventional treatment
The use of transoral robotic surgery (TORS) in ENT is rather controversial, but the use of robotic surgery for obstructive sleep apneoa (OSA), makes it doubly so. Previous studies on TORS in OSA have been performed with other types of...
Botulinum toxin injection for bilateral recurrent laryngeal nerve paralysis
All traditional surgical treatments for bilateral recurrent laryngeal nerve (RLN) paralysis are essentially a balance between maximising airway patency and ensuring adequate phonation / airway protection. This paper highlights the potential role of botulinum toxin (Botox) injection into the cricothyroid...
Nasal steroids do not cause ocular problems
This excellent, high quality and detailed systematic review from Australia dispels the myth propagated recently by some poorly designed studies that intranasal corticosteroids cause intraocular problems. A 40 year review of the usual databases found 665 articles and 19 were...
The middle way: treating idiopathic facial nerve palsy
Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...
Treating keloid scarring with pressure clips following excision: does it work?
Keloid scars can pose a difficult management problem. Whilst not harmful in themselves they can be cosmetically unappealing and lead to social embarrassment and resulting isolation, and following surgical excision they often reoccur. Mechanical pressure is an adjuvant to surgical...
Method of delivery: all topical nasal corticosteroids are not made equal
There is an increasing body of evidence that the role of surgery for chronic rhinosinusitis is to facilitate the delivery of topical medical treatment – most notably, topical corticosteroids. Two recent studies, one using flow dynamics and another one examining...
Help or hinder: how and why do SLTs make clinical decisions around swallowing?
Dysphagia is a relatively common consequence of stroke, with estimates between 50% and 60% of people presenting with swallowing dysfunction following stroke. It is associated with pneumonia, malnutrition and dehydration which in turn lead to increased length of hospital admission,...
