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Neuromodulation in drug resistant epilepsy
Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...
Simple preoperative tests predicting outcomes for ESS patients?
We are all familiar with patients suffering extensive nasal polyps who relapse all to soon after careful and thorough endoscopic sinus surgery (ESS). This paper looks to answer whether we can predict which patients will do well, and which less...
An inherited platelet disorder in a post- tonsillectomy haemorrhage
Unexplained bleeding after any surgery is least desirable and to identify a cause for this preoperatively can be a very useful safeguarding measure. By looking for inherited platelet disorders in patients who bled after tonsillectomy, the authors of this publication...
The medially-invasive cholesteatoma: a case series
In this small case series, Casazza et al describe their management of seven cases of complex cholesteatoma presenting during a 16-year period. Patients were included if imaging confirmed restricted diffusion and an endophytic, medially-destructive disease involving the otic capsule, petrous...
A diagnosis-based scoring system to predict outcomes in necrotising otitis externa
Patients admitted with necrotising otitis externa have increased six-fold in the last 10 years. The prognosis is variable and dependent on co-existing morbidities. Charlston Comorbidity Index (CCI) is a weighted comorbidity scoring method, based on the presence or absence of...
Effects of coronavirus pandemic on presentation of head and neck cancer patients
The COVID-19 pandemic caused unprecedented disruption of NHS services. This was compounded by patients’ reluctance to attend hospitals at that time. How this affected the presentation of patients with head and neck cancer is the subject of this study. Head...
Sudden sensorineural hearing loss – who will get better?
Idiopathic sudden sensorineural hearing loss (ISSNHL) is a rare but potentially devastating condition. For patients presenting with this condition, prognosis is of paramount importance. Wu et al begin to address this issue by retrospectively studying 17 potential prognostic factors for...
Extracapsular dissection alone for low-grade malignancies of the parotid gland – oncologically sound?
The general treatment strategy advocated for a primary carcinoma of the parotid gland is surgical resection +/- adjuvant radiotherapy. A selective neck dissection is usually recommended in all cases of parotid malignancies, except for small, low-grade tumours. In this paper,...
How reliable are PTH levels for the prediction of hypocalcaemia after thyroid surgery?
Hypoparathyroidism is one of the most common complications of thyroid surgery. There is significant controversy in calcium management practices post thyroid surgery. The drop in PTH levels has been used to predict the likelihood of hypocalcaemia after thyroid surgery. But...
I saw it on the internet: gathering evidence for clinical decision making
Evidence-based practice is often described as the integration of three sources of information to inform clinical practice, namely: 1) research evidence/practice guidelines; 2) client preferences/needs, and: 3) clinical experience. Speech and language therapists have reported a lack of time and...
How well do different assessments of swallowing correlate with one another?
Swallowing (dys)function may be assessed by three key measures: 1. instrumental swallowing techniques such as the modified barium swallow (MBS) or videofluoroscopy; 2. functional measures of diet texture that patients can eat comfortably (usually rated by the clinician); and 3....
