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The effects of paediatric tracheostomy

Paediatric tracheostomy is usually an essential procedure to preserve life, or to allow a patient to function in the community. However, the effect of tracheostomy on the developing child - care requirements, lack of voice, impaired swallow, constant risk of...

Risks of tracheostomy in head and neck cancer

Tracheostomy is associated with several complications, with rates quoted as high as 8-45%, including: bleeding; displacement; obstruction; surgical emphysema; pneumothorax; fistulae and failure to decannulate. There are now many studies that confirm the increased length of stay and complications of...

The hippo and the nose

Chronic rhinosinusitis with nasal polyps (CRSwNP) leads to histological changes including thickening of the basilar membrane and epithelial proliferation. Molecular mechanisms underlying these changes are still not fully clear. A signalling pathway called the hippo with Yes‐associated protein (YAP) as...

Hypoglossal nerve stimulation for OSA

Hypoglossal nerve stimulation has been lauded as the great new surgical treatment panacea for obstructive sleep apnoea (OSA). This meta-analysis includes 12 studies with a total of 350 patients, including the five-year follow-up data from the STAR trial which was...

How best can we manage Samter’s Triad/AERD?

The classic ‘Samter’s Triad’ of asthma, chronic rhinosinusitis with nasal polyposis (CRSwNP), and aspirin sensitivity is now referred to as aspirin-exacerbated respiratory disease (AERD) or non-steroidal anti-inflammatory-exacerbated respiratory disease. We often come across in our rhinology setting, patients with recalcitrant...

Assessment and management of dysphagia in the elderly

This article covers dysphagia in older patients, which is an important topic due to an ageing population, and a relatively common symptom that we see in clinic. Dysphagia could be due to presbyphagia secondary to changes in head and neck...

Grading dysphagia as a toxicity in treating head and neck cancer

Common Terminology Criteria for Adverse Events (CTCAE) is a system used by clinicians to grade the toxicity of oncology treatments in a standardised manner. Dysphagia is perhaps the most common long-term toxicity of head and neck cancer treatment. Currently, a...

Can laryngeal sensitivity testing predict aspiration and pneumonia in dysphagic patients?

The laryngeal adductor reflex (LAR) is characterised by brief vocal cord closure in response to laryngeal stimulation. It is important in swallowing physiology as it represents a mechanism for airway protection. The authors of this study examined whether the absence...

Stem cells in nasal polyposis

Chronic rhinosinusitis with nasal polyps (CRSwNP) is common and is multifactorial with increased T-helper 2 response and active role of interleukin 5. It can be associated with asthma and control of CRSwNP improves lower airway disease. Due to constant cellular...

Rationales to explore the neck in penetrating injuries

Penetrating neck injuries in the UK are more commonly associated with low velocity objects such as knives and blades as opposed to gunshots. To explore the neck requires careful consideration of the need to do so in line with Burgess...

Cystic fibrosis – sinus surgery delays chronic Gram-negative lung infection

This prospective clinical follow-up study is of 106 patients with cystic fibrosis in Copenhagen. Morbidity and mortality in CF are significantly associated with pulmonary colonisation and infection, usually with Gram-negative bacteria. Initially this can be well treated with antibiotics until...