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Canal wall down with obliteration of cavity for paediatric cholesteatoma

The authors present evidence that canal wall down (CWD) surgery with primary obliteration is an effective way to treat paediatric cholesteatoma. Fifty-eight ears were operated on and follow-up was for five years on average. Residual cholesteatoma rate was 9.9% with...

Application of paper patching in patulous eustachian tube

The condition of patulous eustachian tube, as opposed to dysfunctional eustachian tube, is less frequently diagnosed. Symptoms related to this, such as autophony, aural fullness, ‘being under water’, ‘hearing their own breathing’, and hearing sensitivity (varying in either direction) can...

Investigation of the role of KPNA2 biomarker in oral SCC invasiveness

This edition of Head and Neck has a strong focus on studies using immunohistochemistry (IHC) to elucidate potential roles of various cell-signalling molecules in both HNSCC and thyroid cancer. The ‘cellular-protein heavy’ title of this article may be off-putting to...

Vascularised tissue in salvage total laryngectomy

Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...

Recurrent ENT infections in children – is it a sign of primary immunodeficiency disease?

ENT clinicians often come across children with recurrent ear, sinus and pulmonary infections. These recurrent infections, albeit common in childhood, can represent an early sign of primary immunodeficiency diseases (PIDD). PIDD is an underdiagnosed group of genetic disorders involving absent...

How to tackle the problem of ciprofloxacin-resistant ear infections?

The growing issue of ciprofloxacin-resistant ear organisms is certainly a pertinent one. The situation here in the UK, where ototoxic topical drops are frequently given initially in the presence of pus and a perforation, differs markedly from elsewhere where fluoroquinolones...

Double suspension sutures for obstructive sleep apnoea

This study examines the benefit of an operation that targets the lateral pharyngeal wall. The double suspension sutures are, in essence, a suture through the palatopharyngeus muscle which is then tied around the hamulus in the retro molar area. This...

Button batteries – how can we reduce harm to children?

This article explores the history of button batteries and how clinicians and industries alike could reduce the harm to children following ingestion. Following ingestion, if lodged, button batteries cause an alkaline reaction leading to necrosis of mucosa. Significant oesophageal injury...

Corticosteroid prescribing in ENT - are we at risk of being sued?

Of medications leading to malpractice claims, corticosteroids comprise the third most common. They are used widely and have a significant side-effect profile: hypertension, lipodystrophy, diabetes, avascular necrosis of the femoral head, peptic ulceration and psychiatric reactions to name but a...

Electrocochleography and cochlear implants programming

Cochlear implants (CIs) often are the only option for people with severe to profound sensorineural hearing loss to be able to hear. Therefore, effective CI programming seems very important, especially in children who are still developing their speech. Using acoustic...

Reducing pulse rate in videofluoroscopy: less is not best!

Recently, there has been increasing discussion in clinical meetings about the use of ionising radiation in swallowing assessments and the associated cancer risks. This is therefore a timely publication to inform discussions around whether reducing pulse rate from 30 pulses...

Bones, stones and surgical moans: rethinking PTH dynamics in parathyroid surgery

Intraoperative parathyroid hormone (IOPTH) testing has revolutionised minimally invasive unilateral parathyroidectomy (MIP) as the gold standard treatment for primary hyperparathyroidism, replacing old-timey four-gland exploration. IOPTH testing ensures reliable excision of all hypersecreting glands, including those pesky hard-to-find ones, without relying...