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Gastro-oesophageal reflux and cricopharyngeal dysfunction – how do they link?

It has been hypothesised that cricopharyngeal muscle hypertrophy develops as a response to chronic gastro-oesophageal reflux disease. The cricopharyngeus muscle is an important component and contributor to the upper oesophageal sphincter that creates a barrier between the pharynx and oesophagus....

Deglutition in pharyngolaryngectomy patients

Circular defects after total pharyngolaryngectomy present a reconstructive challenge. In this study, the authors compared the swallowing results after three reconstructive techniques: free forearm flap, free jejunal loop and folded pectoralis major flap. Forty-six patients were included and were evaluated...

The changing spectrum of cancer of the oropharynx: dilemmas and future directions

The association of HPV in oropharyngeal cancer has identified a ‘new disease’, with its unique biologic behaviour, and challenges for clinicians in selecting therapeutic combinations offering maximum efficacy and minimum morbidity or long-term sequela currently under study in clinical trials....

New ventilation technique FCV: improvement for patient, anaesthetist/intensivist and surgeon

Per-oral surgical access to the larynx can be hampered by the presence of an endotracheal tube. Various systems have been developed for tubeless ventilation, but these all carry a risk of aerosolisation of secretions with obvious inherent risks. We hear...

Emerging robotic systems for head and neck surgery

As of December 2020, seven robotic surgical systems have received approval for use in different jurisdictions, and many more task-specific robots are in the pipeline. Jack Faulkner takes us through what’s on the horizon for head and neck cancer surgery....

Head and neck robotic surgery – considerations for the surgical trainee

In 2021, training in head and neck cancer surgery would be incomplete without some robotic resections under the belt. Henry Zhang explains how he did it and outlines the options available. With a wide range of applications in both benign...

Developmental stuttering: a speech-motor impairment with sensory aspects

In treating patients who stutter, understanding the effects of sensory input (i.e. auditory input) can help to direct therapeutic approaches. Sensory processing has been identified as a contributory factor in several diagnoses, notably autism and ADHD [1], however it has...

Laryngeal endoscopies

Here, the authors provide some great tips for performing a successful microlaryngoscopy which should be of benefit to those learning this very common procedure. In this article, we will discuss tips for performing a microlaryngoscopy, and different laryngoscopes used to...

Sushruta and Indian rhinoplasty

Vijay Pothula explains rhinoplasty’s roots in ancient Indian Ayurvedic medicine, and how it was introduced to the Western world. In 1794 The Gentleman’s Magazine published a surgical operation which was long established in India but unknown in Europe [1]. A...

Alfred Alexander: a life in ENT, but mainly music

Your own voice clinic may be filled with teachers, elderly clergy and badly trained pub singers, but it wasn’t always like this... When I was first invited to write an article about opera and ENT for this edition of ENT...

Vocal cord dysfunction and dysfunctional breathing: an evolving clinical paradigm

Patients frequently present to the ENT department with breathing difficulties. The entity of ‘vocal cord dysfunction’ (also known as paradoxical vocal cord movement, inducible laryngeal obstruction, and many other names) is increasingly well recognised. Ravi Thevasagayam gives us an overview....

Reconstruction of the Head and Neck: A Defect-Oriented Approach

This is the second Thieme book on head and neck cancer by this author that follows on from Head and Neck Cancer: an Evidence-Based Team Approach four years ago. It is a well-structured, up-to-date book in a readable layout with...