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American Thyroid Association Thyroid Cancer Management Guidelines: utilising risk stratification to optimise patient care

The steep rise in thyroid surgery around the globe, has led to the development of risk stratification to define the indications for surgery and the extent of surgery as well as adjuvant therapies for papillary carcinoma, to avoid over treatment....

From the editor March/April 2023

Declan Costello, MA, MBBS, FRCS(ORL-HNS),Consultant Ear, Nose and Throat Surgeon, Wexham Park Hospital, Slough, Berkshire, UK. E: d.costello@nhs.netTw: @Voicedoctor_uk The world of audiology and ENT will already know of the tragic death of Professor David Baguley in June 2022 at...

How will our grandchildren view COVID-19?

Alan Johnson, known to our readers as the former President of ENT UK, gives us his thoughts on the COVID pandemic, looking at it through the lens of other health crises. As I write, COVID-19 is displacing almost all other...

Low risk options following failure of intratympanic gentamicin for Meniere’s

This article is a useful summary of the options available when intratympanic gentamicin (ITG) fails to adequately control vertigo episodes in Meniere’s patients. The authors describe the anatomical reasons that may impede drug delivery to the round window with the...

Intracranial complications of otitis media – the difference between kids and adults

Despite a decrease in intracranial complications from otogenic infections since the introduction of antibiotics, there is still morbidity and mortality associated with this. This group from the Netherlands conducted a retrospective review of all the patients treated for intracranial complications...

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...

Beware of GPA as a cause of subglottic stenosis

Up to 92% of patients with granulomatosis with polyangiitis (GPA) have concurrent ENT manifestations of the disease. Whilst we are familiar with sinonasal and middle ear presentations of GPA, subglottic stenosis (SGS) is another important and potentially life threatening manifestation....

When should we decompress the facial nerve in Bell’s Palsy?

It has been over three decades since Fisch popularised facial nerve (FN) decompression for Bell’s Palsy. Studies further exploring this have been few since, partly due to the major complications that can occur following this type of surgery. The current...

Head injury and prolonged bed rest, but not inner ear disease, predict poorer outcome after Epley manoeuvre in posterior semicircular canal benign paroxysmal positional vertgo (P-BPPV)

This Japanese study included 197 patients with P-BPPV treated over a two and a half year period. The vast majority had idiopathic BPPV (n=157). The remaining 40 had secondary BPPV, eight following head trauma, 14 due to prolonged bed rest...

Bamboo nodes – a case series

Bamboo nodes are band-like, cream-coloured submucosal deposits affecting the middle third of the vocal cord. They are reported to affect women exclusively and are frequently bilateral but can be asymmetrical. They are distinct from vocal cord nodules but can be...

Management of postoperative cholesteatoma

This prospective longitudinal observational study compared the ability of second-look surgery with that of surveillance using serial non-echo-planar diffusion-weighted imaging to detect residual cholesteatoma after canal wall-up mastoidectomy. A total of 34 patients were included in the study who underwent...

Is it really working? Assessment versus real-life language measures

Research in the field of language treatment and rehabilitation to date has used single-word naming as a controlled measure of outcome. Yet, given people do not actually communicate in single words, there is much debate as to whether this approach...