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Salivary gland blues…
Intravenous methylene blue is a well-described method to assist in intraoperative localisation of parathyroid glands. The technique does come with challenges as anybody will know who has had to run adjacent to a theatre-bound trolley to ensure that the infusion...
Surgical voice restoration after laryngopharyngectomy
Voice restoration is one of the key rehabilitative steps after laryngectomy or total laryngopharyngectomy (TLP). Patients who undergo TLP require reconstruction – increasingly commonly with microvascular free flaps. Despite their advantages in terms of fistula rates and swallowing outcomes, these...
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...
New diagnostic criteria for Ménière’s disease – an international consensus
Most readers are familiar with the American Academy diagnostic criteria for Ménière’s disease (MD) but a significant minority will be aware of other criteria from Japan and Korea. This new effort is a collaboration between these three bodies and the...
Inter-aural hearing preservation in cochlear implantation
Hearing preservation during cochlear implantation is becoming increasingly important, although results can be unpredictable. NICE are in the process of updating their guidance in the UK and it is possible that those with better hearing than the current candidates will...
From a dysphagia clinical trial to a multidisciplinary head and neck clinical pathway – the road to implementation
This paper describes the barriers and facilitators to establishing a structured and coordinated multidisciplinary care pathway for patients with head and neck cancer at a medical centre in the USA. The initiative was set in motion by the roll out...
Stapedotomy in osteogenesis imperfecta
Osteogenesis imperfecta (OI) is a rare connective tissue disease caused by a defect in collagen structure. Hearing loss is a characteristic feature of OI. It typically presents with conductive hearing loss initially, followed by a superimposed sensorineural component later in...
Enhanced recovery following surgery for head and neck cancer – the current evidence
Enhanced recovery after surgery (ERAS) programmes are now well established in many surgical specialities as a means of reducing postoperative complications and length of stay in hospital. Whilst many head and neck teams have interventions used to aid postoperative recovery,...
Unravelling the Meniere’s vs. migraine conundrum – what does the mastoid contribute?
This is an interesting observational study that attempts to classify subtypes of Meniere’s disease (MD) in relation to the coexistence of migraine. It is well known that the two conditions share common characteristics, making diagnosis and treatment challenging at times....
Cartilage interposition versus PORP ossiculoplasty
In this Egyptian study, the authors looked at the hearing outcomes in patients who underwent ossiculoplasty with cartilage interposition versus those with partial ossicular replacement prosthesis (PORP). They looked at a total of 47 ears from 45 consecutive patients with...
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....
