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Botulinum toxin and drooling – how much, how often and where?
This was an incredibly useful article covering all aspects of the use of botulinum toxin as a treatment modality in sialorrhoea. The article starts by outlining why treating sialorrhoea is important and describes the non-pharmacological and pharmacological options, highlighting that...
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...
Anterior skull-base surgery: current opinion
This review examines the changes in the field of anterior skull-base surgery and the rapid advancement that has taken place in the last 10–15 years. Tumours of the anterior skull base that were once considered inoperable are now routinely resected...
Factors affecting the occurrence of salivary fistula after total laryngectomy
It is generally believed that patients should be fed by nasogastric tube for 7-10 days after undergoing total laryngectomy or laryngopharyngectomy to avoid the occurrence of post-operative salivary fistula. This study challenges this belief and looks into various factors that...
Do nasogastric tubes affect aspiration risk?
A nasogastric tube (NGT) is frequently used for patients who are at risk of endotracheal aspiration of oral diet. However, this cannot eliminate the aspiration of saliva. The incidence of aspiration pneumonia in patients with NGT therefore remains high. Some...
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....
Analysing videofluroscopy: does it matter how it’s done?
Videofluoroscopy, as a tool that assesses the process of swallowing, has transformed our understanding of dysphagia. Clinicians can observe the biomechanics of a bolus moving from the oral cavity through the pharynx and oesophagus and into the stomach. Over the...
Measuring radiation fibrosis in patients with head and neck cancer
People treated with radiotherapy for head and neck cancer experience several acute and chronic effects of this treatment, of which fibrosis is perhaps the most common. Fibrosis occurs as a wound healing response and leads to scarring and reduced range...
The use of 3D videos to improve patient engagement with compensatory swallowing strategies
Patients with dysphagia are often asked to use compensatory techniques or manoeuvres to facilitate safe swallowing. For example, they may be taught to do a supraglottic swallow to minimise aspiration or a specific postural adjustment to support bolus flow. These...
