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Should patients with dysphagia be allowed water freely?

Patients with dysphagia often experience dehydration as a consequence of “nil by mouth” or having to consume thickened fluids due to aspiration of thin fluids. However, not all incidents of aspiration develop into an infection. Factors that contribute to aspiration...

Isshiki Thyroplasty Type 2

Indication Adductor spasmodic dysphonia is a neurological condition of unknown aetiology. The symptoms are believed to be caused by involuntary contraction of the adductor muscles of the vocal cord as a result of an abnormality of neurotransmitters in the basal...

Gardasil vaccination as an adjuvant treatment for established recurrent laryngeal papillomatosis in male adults - does it stimulate an immune response?

Recurrent respiratory papillomatosis (RRP) is well known to be caused by infection with the human papilloma virus (types 6 and 11). Recurrence after surgical removal is common and potentially frequent and severe. Previous research has established that many patients with...

A new treatment for smell loss?

It has been well established that smell training can be effective in the recovery of smell function post Covid-19 infection, and many other treatment modalities have been assessed. There have been limited studies to date evaluating the effects of dietary...

Intra orbital treatment to save the eye!

Invasive fungal sinusitis can be a devastating condition, and accepted management is surgical debridement of infected tissue, systemic antifungal treatment and reversal of immunosuppression. Orbital involvement is common, affecting up to 75% of cases, and in advanced disease orbital exenteration...

Medical training initiative (MTI): stepping outside the box

Medical training initiative (MTI) scheme in the UK are becoming increasingly available and are actively supported by ENT UK. Despite this, knowledge of them is limited and there can be a mismatch between supervisors and potential candidates. Our authors, Manuela...

Clinical Practice Guideline on Tympanostomy Tube in Children Update (AAO-HNS)

The American Academy of Otolaryngology–Head and Neck Surgery Foundation’s ‘Clinical Practice Guideline: Tympanostomy Tubes in Children (Update)’ has been recently published - an update of the original 2013 guideline. This article forms an executive summary to accompany the full guideline....

Ossicular reconstruction

Ossicular reconstruction often yields disappointing results, even for the most experienced and skilled of otologists. John Dornhoffer and David Walker explain that the most important determinant of outcome is the patient’s middle ear environment, and offer some valuable words of...

Aerosols and polypi

Infection in the operative cavities after endoscopic sinus surgery for sinonasal polyposis leads to recurrence of symptoms and mucopurulent discharge. The usual therapies include systemic antibiotics sometimes with steroids. The authors hypothesised that the use of a topical antimicrobial (tobramycin...

Techniques of Botulinum Toxin Injections in the Head and Neck

The foreword begins with a saying by George Bernard Shaw, “all great truths begin as blasphemies”. This certainly was the case with medical application of Botox initially, however, botulinum toxin now has an accepted role and is widely used in...

The effect of adenotonsillectomy on the immune system

Parents often ask about the effect of adenotonsillectomy on the immune system, with concerns that the child may be prone to more infections postoperatively due to the absence of immune tissue. This Belgian literature review looked at the local and...

How do we manage immune deficiency-related ENT disorders

It is not unusual to come across patients with recurrent sinonasal infections, lung infections and recurrent ear infections needing regular antibiotics in the outpatient setting. Physicians need to have a high index of suspicion that patients may have immune deficiency...