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Diaphanoscopy of the paranasal sinuses (Halloween in ENT Practice)

Since time immemorial, humans have tried to enhance the limited capabilities of their sense organs. It would be a clear advantage to be able to see through objects and discern what lies inside or behind them! This concept of transillumination...

Awake transnasal laryngeal and pharyngeal biopsy in the unsedated patient

In an attempt to improve the efficiency and flow of patients through a busy ENT clinic, technology now allows the ENT surgeon to consider biopsies in the outpatient setting on a more regular and controlled basis. This can avoid the...

Have we reached our limits in endoscopic skull base surgery?

As being an anterior skull base surgeon becomes the aspiration of many ENT trainees, Professor Nicolai gives his personal insights into the future for this exciting subspeciality. Having been directly involved in the evolution of transnasal endscopic surgery (TES) since...

The hot nose

Capsaicin nasal spray can offer moderate to significant symptomatic relief to 70-80% of patients with idiopathic rhinitis (IR). Efficacy was also shown in lab studies. Nasal hyper reactivity (NHR), absence of allergy / infective rhinosinusitis, age limits (18-60), no anatomical...

Advances in surgical innovation for head and neck cancer

This article reviews current advances in surgical treatment of head and neck cancers such as sentinel node biopsy, stereolithic modelling, transoral robotic surgery and intra-operative imaging of tumour margins. Sentinel node biopsy has been found to be especially useful for...

Differing types of pharyngeal pouch

This article raised an eyebrow on the grounds that apparently more than one type of pharyngeal pouch exists! They differ in terms of aetiology, site and approach to treatment, therefore awareness of them is advised to ensure the appropriate surgical...

Botulinum toxin injection for bilateral recurrent laryngeal nerve paralysis

All traditional surgical treatments for bilateral recurrent laryngeal nerve (RLN) paralysis are essentially a balance between maximising airway patency and ensuring adequate phonation / airway protection. This paper highlights the potential role of botulinum toxin (Botox) injection into the cricothyroid...

Voice outcomes following extended laser resections for laryngeal cancer

It is now widely accepted that the oncological and voice outcomes following transoral laser microsurgery for early T1a glottic cancers are equivalent to, if not superior to, traditional radiotherapy. Voice outcomes following more extensive resections have not been as frequently...

A histological test for LPR?

Laryngopharyngeal reflux (LPR) is often considered to be a contributory factor to the development of a spectrum of laryngeal abnormalities including vocal cord leukoplakia and dysplasia. This is especially the case when traditional risk factors, such as tobacco smoking, are...

Combined endoscopic and transcutaneous approach for removal of parotid stones

The authors describe a small case series (n=8) of patients with obstructive symptoms from sialolithiasis of the parotid gland. A combined endoscopic and transcutaneous approach was used. The position of the stone in Stensen’s duct was identified by endoscopic transillumination....

Post tonsillectomy recovery in thermal welding method compared with recovery in cold steel method

Many different methods for tonsillectomy have emerged but whether they provide an improvement over the traditional cold steel tonsillectomy is another matter. Thermal welding is a recent method of tonsillectomy in which the tissues are simultaneously coagulated and divided. In...

The degree of barbecue rotation matters in horizontal canal BPPV

Treatment of horizontal canal BPPV (Hc-BPPV) is not without controversy due to the several repositioning manoeuvres advocated for its treatment. Among the many, barbecue rotation (Br) is perhaps the most commonly used for canalithiasis of Hc-BPPV. Should the rotation be...