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What is voice?

Voice is an area of clinical practice in speech and language therapy where there remains much debate, not only around the aetiology and classifications of voice disorders, but around the treatment of them. In general, it is accepted that ‘voice...

Does speech and language therapy provide value for money?

Within the NHS (and outside it), managers, commissioners and consumers will consider value for money as a key component in making a decision about whether to pay for speech and language therapy (or any other service for that matter). Yet...

Feel what you say: a framework to demonstrate the emotional response to aphasia is intertwined with the emotional toll

The authors start this paper by flagging a recent study demonstrating that speech and language therapists in clinical practice rarely have time to focus on emotional issues in relation to aphasia. Yet, people with aphasia describe the close relationship between...

Swallowing their words: translating and adapting swallowing questionnaires to other languages

Dysphagia (swallowing difficulties) is increasingly relevant given the ageing population. Yet measuring or assessing dysphagia is challenging and often costly when exploring instrumental examination. The aim of this study was to translate and validate a patient-reported swallow questionnaire; the Sydney...

From aaargh to zzzzz: the ABC of paediatric anaesthesia

Andrew McTavish is one of those special breeds who not only relishes complex anaesthesia, but also does so in paediatric patients. Dealing with this group of patients requires careful planning according to accepted practice, and here he discusses some recent...

Erwin Geising and the fall of the Third Reich

It’s mid 1944. The allies have landed at Normandy, the Germans have abandoned Rome and are retreating from the Russians on the eastern front. The Fuhrer was in way over his head and out of his depth. Watching this series...

Is major ear surgery financially viable?

It is difficult to ignore the present reality in the NHS that understanding clinical coding is perhaps of more relevance to the practising clinician than the human genome! Clinician engagement is becoming more essential to protect patient care and maximise...

Results of hypoglossal-facial nerve anastamosis techniques for facial palsy

Preserving facial nerve function is of prime importance in acoustic neuroma surgery. A comprehensive knowledge of anatomy, experience and surgical precautions can reduce the incidence significantly. Important considerations are when and how to repair if injury occurs. Several options include:...

The middle way: treating idiopathic facial nerve palsy

Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...

Clinical assessment in OSA

This paper divides the assessment up into anatomical (nasal and oropharyngeal), endoscopic and imaging. It points out the salient features to look out for in OSA patients with regards the nasal valve and also oropharyngeal anatomy, with tonsil hypertrophy grading...

MRI in diagnosis Meniere’s disease: what is the evidence?

The utility of magnetic resonance imaging (MRI) in the diagnosis of Meniere’s disease (MD) has attracted a lot of interest recently. It is well accepted that the saccule is the most common vestibular organ affected by endolymphatic hydrops (EH) and...

Gadolinium enhanced MRI and the diagnosis of Ménière’s disease

Despite various criteria applied over the years to diagnose Ménière’s disease since the concept of endolymphatic hydrops was first observed in postmortem examinations of patients in 1938, the diagnosis still remains mainly clinical. To visualise endolymphatic hydrops in MRI imaging,...