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Voice therapy is an effective treatment for presbyphonia

The quality of an individual’s voice often declines with age. This deterioration occurs firstly as a result of vocal fold atrophy secondary to histologic alteration of the vocal fold mucosa as well as atrophy of the laryngeal musculature. Phonatory efficiency...

Long term morbidity of extended medial maxillectomy for inverted papilloma

This Italian review paper looks at five-year morbidity after extended endoscopic medial maxillectomy in 59 patients in a university teaching hospital setting. All patients underwent an extended approach medial maxillectomy for inverting papilloma, this included removal of the entire medial...

Is there a ‘best’ ventilation tube?

Studies on grommet materials and sizes are not exactly new but this was a well-designed randomized study in Sweden with some useful findings. The extrusion rate and complications associated with four different ventilation tubes (grommets) were assessed prospectively in 400...

Cochlear implant electrode insertion technique

Atraumatic cochlear implant insertion techniques (so-called ‘soft surgery’) are now standard practice in most centres for all cases (no longer just for attempted hearing preservation cases). This has led to several studies examining cochlear trauma and electrode insertion force. In...

Laser for active mucosal chronic otitis media

Active mucosal chronic otitis media (COM) is a condition characterised by otorrhoea secondary to chronic inflammation of the middle ear and mastoid mucosa associated with granulations and a tympanic membrane perforation. Surgical intervention is often required, but concurrent mastoidectomy with...

Fingernail for orbital floor reconstruction

Orbital damage is common in maxillofacial injuries and about half of them result in damage to the orbital floor. Suitable material that could be used for repairing the orbital floor includes autografts, allografts and alloplastic materials. The disadvantage of using...

Expanding the role of FNA in thyroid nodule decision-making

Papillary thyroid cancer, the commonest histological type, has been extensively reported as having BRAF proto-oncogene mutations (most commonly the V600E mutation). There is great interest in BRAF as a molecular marker, particularly as a prognostic factor that may guide the...

Reactive lesions of the contralateral vocal cord – excise or leave?

It is well recognised that benign lesions of one vocal cord can give rise to reactive lesions of the contralateral vocal cord directly opposite to the primary lesion. These contralateral reactive lesions (CRLs) are thought to arise due to impact...

A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth

It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...

Does cholesteatoma surgery affect school performance?

While much focus has been placed on short-term complications associated with cholesteatoma, a lack of knowledge remains about the impact suffering from cholesteatoma in childhood may have on educational outcome. The aim of the study was to investigate whether suffering...

Myringoplasty in a bottle?

Management of large traumatic TM perforations can involve observation and water precautions or surgical repair. Closure rates for larger perforations can be 8-12 weeks and occurs for between 38-79%. Animal and human studies have shown that exogenous application of epidermal...

Managing high flow head and neck arteriovenous malformations (AVM)

Vascular malformations are lesions where the traditional network of capillaries linking arteries and veins are lacking. Patients usually present with bleeding, pain, disfigurement and tissue expansion and destruction. High flow lesions can be challenging to manage in the head and...