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Surgical voice restoration after laryngopharyngectomy
Voice restoration is one of the key rehabilitative steps after laryngectomy or total laryngopharyngectomy (TLP). Patients who undergo TLP require reconstruction – increasingly commonly with microvascular free flaps. Despite their advantages in terms of fistula rates and swallowing outcomes, these...
Can laryngeal sensitivity testing predict aspiration and pneumonia in dysphagic patients?
The laryngeal adductor reflex (LAR) is characterised by brief vocal cord closure in response to laryngeal stimulation. It is important in swallowing physiology as it represents a mechanism for airway protection. The authors of this study examined whether the absence...
Is it worth paying for group therapy?
Group therapy for post-stroke communication difficulties has been described in the research literature for more than 50 years and is generally considered an efficacious approach. Yet these authors express concern that the American Medicare system is less willing to fund...
CSF leak – endoscopic or open repair?
Cerebrospinal fluid (CSF) rhinorrhoea is well known to the ENT surgeon. It commonly occurs secondary to a predisposing event such as accidental or iatrogenic trauma. When it occurs spontaneously, it can be associated with benign intracranial hypertension. The commonest CSF...
Mitomycin in adjuvant treatment of laryngotracheal stenosis
Laryngotracheal stenosis (LTR) is a difficult condition to manage, and the effectiveness of surgical treatment is limited by the tendency of scar tissue to reform. Mitomycin has been used as a controversial adjuvant to surgical treatment for many years. Drawbacks...
Are organ-preserving treatment strategies for T3 laryngeal cancers reducing patient survival?
This article presents the 10-year results of a single institution’s treatment of advanced laryngeal cancer. The institution established a protocol based on the Dutch Head and Neck Society consensus document on laryngeal cancer diagnostics and treatment published in 1991. This...
Immunotherapy – could it be cheaper?
Immunotherapy is the only treatment for allergy to alter the disease course. Limited data exist on direct and indirect costs of subcutaneous (SCIT) and sublingual (SLIT) immunotherapy in America. This article assesses the cost effectiveness worldwide of the two immunotherapies....
Role of potassium channel opener in salicylate induced tinnitus
The exact mechanism in the origin of tinnitus is not known. Many pharmacological agents have been tried to to treat tinnitus without great success. Aspirin is a commonly used medicine in the elderly population to reduce the risk of stroke...
Measuring is understanding: an unsupervised PROM clustering of CRS patients
It has been clear for quite some years, at least for anyone dealing daily with chronic rhinosinusitis (CRS) patients, that CRS is an ‘umbrella’ diagnosis. There are significant differences between patients, including different demographic data, different endoscopic and radiographic images,...
When should that child’s wet ear be operated on?
The team from Birmingham have provided a meta-analysis to answer the question of when to perform a type 1 tympanoplasty on chronic paediatric perforations (under 18 year olds). Forty-five studies were included which resulted in 2609 cases. Closure rate at...
Depth of invasion of oral cancer should be incorporated in new AJCC staging system
Since 1977, when the first edition of the Manual for Staging of Cancer was published by the American Joint Committee on Cancer (AJCC), the primary tumour staging for oral squamous cell carcinoma (SCC) has remained unchanged. In the last four...
