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Tonsillectomy in or out?

Although tonsillectomy is the most common surgical act performed in ENT practice, there is still some concern about the safety of outpatient or day surgery scheduling, especially in adults. Although this has been common practice in many departments for some...

Do nasogastric tubes affect aspiration risk?

A nasogastric tube (NGT) is frequently used for patients who are at risk of endotracheal aspiration of oral diet. However, this cannot eliminate the aspiration of saliva. The incidence of aspiration pneumonia in patients with NGT therefore remains high. Some...

DVT prophylaxis in cranial procedures

Deep vein thrombosis (DVT) is a result of disturbed balances in blood flow patterns, blood clotting factors promoting coagulation and vessel wall endothelial injury. The subsequent disruption of coagulation and fibrinolysis mechanisms lead to venous clot formation and propagation. The...

The power of (younger versus older) lips

The Directional into Velocity of Articulators (DIVA) model theorises that we require both auditory and sensory feedback - from our articulators - in order to ensure we are able to produce precise and powerful articulatory movements. This study aimed to...

Socially appropriate part 1: assessing people with TBI

Social communication disorders are one of the most common and yet most under-addressed sequelae of a traumatic brain injury (TBI). Yet speech and language therapists report a lack of assessment tools and a lack of time to fully assess these...

An alternative device for obstructive sleep apnoea

Continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnoea (OSA), primarily due to the vast amount of short-term evidence in the medical literature it has accrued. The enduring obstacle to CPAP from becoming a treatment option...

Rhinotillexomania - how bad can nose picking get?

This is a fascinating first case report of rhinotillexomania associated with empty nose syndrome (ENS). Rhinotillexomania encompasses compulsive, pathological nose picking and is a variant of self-harm. Tranchito and Chhabra describe an elderly patient presenting with longstanding symptoms of nasal...

3D endoscopy in pituitary adenoma surgery

Endoscopic approach for pituitary adenoma surgery is well recognised. There has been recent refinement of 3D endoscopy technology which improves on the depth of vision offered and more compact delivery. This may improve visualisation of the critical structures involved in...

Active smoking predicts poor outcome in HPV positive oropharyngeal squamous cell carcinoma

Tobacco smoking is a well-known risk factor in human papilloma virus (HPV)-negative head and neck squamous cell cancer. Its effects include increased risk of treatment failure, distant metastases and reduced overall survival. HPV has been increasingly implicated as a causative...

Enhanced recovery following surgery for head and neck cancer – the current evidence

Enhanced recovery after surgery (ERAS) programmes are now well established in many surgical specialities as a means of reducing postoperative complications and length of stay in hospital. Whilst many head and neck teams have interventions used to aid postoperative recovery,...

Do we need contrast MRI when screening for vestibular schwannoma?

Gadolinium contrast enhanced T1-weighted (gT1w) MRI images of the internal acoustic meati have long been considered the gold standard in the diagnosis of vestibular schwannoma (VS). However, the addition of contrast to the MRI examination increases the cost and time...

An inherited platelet disorder in a post- tonsillectomy haemorrhage

Unexplained bleeding after any surgery is least desirable and to identify a cause for this preoperatively can be a very useful safeguarding measure. By looking for inherited platelet disorders in patients who bled after tonsillectomy, the authors of this publication...