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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...

Impact of the updated cancer staging system on HPV-positive disease

The AJCC cancer staging manual was updated in 2017 (8th edition). It is used in the MDT setting for planning treatment and assessing prognosis for individual patients, and is also widely used internationally in clinical trials. Unlike previous iterations of...

Method of delivery: all topical nasal corticosteroids are not made equal

There is an increasing body of evidence that the role of surgery for chronic rhinosinusitis is to facilitate the delivery of topical medical treatment – most notably, topical corticosteroids. Two recent studies, one using flow dynamics and another one examining...

Help or hinder: how and why do SLTs make clinical decisions around swallowing?

Dysphagia is a relatively common consequence of stroke, with estimates between 50% and 60% of people presenting with swallowing dysfunction following stroke. It is associated with pneumonia, malnutrition and dehydration which in turn lead to increased length of hospital admission,...

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...

Cochlear implants for tinnitus

This study from Belgium is the first to look at the long term reduction in tinnitus for a cohort of 23 patients with unilateral profound hearing loss and incapacitating tinnitus implanted with cochlear implants (CI). The authors were able to...

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....

The benefits of early voice therapy for unilateral vocal cord paralysis

This retrospective review of voice outcomes following a diagnosis of unilateral vocal fold paralysis divided patients into three groups according to the time of initiation of voice therapy following the onset of paralysis. The ‘early’ group started voice therapy within...

Transnasal oesophagoscopy in head and neck cancer: an update

The role of transnasal oesophagoscopy (TNE) in the management of head and neck cancer patients is evolving. Until 1990, oesphagoscopy required specialist endoscopists, general anaesthesia or sedation. This review succinctly summarises updates in the evidence for TNE in: i) Screening...

Grading dysphagia as a toxicity in treating head and neck cancer

Common Terminology Criteria for Adverse Events (CTCAE) is a system used by clinicians to grade the toxicity of oncology treatments in a standardised manner. Dysphagia is perhaps the most common long-term toxicity of head and neck cancer treatment. Currently, a...

Does pre-op intratympanic gentamicin improve balance control after vestibular schwannoma surgery?

This retrospective study was based on data from 44 patients selected from a cohort of 153 who had undergone surgical resection of vestibular schwannoma over a 10-year period. The aim was to evaluate the dynamics of the postural control system...

Facial pain and headaches

This paper reviews the present knowledge and the recent publications on the cause, characteristics, course and treatment of chronic and recurring facial pain and headaches. Facial pain should be defined in terms of frequency, duration and severity, and also in...