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Vascularised tissue in salvage total laryngectomy

Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...

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...

How to tackle the problem of ciprofloxacin-resistant ear infections?

The growing issue of ciprofloxacin-resistant ear organisms is certainly a pertinent one. The situation here in the UK, where ototoxic topical drops are frequently given initially in the presence of pus and a perforation, differs markedly from elsewhere where fluoroquinolones...

Peripheral nerve stimulation for chronic refractory pain

Peripheral nerve stimulation (PNS) plays an important role in treating chronic refractory pain syndromes that manifest in limited distributions and overlap with areas of neurologic innervation. The process is generally thought to capitalise on the inhibition and activation of pain-related...

Home alone with aphasia

Relationships and social networks are known to impact outcome following a stroke. Studies have shown that group-housed animals who have had a stroke show greater neurological recovery than those who are isolated. Similarly, adults who are socially isolated following a...