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Assessing post-extubation dysphagia on the intensive care unit

The incidence of post-extubation dysphagia (PED) is reported to be about 12% in the general ICU population and around 18% in patients admitted to ICU as emergencies. PED was found to be an independent predictor of 28-day and 90-day mortality....

Variations in obstructive level with increasing depth of sedation in DISE

This study highlights some of the controversies surrounding DISE (Drug Induced Sedation Endoscopy, or otherwise known as sleep nasendoscopy in the UK). On one hand it provides some evidence that the BIS (BiSpectral Index), recordings of patients while they are...

Meeting myself coming back

Sometimes, it can seem like trainers and trainees are separate entities, inhabiting separate worlds, in two separate spheres of experience. However, trainees become trainers, and there is always a period where the trainer has only just stopped being the trainee....

Are there benefits of prophylactic swallowing exercises for patients with head and neck cancer?

This randomised controlled trial aimed to establish the impact of prophylactic swallowing exercises in patients undergoing chemoradiation therapy for head and neck cancer. The primary outcome was the functional oral intake scale (FOIS), although secondary measures for feeding tube use,...

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...

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...

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,...

Oesophageal atresia and trachea-oesophageal fistula: a perspective on dysphagia management from Turkey

Children born with oesophageal atresia with or without trachea-oesophageal fistula usually receive early surgical repair to create tension-free anastomosis that facilitates oral feeding. However, many children are at risk of problems related to subsequent dysphagia. This includes respiratory, nutritional, motility...

Be sober to stay on your feet

Readers would either have had a personal experience or observed the inelegant gait of the inebriated. Re-aligning the body during postural perturbations involves changes in head position, shoulders, and hip, knee and ankle joints. The main hypothesis of this study...

Treating voice disorders in singers

There are few ENT surgeons who have as much insight into singers’ problems as Nick Gibbins. A good knowledge of working patterns, repertoire and the physiology of ‘vocal athletes’ is essential. He shares a few thoughts with us. When deciding...

One-stage laryngotracheal reconstruction in young infants

Airway inadequacy is a significant problem in young infants and may go undetected until inflammatory conditions trigger acute episodes, some of which require a tracheostomy. In addition to breathing difficulties, feeding problems are also common. This study involves 11 children...

Developments in diagnostic approaches for acutely dizzy patients

The acutely dizzy patient can be a diagnostic and management dilemma for emergency departments and general practitioners, with many patients consequently having delayed access to specialised assessment and treatment. David Jay tells us about HINTS, a bedside test that can...