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Therapeutic alliance: more than the ‘nice person’ effect

Therapeutic relationship is considered a key component of many healthcare interventions, including speech and language therapy. Yet definitions and descriptions of what this concept comprises are ambiguous and sparse. This scoping review used the Joanna Briggs Institute guidelines to guide...

Globe Trotting and 62 years of ENT

Vasant Oswal was, for many years, ‘Mister ENT’ in the Northeast of England. Appointed as a consultant to the old North Riding Infirmary in 1970, he led what was a small and little-known department through a period of tumultuous change...

Fingernail for orbital floor reconstruction

Orbital damage is common in maxillofacial injuries and about half of them result in damage to the orbital floor. Suitable material that could be used for repairing the orbital floor includes autografts, allografts and alloplastic materials. The disadvantage of using...

Reconstruction with scapular tip following hemimaxillectomy and rehabilitation with dental implants

Post ablative defects in the maxilla can be extremely complex, involve all three dimensions and may result in significant morbidity. Rehabilitation may be difficult with either an obturator or surgical reconstruction with a free fibula, Iliac crest or scapula. This...

Staphylococcus aureus as a cause of refractory chronic rhinosinusitis

Staphylococcus aureus has long been linked to chronic rhinosinusitis, particularly recalcitrant cases. In this article, Alkis Psaltis describes how newer techniques have shown higher rates of S. aureus infection than were previously thought, and explains how the bacteria are able...

Random-pattern skin flaps: part 1 – advancement flaps

In the first of a short series covering random pattern skin flaps and their use in clinical practice (see Part 2 here, Part 3 here and Part 4 here), Christopher Thompson and Miles Bannister describe in some detail their techniques...

What are the risk factors for new onset tinnitus?

Factors associated with tinnitus have mainly been studied cross-sectionally. Tinnitus is associated with hearing loss, noise exposure, ototoxic medication, head and neck trauma, smoking and depression and anxiety. Only a few studies exist that report on risk factors for developing...

Changing perceptions in head and neck cancer management caused by quality of life issues

Sir Felix Semon was an outstanding clinician and exceptional laryngologist. The money raised by donations from his colleagues on his retirement in 1909 was used to establish the London University’s Semon Lecture. Semon’s Obituary in the BMJ, reads: “In Semon's...

Free flap reconstruction in stage three bisphosphonate-related osteonecrosis

There is no widely accepted gold standard for the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Early BRONJ is managed conservatively but there is controversy regarding the treatment of the later stages. Stage three is defined as exposed bone...

Malignant lesions and reconstruction of the pinna

External ear reconstruction can be challenging. Baskaran Ranganathan and Amr Abdelhamid describe how careful assessment, planning and surgery following the subunit principles and reconstructive ladder will ultimately lead to good aesthetic outcomes with restored form and function. The external ear,...

Helicobacter pylori infection delays mucociliary clearance in the nose

Chronic rhinosinusitis is not uncommonly a difficult condition to treat and therefore any possible association of this condition with factors outside the nose and sinuses is the subject of worthwhile research. Impairment of mucociliary clearance is paramount to upper respiratory...

Active middle ear implants and bone-anchored hearing systems

The implantable hearing device market has grown significantly over recent years. But as conventional hearing aids improve and cochlear implant candidacy widens, what is the role for active middle ear implants and bone anchored hearing systems, and how should we...