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Tricky post-laryngectomy swallows

Despite improvements in chemoradiation therapy and the adoption of organ preservation for some head and neck cancers, total laryngectomy remains the treatment often providing best survival chances for advanced laryngeal cancer. This article reviews the causes of dysphagia post-laryngectomy and...

Thyroid nodules in children

Whilst 5% of nodules in adults may harbour malignancy it is reported in this review that about a quarter of nodules may do so in children. Malignancies in this group are almost always well-differentiated subtypes of papillary, follicular and medullary...

Is there a need for magnetic resonance imaging six-month post-radiosurgery for vestibular schwannoma?

With advances in imaging and radiation technologies, small, slowly growing vestibular schwannomas (VS) are treated primarily with either observation or stereotactic radiosurgery (SRS). Routine magnetic resonance (MRI) scans with gadolinium are obtained six months and one year after SRS in...

Swallowing it whole: the physical and psychological consequences of dysphagia

Living with dysphagia in the real world can be extremely challenging, both practically and psychologically. Long-term changes in taste due to chemo-radiation treatment for head and neck cancer, fatigue due to Parkinson’s disease, and physically impaired structures due to stroke...

Does Koos classification predict facial nerve dysfunction?

The Koos classification is a grading system used often for preoperative evaluation of acoustic tumours on imaging studies. It indirectly correlates to the size of the tumour. Size of the vestibular schwannoma is often considered the main determinant for hearing...

How best to follow up a sinonasal cancer?

Sinonasal malignancies are rare tumours and, in the UK, are usually treated in tertiary treatment centres but may well be followed up long term in the patient’s local hospital, so advice on how best to manage these patients is invaluable....

Effect of swallowing exercises following free flap for oral cancer reconstruction

This paper from Beijing looked at 68 patients, 34 in a control group and 34 in an intervention group. Oral exercise training was performed by a specialist swallowing nurse in the intervention group. They found that personalised oral exercises had...

Balloon dilatation of the eustachian tube - largely very safe but not entirely without risk

Consent is a fundamental part of our daily working lives. This is something as simple as consent to examine a patient, consent to undertake a procedure as minor as taking blood, through to consent for a major operation. Whatever the...

JLO surgical video: right selective neck dissection levels 2-5

Surgical training has become more challenging following the introduction of the European Working Time Directive. The consequences of reducing the amount of time we operate has driven us to look for other resources to fill this gap. These initially began...

Is major ear surgery financially viable?

It is difficult to ignore the present reality in the NHS that understanding clinical coding is perhaps of more relevance to the practising clinician than the human genome! Clinician engagement is becoming more essential to protect patient care and maximise...

The applicability and reliability of SHIMP, a new vestibular test, in adolescents

The video head impulse (now called the head impulse paradigm – HIMP) is now a routine test battery in neuro-otological practice. Few will be familiar with the new suppression head impulse paradigm (SHIMP) test. The key difference is that, in...