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Increasing tongue strength to reduce dysphagia: what is the potential benefit of a device driven exercise?
Weakness in tongue muscle strength and laryngeal elevation is known to have an adverse impact on swallowing function. Various swallowing exercises are often recommended to improve function of these important structures with the goal of preventing aspiration and improving swallow...
The polyp shrinker
Inflammatory markers, including T2 cells beta common (βc) cytokines IL-3, IL5 and granulocyte-macrophage colony-stimulating factor (GM-CSF), are known to play an important role in chronic rhinosinusitis with nasal polyps (CRSwNP). CSL311, a monoclonal antibody (mAb), was developed to target human...
Active smoking predicts poor outcome in HPV positive oropharyngeal squamous cell carcinoma
Tobacco smoking is a well-known risk factor in human papilloma virus (HPV)-negative head and neck squamous cell cancer. Its effects include increased risk of treatment failure, distant metastases and reduced overall survival. HPV has been increasingly implicated as a causative...
The effects of paediatric tracheostomy
Paediatric tracheostomy is usually an essential procedure to preserve life, or to allow a patient to function in the community. However, the effect of tracheostomy on the developing child - care requirements, lack of voice, impaired swallow, constant risk of...
Prediction of morbidity and mortality in patients undergoing thyroid or parathyroid surgery
Major postoperative adverse events in thyroid or parathyroid surgery are uncommon. Various authors have developed risk indices to identify physical deficits in patients undergoing elective surgery. The literature is less clear about patients undergoing thyroid or parathyroid surgery. In this...
Thyroidectomy patient survey regarding voice outcomes
One of the common adverse effects following thyroid surgery is a change in voice, which may be related to iatrogenic injury to the recurrent laryngeal nerve or superior laryngeal nerve during surgery or by direct cancer involvement. The burden of...
What to do if adenotonsillectomy does not cure sleep apnoea in children?
This article reviews the management of children with persistent obstructive sleep apnoea (OSA) following adenotonsillectomy (AT). Risk factors for patients to have persistent disease include obesity, being Afro-Caribbean and existing co-morbidities such as craniofacial and neuromuscular disorders. Initial assessment of...
Allergic rhinitis, the usual suspects
Allergic rhinitis (AR) is characterised by allergen binding to IgE on mast cells and basophils and subsequent histamine, prostaglandine D2 (PGD2) and cysteinyl leukotrienes (cysLTs) release causing early-phase response. This is followed by late-phase response mediated by eosinophils. Other cells,...
Rhinotillexomania - how bad can nose picking get?
This is a fascinating first case report of rhinotillexomania associated with empty nose syndrome (ENS). Rhinotillexomania encompasses compulsive, pathological nose picking and is a variant of self-harm. Tranchito and Chhabra describe an elderly patient presenting with longstanding symptoms of nasal...
Treatment of incus lysis with hydroxyapatite bone cement
Middle ear implants provide a suitable alternative for some patients with a certain degree of sensorineural or mixed hearing loss, not wanting a hearing aid. Vibrant SounBridge® (VSB) middle ear implant (MEI), of Med-El®firm, is one such implant. In this...
Doing it for the people: how to do speech and language therapy
This review article distils 58 studies, collating information from people with aphasia, their families and clinical speech and language therapists summarising the seven habits of highly effective aphasia therapists. Habit 1: Effective therapists invest time in and prioritise relationships with...
