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Finding the elusive parathyroid glands
While reading in the literature about new advances in knowledge and surgical techniques, it is often easy to lose track of the longstanding knowledge that we all acquired during our training. This is why this article on the anatomy and...
Is bone cement a cost-effective solution?
This study looks at the functional results of 52 patients who underwent bone cement ossiculoplasty. Patients were divided into four groups based on ossicular disruption. Group 1 (30 patients) had lenticular erosion only. Group 2 (13 patients) had absent incus....
Outpatient closure of CSF leaks: a good idea or a step too far?
After day-case septoplasty, day case thyroidectomy, now day case CSF leak repair – has the pendulum moved too far? The authors put forward a convincing case for what, only 10 years ago, would have sounded like a provocation. They quote...
Cystic fibrosis – sinus surgery delays chronic Gram-negative lung infection
This prospective clinical follow-up study is of 106 patients with cystic fibrosis in Copenhagen. Morbidity and mortality in CF are significantly associated with pulmonary colonisation and infection, usually with Gram-negative bacteria. Initially this can be well treated with antibiotics until...
Role of sentinel lymph node biopsy in managing papillary thyroid cancer
Although studies have shown that the presence of lymph nodes metastases in papillary thyroid carcinoma does not alter survival, other studies have shown that it increases morbidity and mortality and that the presence of cervical lymph node metastasis at diagnosis...
Deep space neck infections – salivary gland as source is commoner in elderly patients
Whilst deep space neck infections (DNI) can originate from many sources, dental and salivary glands are commonly the culprit. This paper details 44 patients treated for deep space neck infections originating from salivary gland and compares them to a previously...
Marshmallows for swallowing assessments!
The complaint of ‘food sticking in my throat’ is one many of us will have heard several times in clinical practice. The authors of this study report the prevalence of this symptom to be between 5-8% in the general population...
Incidental thyroid nodules: should we observe or operate?
Thyroid nodules are extraordinarily prevalent, detected by physical examination in 7% and by imaging studies in 67% of the population. Although most of these nodules are benign, up to 20% are found to be malignant on excision. It’s a very...
Use of topical steroids and antibiotics, compared to systemic antibiotics in the treatment of acute rhinusinusitis
Acute rhinusinusitis is mainly initiated by viral infections. Bacterial infection is usually superadded. The inflammatory cascade upregulates the pro-inflammatory mediators resulting in pain, nasal obstruction and nasal discharge. Local application of steroids and antibiotics could provide a higher concentration of...
Voice therapy is an effective treatment for presbyphonia
The quality of an individual’s voice often declines with age. This deterioration occurs firstly as a result of vocal fold atrophy secondary to histologic alteration of the vocal fold mucosa as well as atrophy of the laryngeal musculature. Phonatory efficiency...
What is the evidence for contralateral tonsillectomy in TORS for known unilateral tonsil malignancy?
The concept of field changes by carcinogens within the upper aerodigestive tract is well established with reported rates of synchronous tumours of 4% and second primaries of 36%. The tonsil in particular has the highest rate of synchronous tumours, postulated...
