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I saw it on the internet: gathering evidence for clinical decision making

Evidence-based practice is often described as the integration of three sources of information to inform clinical practice, namely: 1) research evidence/practice guidelines; 2) client preferences/needs, and: 3) clinical experience. Speech and language therapists have reported a lack of time and...

Modifying two-week wait protocol for suspected head and neck cancer patients during COVID-19

As healthcare workers, we are committed to ensuring that our patients continue to receive the optimum care that we are set up to deliver. However, the last year has shown that we need to be mindful of balancing this with...

Elasticated retraction in head and neck surgery – a trainee’s perspective

The effectiveness of surgical technique and satisfactory outcome is greatly dependent on good surgical exposure. Retraction requires adequate traction and counter-traction of tissues in order to expose the tissue or organ under scrutiny for the surgeon. This is a universal...

Outcomes after facial nerve preservation surgery for large vestibular schwannomas

Large vestibular schwannomas (Koos grade three or four) are traditionally treated by surgical resection. Gross total resection of such large tumours often results in facial nerve dysfunction. Hence facial nerve preservation surgery was introduced in which maximal surgical resection is...

Chronic rhinosinusitis management: back to the future?

Immunology is a dim and distant medical school memory to many ENT surgeons, but the increasingly complex immunology of chronic rhinosinusitis is fascinating (honestly!). Medical management options in CRS no longer just involves saline and steroids, and we need to...

Progress of head and neck surgery in China over the last 20 years

Although China was late to establish head and neck surgery in comparison to other areas of oncological surgery, with the persistent hard work of head and neck surgeons nationally, it has progressed significantly during the last two decades. Yueying Ma...

The role of the maxillo-facial surgeon in the management of skull base malignancy

Whilst ablative surgery remains the principal treatment option for head and neck malignancy, the skull base is the last frontier. The complex anatomy, supreme functionality of the brain, and varied pathology provokes many a detailed discussion in the multidisciplinary team...

A twitch in time with a flicker of knowledge

The middle ear muscles can be seen as one of the ear’s safety mechanisms, and the interplay between eyes and ears has been established; think vestibular ocular reflex (VOR) or semi-circular canal dehiscence (SCCD). But can this protective mechanism be...

Preoperative prediction of pain outcomes in patients with trigeminal neuralgia

The authors of this retrospective study have developed a preoperative trigeminal neuralgia (TN) grading system for the preoperative prediction of long-term pain relief after microvascular decompression (MVD). Patients who had become refractory to or developed toxicity to carbamazepine or oxycarbamazepine...

Resection margins in head and neck surgery

Although an increasing proportion of head and neck malignancies are treated with non-surgical modalities, when surgery is undertaken an incomplete clearance results in significantly worse prognosis. However, the intraoperative assessment of an adequate margin is difficult. The personal practice of...

Gastric inlet patch – an under-diagnosed cause of globus

A gastric inlet patch (GIP) is an island of heterotopic gastric mucosa found commonly in the proximal oesophagus just below the upper oesophageal sphincter. It is often underdiagnosed due to its location. Its importance and clinical relevance can be underestimated...

Psychogenic vestibular disorders: understanding and management

‘Psychogenic vestibular disorders’, also known as ‘functional vertigo and dizziness’, are common causes of dizziness and balance difficulty. Although our understanding of their underlying pathophysiology remains incomplete, Drs Diego Kaski and Amy Edwards outline how early identification and positive diagnosis...