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Measuring the ‘impact’ of preoperative immunonutrition

Using preoperative nutritional supplements as part of ‘enhanced recovery’ in surgical patients is not a new concept. This interesting paper looks at the latest development in optimising patients undergoing head and neck oncological surgery. Immunonutrition (Nestle’s ‘Oral Impact’ in this...

Combined endoscopic and transcutaneous approach for removal of parotid stones

The authors describe a small case series (n=8) of patients with obstructive symptoms from sialolithiasis of the parotid gland. A combined endoscopic and transcutaneous approach was used. The position of the stone in Stensen’s duct was identified by endoscopic transillumination....

Gardasil vaccination – an effective adjuvant therapy for RRP?

The clinical manifestations of recurrent respiratory papillomatosis (RRP) can vary hugely from individual to individual. Whilst some affected children will outgrow the disease, a subset of patients will experience frequent recurrences and require multiple surgical procedures over the course of...

Experience of the Sophono transcutaneous bone conduction system

This article is a frank discussion of the authors’ experience implanting these devices. The principle of the device is surgical implantation of a bilobed magnet within a bony well in the cranium (similar position to BAHA). The implant is a...

Consider PCR testing in culture negative necrotising otitis externa

Necrotising otitis externa (NOE) often does not yield identification of a causative organism to treat although in 90% of cases it is a member of the pseudomonas species. The incidence of fungal NOE is not to be forgotten and this...

Random-pattern skin flaps: part 2 - rhomboid and bilobed flaps

In the second of our series on local skin flaps (see Part 1 here, Part 3 here and Part 4 here), the authors describe more techniques and examples of various skin flaps that trainees should find very interesting. Rhomboid flap...

Scott-Brown’s Essential Otorhinolaryngology, Head and Neck Surgery

The three-volume Scott-Brown’s Otorhinolaryngology Head and Neck Surgery is arguably the definitive encyclopaedia of ENT. Its comprehensive nature, however, limits its utility when preparing for examinations. The authors, in creating an “essential” version, have managed to produce an ideal textbook...

Coupler microvascular anastomoses: how good?

This paper is written by a group of reconstructive surgeons and a school of computing. The study used computational fluid dynamics to model blood flow through idealised sutured and coupled vessels, to investigate if differing anastomotic techniques affect intravascular blood...

Counting up discourse

Speech and language researchers and health professionals alike strive to measure communication abilities using relevant and psychometrically sound tools. Discourse measures are potential tools which reflect everyday communication more accurately than other more traditional measures. However, time has been a...

Back to the future: aphasia therapy post stroke

When speech and language therapist first started working with people with stroke-related aphasia, they employed a general stimulation approach, the same with every patient they met. In the '70s this changed, and a more tailored approach was developed whereby therapists...

Cochlear implant use in young children

There are clear and well-established links between those identified and fitted with amplification early and good spoken language outcomes, but how much does the time an appropriately fitted hearing instrument is used each day contribute to this? During the first...

Those little friends in our noses

Human microbiota plays an important role in both health and disease including metabolism, immunomodulation, and a potential role in chronic inflammatory conditions such as chronic rhinosinusitis (CRS). The authors aimed to investigate the sinonasal microbiome using 16S rRNA gene sequencing...