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When you regret an implant!
Cochlear implants (CIs) offer a solution to hearing loss not helped by conventional hearing aids. CIs help in improving speech recognition scores. While significant, it is not sufficient to provide satisfaction in some implantees. Alignment between expectations and realistic outcomes...
The push towards scarless parotid surgery
When dealing with benign parotid pathology, high expectations are placed on the operating surgeon to preserve key neurovascular structures, especially the animating facial nerve, through meticulous dissection. With time, there has been a greater emphasis on improving cosmesis in parotid...
THRIVE: redefining airway management in endoscopic oesophageal surgery
Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) is no longer just a tool to help anaesthetists secure a difficult airway. Thanks to the work of authors like Yang and colleagues, it is being revolutionised to provide apnoeic oxygenation during endoscopic...
COVID-19 and dysphagia in critically ill patients: a reflection of some findings
Dysphagia was a common occurrence in patients admitted to intensive care units (ITU) during the pandemic. This paper explores data from 26 ITUs over 12 months during 2020-2021. Findings from 235 patients admitted with Delta and subsequent Covid variants who...
Diurnal and monthly variations in secondary post-tonsillectomy haemorrhage rates
Several studies have looked into variable haemorrhagic rates with different methods of surgery and clinical backgrounds. Few have looked into non-clinical factors such as environment and diurnal influence on occurrence of post-tonsillectomy bleeding. This extensive study comprises 5357 tonsillectomy patients...
Adenoid cystic carcinoma – insights from a national database
Adenoid cystic carcinoma (AdCC) is a rare cancer of the salivary glands that accounts for approximately 1% of all head and neck malignancies. Hallmarks of this cancer type include a predilection for perineural infiltration, a prolonged clinical course with late...
Systemic steroids for sensorineural hearing loss
This Japanese retrospective study looked at whether the dosage of prednisolone affects the response rate in patients with idiopathic sudden sensorineural hearing loss. The authors included a total of 159 patients over a 14-year period who were treated with 200mg/day...
Reducing pulse rate in videofluoroscopy: less is not best!
Recently, there has been increasing discussion in clinical meetings about the use of ionising radiation in swallowing assessments and the associated cancer risks. This is therefore a timely publication to inform discussions around whether reducing pulse rate from 30 pulses...
How are swallowing and voice affected following anterior cervical discectomy and fusion (ACDF)?
Anterior cervical discectomy and fusion (ACDF) requires an anterior transcervical approach (ACA) to allow decompression of the cervical spine and nerve roots. This approach is also occasionally used for corpectomy and osteophyte removal. Key neurovascular structures related to swallowing and...
How rare is vocal fold paralysis after spinal and epidural anaesthesia – should we be more concerned?
The authors present an unusual case of right vocal fold paralysis. Their patient was a 38-year-old woman who experienced new onset dysphonia following neuraxial anaesthesia (NA) for a caesarean section. Flexible nasendoscopy showed a right VFP with fixation in the...
Intra orbital treatment to save the eye!
Invasive fungal sinusitis can be a devastating condition, and accepted management is surgical debridement of infected tissue, systemic antifungal treatment and reversal of immunosuppression. Orbital involvement is common, affecting up to 75% of cases, and in advanced disease orbital exenteration...
