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Why is a Raven like a writing desk? Some reflections on countertenors and castrati

The countertenor voice has seen a resurgence in popularity in the last 50 years. Nicholas Clapton is one of the foremost performers and teachers of his generation, and he tells us here about the link between countertenors and the (fortunately...

Recurrent respiratory papilloma treatment in the office

In this interesting new article, Markus Hess and Susanne Fleischer describe their technique for managing recurrent laryngeal papillomatosis in an outpatient setting using channelled endoscopes. The recurrent respiratory papillomatosis (RRP) of the larynx is a chronic HPV-associated viral disease. Clinical...

To drain or not to drain

These two separate papers neatly tie together the same ideas. The first, a retrospective study of 107 patients and 116 procedures over a 10-year period who underwent a CSF leak repair, 82.2% without a lumbar drain and 17.8% with. The...

CSF leak – endoscopic or open repair?

Cerebrospinal fluid (CSF) rhinorrhoea is well known to the ENT surgeon. It commonly occurs secondary to a predisposing event such as accidental or iatrogenic trauma. When it occurs spontaneously, it can be associated with benign intracranial hypertension. The commonest CSF...

Muscle tension dysphagia: an underdiagnosed problem

In this article, the authors introduce the description of swallowing problems which have been recently attributed to muscle tension dysphagia (MTDg). The authors are clear that this is a diagnosis of exclusion, and it is important to rule out other...

Bile acids and pharyngeal malignancy

Laryngopharyngeal reflux is a commonly described condition. There is strong evidence linking gastro-oesophageal reflux with oesophageal carcinomas. Gastric refluxate consists of gastric acid, pepsin and bile acids. The roles of pepsin and acidic conditions in the development of laryngopharyngeal carcinoma...

The theory of everything (tonsil)?

Tonsil sepsis can manifest as acute tonsillitis, a peritonsillar abscess (PTA) or rarely as an intra-tonsillar (ITA) abscess. Whilst the management of these conditions is familiar to ENT surgeons from early in training, perhaps little attention has been paid to...

Laryngeal Cancer: Clinical Case-Based Approaches

This book, published by Thieme, provides a lot of information in a compact size. I enjoyed reading the book as it has an international list of authors and contributors from South America, USA, Europe and Asia which gives it an...

Laryngeal Function and Voice Disorders

This is a detailed, 323-page resource covering laryngeal function and voice disorders, basic science and clinical assessment. Spanning nine chapters, the authors cover the anatomy and physiology of phonation, survey of voice disorders, voice diagnostics, acoustic analysis, aerodynamic analyses, endoscopy...

Should we reconsider induction chemotherapy in advanced stage laryngeal cancer?

Use of chemo-radiotherapy for advanced laryngeal cancer led to a major shift in treatment as an alternative to total laryngectomy. Despite widespread adoption of chemoradiotherapy, survival rates have not improved and the original premise of matching neoadjuvant chemotherapy tumour response...

Unilateral vocal cord mobility impairment and laryngopulmonary physiology

The concept of iatrogenic recurrent laryngeal nerve injury following thyroid surgery is often considered with respect to voice change but its potential impact on airway physiology has thus far not been evaluated. A cross-sectional observational study reviewed 21 patients with...

Laryngeal cleft in a 66-year-old man!

This is a fascinating case report of a 66-year-old man who presented with a carcinoma of the piriform sinus. During chemoradiotherapy, he developed dyspnoea, dysphagia and aspiration pneumonia. His chemoradiotherapy was stopped and he underwent a pharygnolaryngectomy. When the surgical...