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Allergy – what’s in a name?

Allergy is defined as an “abnormal immune reaction to an ordinarily harmless substance” [1], however the meaning of the word has taken many forms since its introduction in 1906 by Austrian Paediatrician and Immunologist, Clemens von Pirquet [2]. Combining his...

TORS for patients with sleep-disordered breathing

Transoral robotic surgery is now a well-accepted technique in malignant tumours of the tongue base. Here the team from St Mary’s and the Royal National Throat Nose & Ear Hospital in London describe its use in carefully selected patients with...

What’s happened since the European position paper on nose and sinus tumours?

The management of malignant sinonasal tumours has gone through radical changes in recent years. Prof Valerie Lund gives us an update based on her upcoming talk at IFOS. In 2010 when we published the European position paper on ‘endoscopic management...

Ear wax: the good, the bad, and the ugly

With ear wax removal being a core part of ENT and audiology services, Seth Schwartz gives us his dos and don’ts. We have all seen cartoons where a character pulls enough wax out of their ears to make a candle....

Do endonasal approaches for meningiomas have more CSF leaks?

Rarely, patients presenting to the ENT surgeon with anosmia may have an anterior skull base neoplasm such as a meningioma. Historically, the traditional approaches have focused on several transcranial, external routes, including the pterional craniotomy, and the subfrontal craniotomy. The...

Surgical challenges in advanced or recurrent thyroid malignancy

The management of thyroid malignancy and extent of surgery is controversial, especially considering the limitations of preoperative diagnosis. Neil Tolley provides guidance and reminds us of our responsibility not to over-treat. In the UK, 16% of thyroidectomies are performed for...

Delirium post-op

This is a retrospective study from Japan analysing 102 patients who underwent oral cancer resection and free flap reconstruction. Postoperative delirium occurred in a third of these patients. An increased risk was identified in those with high preoperative albumin, postoperative...

5-cm incision for neck dissection and free flap reconstruction

Patients with oral cavity squamous cell carcinoma (SCC) will commonly require neck dissection as it is associated with a higher rate of overall and disease free survival. Free flap reconstruction of the defect following surgical resection is considered the gold...

Global health missions – not just for consultants. A guide for trainees.

Lulu Ritchie is a courageous and driven trainee in London, inspired by humanitarian missions but conscious of the usual requests for consultant level doctors. Lulu didn’t let that hold her back. She found a way and has kindly summarised her...

Staphylococcus aureus as a cause of refractory chronic rhinosinusitis

Staphylococcus aureus has long been linked to chronic rhinosinusitis, particularly recalcitrant cases. In this article, Alkis Psaltis describes how newer techniques have shown higher rates of S. aureus infection than were previously thought, and explains how the bacteria are able...

Using the Ling-Madell-Hewitt (LMH) Test Battery

Why change a classic? Because of new knowledge and improved technology, of course! Drs Hewitt and Madell present an update to Daniel Ling’s classic speech test. One of Daniel Ling’s legacies is the Ling Six Sound Test which presents six...

McIsaac scores in tonsillitis

Acute tonsillitis is usually caused by a viral infection, however often antibiotics are prescribed without a confirmed diagnosis of a bacterial infection. The Modified Centor (McIsaac) criteria, which include fever (>38°c), tonsillar exudate, no cough, anterior cervical lymphadenitis and age,...