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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...

Remembering how to speak

Reminiscence therapy (RT) is an approach that provides people with dementia opportunities to recount nostalgic memories and access thoughts for communication. It is one of the most commonly used therapies in aged care settings. The aim of RT is to...

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,...

Commentary: dementia, hearing loss, and the danger of professional rabbit holes

The Lancet, a world-leading general medical journal, has a global impact. Its commissioned report into dementia prevention, intervention and care has been cited over 6000 times and has further been reviewed and updated in 2020 and now 2024. Here, Profs...

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...

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....

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...

Keep the condyle if you can

This is a study of 41 patients who underwent benign tumour resection and reconstruction over a four year period. Patients fell into three groups; condyle preserved, condyle sacrificed, condyle frozen in combination with a DCIA free flap. Following this, they...

Which da Vinci surgical system? Novel flexible, single-port versus current multiport, rigid-arm robotic surgical system

The da Vinci robotic surgical system has transformed how oropharyngeal head and neck surgery can be delivered. The existing da Vinci Si model has challenges: the dimensions of this are larger than would be ideal for head and neck surgery...

Panetti Endoscopic Ear Instruments

Giuseppe Panetti is a renowned otologist and one of the forerunners of endoscopic ear surgery. One of his major contributions to ENT has been through designing bespoke equipment to assist in some of the challenges of operating endoscopically. In this...