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Transnasal oesophagoscopy (TNO) and balloon dilatation under a local anaesthesia

Many of us are becoming more and more familiar with the use of transnasal oesophagoscopy. It has a number of well-described uses in the outpatient setting and is well tolerated by our patients. Yakubu Karagama describes taking this technique a...

Demystifying laryngology in the era of examination and collaboration

In the field of laryngology, perhaps more than in any other area of ENT, there has been a philosophical shift (as well as a technological one) in the approach of clinicians caring for patients. Albert Merati explains. Progress in laryngology...

Ear, nose and throat surgery in children – where will it be in 15 and 50 years?

Michael Kuo, David Albert and Mike Saunders have put their collective heads together to predict the future of ENT surgery in children; will there be a rise in workload due to increasing survival of children with complex medical problems? Or...

Double suspension sutures for obstructive sleep apnoea

This study examines the benefit of an operation that targets the lateral pharyngeal wall. The double suspension sutures are, in essence, a suture through the palatopharyngeus muscle which is then tied around the hamulus in the retro molar area. This...

What characterises dysphagia in unilateral vocal fold impairment?

The closure of the vocal folds during swallowing is known to contribute to airway protection along with epiglottic inversion and closure of the false vocal folds. It is therefore plausible to expect that unilateral vocal fold impairment without complete closure...

Does the appearance, texture, and flavour of food affect how we swallow?

Texture modification and the use of thickened fluids are well-known strategies used to facilitate swallowing in people with dysphagia. However, some controversy exists around thickeners and their possible negative impact on hydration and medication absorption. This paper considers other properties...

Does vocal tremor lead to changes in swallowing function?

Vocal tremor (VT) is a debilitating problem, but remains challenging to treat. Its pathophysiology remains indeterminate and there is a lack of consensus on phenotypes. Clinically, VT is often noted to be present in muscles outside of the larynx, including...

Guidelines on COVID-19 published by Asia Pacific Laryngology Association (APLA)

Due to a vast geographical spread with diverse socio-economic conditions in the Asia Pacific countries, APLA Founding Chair, Vasant Oswal, President, David Lau, and Secretary, Vyas Prasad decided to publish guidelines on COVID-19 in the form of an ‘International Consensus',...

Laryngeal evaluation during COVID-19 using transcervical ultrasonography

In light of the COVID-19 pandemic, the authors highlight their protocol of transcutaneous laryngeal ultrasonography as an alternative to flexible fibreoptic laryngoscopy when appropriate. This is to reduce the risk of aerosolisation posed by laryngoscopy. Ultrasonography is a rapid, non-invasive...

Dysplasia at the margins of laryngeal cancer specimens following laser resection – is conservative management appropriate?

Transoral laser microsurgery (TOLM) remains the cornerstone of treatment for early laryngeal squamous cell carcinomas. Whilst the hope is always to achieve a complete surgical excision with clear margins, it is sometimes the case that on histological analysis, disease is...

Destination unknown

We as doctors do not always know the answer. Associate Professor Jacqueline Allen guides us through the importance of acceptance of this uncertainty and its complex mental journey. She highlights that, as clinicians, we must embrace the unknown and be...

Benefit of prolonged voice rest following phonosurgery

The recommendation for voice rest following surgery is not agreed amongst surgeons, regarding either the type of voice rest (absolute or relative) or the optimal duration. In this ongoing study, 31 elective patients operated on for benign laryngeal lesions were...