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Epistaxis and anticoagulants

The French Society of Otorhinolaryngology Head and Neck surgery issued some recommendations on the management of epistaxis in patients receiving anticoagulants, anti-platelet aggregants and anti-vitamin K drugs. This was a national multidisciplinary evidence-based concensus document. The group recommends review of...

Functional Endoscopic Sinus Surgery (FESS) - Part 2

In the first of this two-part series, Martyn Barnes and colleagues discussed indications for functional endoscopic sinus surgery (FESS), the surgical objectives and techniques, patient expectations and the risks of surgery [1]. In this second and final part, the authors...

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...

Inspiratory peak flow and tracheostomy

The evaluation of the degree of laryngeal obstruction to indicate a tracheostomy has always been a subjective decision. The authors correlated the visual laryngeal obstruction by flexible nasolaryngoscopy and the peak inspiratory flow using a pocket peak inspiratory flowmeter. Twenty-two...

Loss of smell in the age of COVID-19

Loss of smell (LOS) is a debilitating symptom with increasing interest for the medical community due to its high prevalence in COVID-19. In the present paper, a team of 15 experts provide recommendations for the investigation and management of patients...

Auditory brainstem implant results in adults and children

Background The auditory brainstem implant (ABI) has been developed from cochlear implant (CI) technology and is indicated for people who have anatomical abnormalities of the cochlea or dysfunction of the auditory nerve. The majority of people who have received an...

Predicting swallowing outcomes post radiotherapy for head and neck cancer

A videofluroscopic swallow study (VFSS), also known as modified barium swallow (MBS) offers a dynamic view of swallow biomechanics and associated swallowing physiology. The authors of this paper investigated whether quantitative timing and displacement measures of key structures involved in...

Role of cochlear implants in the management of incapacitating tinnitus in patients with unilateral hearing loss

This is an interesting paper on patients with unilateral hearing loss and incapacitating tinnitus. The present study was conducted on 23 patients who had a cochlear implant for unilateral hearing loss including patients with single sided deafness (SSD). Most of...

Salivary gland blues…

Intravenous methylene blue is a well-described method to assist in intraoperative localisation of parathyroid glands. The technique does come with challenges as anybody will know who has had to run adjacent to a theatre-bound trolley to ensure that the infusion...

Risks of tracheostomy in head and neck cancer

Tracheostomy is associated with several complications, with rates quoted as high as 8-45%, including: bleeding; displacement; obstruction; surgical emphysema; pneumothorax; fistulae and failure to decannulate. There are now many studies that confirm the increased length of stay and complications of...

Middle ear muscle disorders: presentation, diagnosis and management

Patients often report symptoms relating to disorders of the middle ear muscles. Prof Bance gives us an overview of the anatomy and function, as well as guides our diagnosis and management. The middle ear muscles (MEMs) are a mystery, both...

The Indian method: Sushruta’s influence on modern nasal reconstruction

Ancient Indian medicine, as documented in the Sushruta Samhita, contains one of the earliest known references to nasal reconstruction, including surgical techniques still resembling modern practices. (The Sanskrit word ‘Samhita’ is used to define a collection of written work, similar...