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Patient factors associated with spontaneous CSF leak

This article highlights the role of obesity, sleep apnoea and raised intracranial pressure as linked pathologies in the aetiology of the spontaneous cerebrospinal fluid (sCSF) leak. The authors link sCSF leak with obesity and comment on sCSF leak incidence increasing...

Narrow band imaging in laryngopharyngeal reflux

Narrow band imaging (NBI) is a tool on the Olympus endoscopic systems that uses blue and green wavelengths to enhance visualisation of mucosal vasculature. It has been used to aid in the early diagnosis of upper aerodigestive tract cancers. A...

Speech in noise hearing difficulties

The phenomenon of speech understanding in noise in normal hearing people attracts the interest of researchers continuously. This study’s aim was to further explore the possible reasons behind these difficulties. The participants were 50 adults that reported having normal hearing...

Hierarchy of orthognathic surgical stability

This study was designed as “an overview” of secondary studies and analysed 15 articles. Two procedures were considered highly unstable: a bilateral sagittal split osteotomy for clockwise rotation of the mandible with bi-cortical screw rigid internal fixation, and posterior maxillary...

Bright young things: executive functioning in younger, older and aphasic people

Executive function comprises several higher order cognitive processes such as planning, organisation, adaptation, maintenance, monitoring and decision making. It is thought that difficulties in cognitive flexibility in people with aphasia are associated with difficulties in executive function rather than the...

Diagnosing complications of acute mastoiditis in emergency situations

In many cases, acute mastoiditis is manageable with intravenous antibiotics and hospitalised care. However, the decision whether to intervene surgically remains crucial and reliance is based on radiological findings – CT scans for bony changes and MRI for possible intra-cerebral...

Is posterior epistaxis really ‘posterior’?

In absence of any clear bleeding points seen on the septum, it is generally presumed that the epistaxis is posterior, especially when simple cauterisation of the septum does not help and may progress to sphenopalatine ligation. In this publication, the...

More than words: looking at all the evidence

Evidence based practice (EBP) is a three-pillared approach whereby information on the research evidence, factors relating to the patient and clinical experience are all considered to inform a care decision. Unfortunately, there is frequently very little research evidence to inform...

Thoughts on war: von Clausewitz revisited

We few, we happy few, we band of brothers; For he to-day that sheds his blood with me Shall be my brother; be he ne’er so vile, This day shall gentle his condition: And gentlemen in England now a-bed Shall...

Endoscopic middle ear surgery for cholesteatoma treatment

A critical question when any new technique is proposed is ‘does it work?’ In this article Daniele Marchioni and Davide Soloperto discuss the success rates of endoscopic ear surgery for cholesteatoma. Introduction Surgical management of cholesteatoma is still a controversial...

10 steps to improving transition to adult services

Children and parents like the reassurance that staying under the care of the team who looked after them from birth gives, but as the child approaches adulthood he / she must come under the care of a new team. This...