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Modified barium swallow studies: what is the radiation risk?

A modified barium swallow study (MBSS), also called a videofluoroscopy swallowing study uses ionising radiation to assist the clinician in visualising swallowing biomechanics from the oral cavity to the oesophagus. This procedure is currently one of the best methods used...

Electronic nicotine delivery systems (e-cigarettes): what you need to know

As an aid to stopping smoking e-cigarettes may have a role, but they are heavily promoted by industry as a leisure pursuit and desirable fashion accessory. Sneh Biyani and Craig Derkay gives a thorough account of what we know about...

The ‘umbrella furling’ deflation technique for cuffed tracheostomy tube - a useful tip for an easier tracheostomy insertion

In this article, the authors describe a quick and effective technique to assist with the maximal deflation of a tracheostomy tube cuff prior to insertion, thus making the process easier with less chance of damage to the cuff and a...

Should human beings sleep in the prone position?

Are we poised for a ‘sleep prone’ campaign to reduce nocturnal apnoeas? Prof Armin Moniri presents a fascinating account of how sleeping position can affect obstructive sleep apnoea. Inspired by sleeping position of other mammals, a new mattress and pillow...

In conversation with Harvey Coates

Indigenous health would remain a Cinderella part of our speciality were it not for the work of a few outstanding pioneers. Kelvin Kong speaks to one of them: Professor Harvey Coates AO. Harvey Coates is a paediatric otolaryngologist and clinical...

Alive - an alternative anatomy

Gabriel Weston studied English as a first degree, and then trained in medicine. She entered an ENT registrar training programme and was then offered a book deal, so continued her clinical practice whilst writing. She subsequently appeared extensively on BBC...

A new biomarker for chronic rhinosinusitis

This Chinese study looked at the feasibility of periostin (usually found in bone and lung tissue) as a biomarker for chronic rhinosinusitis. They sampled ethmoid mucosa in 12 patients with chronic rhinosinusitis without nasal polyposis (CRSsNP) and 25 patients with...

Unilateral vocal cord mobility impairment and laryngopulmonary physiology

The concept of iatrogenic recurrent laryngeal nerve injury following thyroid surgery is often considered with respect to voice change but its potential impact on airway physiology has thus far not been evaluated. A cross-sectional observational study reviewed 21 patients with...

How do we manage immune deficiency-related ENT disorders

It is not unusual to come across patients with recurrent sinonasal infections, lung infections and recurrent ear infections needing regular antibiotics in the outpatient setting. Physicians need to have a high index of suspicion that patients may have immune deficiency...

Bone anchored implant stability predicted one week after implantation

Bone conduction (BC) devices can now be implanted as a single stage procedure with minimal soft tissue thinning to reduce the complications in the surrounding skin. The question of optimal loading time has to my mind not been answered. Here...

Consider PCR testing in culture negative necrotising otitis externa

Necrotising otitis externa (NOE) often does not yield identification of a causative organism to treat although in 90% of cases it is a member of the pseudomonas species. The incidence of fungal NOE is not to be forgotten and this...

A funny thing happened on the way to a conference – and other stories

This series of stories is dedicated to those of you with whom some of these moments were shared (or endured) and, above all, to my amazing and long-suffering husband, David Howard. Most of you know him as an exceptional head...