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A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth
It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...
Does cholesteatoma surgery affect school performance?
While much focus has been placed on short-term complications associated with cholesteatoma, a lack of knowledge remains about the impact suffering from cholesteatoma in childhood may have on educational outcome. The aim of the study was to investigate whether suffering...
Myringoplasty in a bottle?
Management of large traumatic TM perforations can involve observation and water precautions or surgical repair. Closure rates for larger perforations can be 8-12 weeks and occurs for between 38-79%. Animal and human studies have shown that exogenous application of epidermal...
What can we tell about swallow physiology from a bedside clinical assessment?
Knowledge about swallowing physiology has greatly increased with the use of instrumental assessments such as videofluoroscopy (VFS). The authors of this paper performed an analysis of data obtained from 60 stroke patients who were assessed via a clinical swallow examination...
Preoperative imaging for thyroid cancer according to 2015 ATA guidelines
The 2015 American Thyroid Association (ATA) management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer suggest that thyroid sonography with survey of the cervical lymph nodes should be performed in all patients with known or suspected thyroid...
Preoperative risk factors: when do you need to refer to the haematologist?
It is essential that clinicians are able to identify and assess which patients are in the high risk category for bleeding during ENT surgery. A full history, including medications, herbal remedies taken, any other medical co-morbidities and family history of...
In-office KTP laser excision of a vocal process granuloma
The KTP laser is increasingly being used in an outpatient setting – particularly in North America – to treat various laryngeal pathologies including papillomas, leukoplakia, dysplasia and vascular lesions. This article reports the use of the KTP laser in the...
Cochlear implantation in SSD
There are currently several trials for cochlear implantation (CI) in single-sided deafness (SSD) being undertaken to answer some of the questions this paper from New York raises. Who is best suited to receive one? What are their outcomes and how...
Darn it! It’s going to take longer to get good at stapes surgery!
Traditionally, it has been said the learning curve for a particular operation lies between 20 and 30 cases. In stapedotomy, a surgeon is deemed successful and perhaps competent if closure of the air-bone gap (ABG) is reached to within 10dB...
Nasal steroids do not cause ocular problems
This excellent, high quality and detailed systematic review from Australia dispels the myth propagated recently by some poorly designed studies that intranasal corticosteroids cause intraocular problems. A 40 year review of the usual databases found 665 articles and 19 were...
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...
