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Learning curve for sialendoscopy

Sialendoscopy represents a minimally invasive technique that permits direct salivary tree visualisation and treatment using endoscopic techniques. Previous studies have shown that it is an efficacious, safe and potentially gland preserving method to treat major salivary gland disease. However, it...

Isshiki Thyroplasty Type 2

Indication Adductor spasmodic dysphonia is a neurological condition of unknown aetiology. The symptoms are believed to be caused by involuntary contraction of the adductor muscles of the vocal cord as a result of an abnormality of neurotransmitters in the basal...

Erasmus Darwin and the larynx – but why is it where it is and when?

Charles Darwin’s grandfather was not only on to where we all came from by the end of the 18th century, but dared to declare it in verse whilst resident in Lichfield Cathedral Close. This needed exceptional temerity, since not only...

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...

Down with the nose, down with it flat

In Shakespeare’s Timon of Athens, Timon urges prostitutes to spread syphilis throughout Athens. He implores the whores, Phrynia and Timandra, to: Consumptions* sow In hollow bones of man; strike their sharp shins,And mar men’s spurring*. Crack the lawyer’s voice**, That...

SoundPrint: an app for finding quieter restaurants

"Is there any chance the music could be turned down a bit”, I asked our server politely on a rare evening out with my husband. We had spent the previous half-hour shouting at each other, only to have the other...

Middle ear reconstruction in children: why, when and how

Every ear in every child is different. Rob Nash discusses the rationale behind reconstructive ear surgery in children and his philosophy on timing and techniques of reconstruction. It is rare for middle ear pathologies to be life threatening. Indeed, it...

To make a difference

Education and training have a key part to play in the development of leaders of the future; Dorte Hammershøi discusses the educational approaches taken in Denmark and the pros and cons of the methods used. Dorte also explains the BEAR...

Biologic therapies for chronic rhinosinusitis with nasal polyps: a new paradigm

Surgery for nasal polyposis has evolved significantly in the last 30 years, and now the medical management may be on the cusp of a revolution. Biologics using monoclonal antibodies to target specific immune pathways have introduced a paradigm shift in...

Why hearing above 8 kHz matters more than you think

This review explores the significance of extended high-frequency hearing loss (above 8 kHz) and why it may be worth doing clinically more frequently. There are many conditions that may hide underneath a normal audiogram, and one of the easiest to...

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...

Why is a Raven like a writing desk? Some reflections on countertenors and castrati

The countertenor voice has seen a resurgence in popularity in the last 50 years. Nicholas Clapton is one of the foremost performers and teachers of his generation, and he tells us here about the link between countertenors and the (fortunately...