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New MRI technique assesses treatment response in skull base osteomyelitis
This paper describes another useful imaging technique to monitor Necrotising Otitis Externa (NOE). Echoplanar diffusion weighted magnetic resonance (DW MR) shows high signal on the ‘ADC map’ with active disease and this reduces in signal intensity as symptoms improve. This...
Botulinum toxin injection for bilateral recurrent laryngeal nerve paralysis
All traditional surgical treatments for bilateral recurrent laryngeal nerve (RLN) paralysis are essentially a balance between maximising airway patency and ensuring adequate phonation / airway protection. This paper highlights the potential role of botulinum toxin (Botox) injection into the cricothyroid...
Adenotonsillectomy can improve ADHD and nocturnal enuresis
The link between chronic adenotonsillar hypertrophy (CAH) and behavioural disturbance is well recognised. Several studies have found that CAH has been associated with attention deficit hyperactivity disorder (ADHD) and treatment of CAH may diminish symptoms of ADHD in a subset...
Can laryngeal sensitivity testing predict aspiration and pneumonia in dysphagic patients?
The laryngeal adductor reflex (LAR) is characterised by brief vocal cord closure in response to laryngeal stimulation. It is important in swallowing physiology as it represents a mechanism for airway protection. The authors of this study examined whether the absence...
Suspect the unsuspecting in thyroid cancer
This article reminds readers of how often invasive thyroid disease can appear, as the symptomatology is minimal. Noticeable airway symptoms appear after 50% of the airway is involved and surgeons can often fall in the unsuspecting trap of discovering locally...
NSC- HHT – a systematic review of intranasal Bevacizumab
This systematic review of 13 studies concerning the use of an anti-angiogenic nasal treatment in the management of epistaxis in HHT patients finds no significant effect. This paper looked at four RCTs, three prospective studies, three retrospective, one case series...
Is submandibular gland transfer effective in prevention of post irradiation xerostomia in head and neck cancer patients?
Post irradiation xerostomia is a common side effect of irradiation to the head and neck region, with up to 90% of patients reporting some symptoms. Submandibular glands account for 70% of resting saliva production. Surgically transferring the submandibular gland to...
Grading dysphagia as a toxicity in treating head and neck cancer
Common Terminology Criteria for Adverse Events (CTCAE) is a system used by clinicians to grade the toxicity of oncology treatments in a standardised manner. Dysphagia is perhaps the most common long-term toxicity of head and neck cancer treatment. Currently, a...
Does pre-op intratympanic gentamicin improve balance control after vestibular schwannoma surgery?
This retrospective study was based on data from 44 patients selected from a cohort of 153 who had undergone surgical resection of vestibular schwannoma over a 10-year period. The aim was to evaluate the dynamics of the postural control system...
Seeking medical attention with tonsillectomy complications depends on who you are. Lessons from the USA
In the current UK model, NHS care is free at point of access so there are no perceived economic barriers to seeking attention with postoperative complications. This study from the US examines surgical and emergency room databases from across California,...
External auditory canal carcinoma
Although uncommon, primary malignant tumours of the external auditory canal (EAC) are associated with a poor prognosis as they often present late. In this study the authors evaluate the clinical and pathological factors associated with treatment and outcome of EAC...
