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1468 results found

Carotid paragangliomas and their management

Paragangliomas in the head and neck are most frequently associated with the carotid artery, classically at its bifurcation and splaying the internal and external vessels. Despite their commonality at this site, large studies of these rare tumours are still lacking...

Surgical and non-interventional management of laryngomalacia

In this elaborate review article, the authors have described various aspects of laryngomalacia and its surgical management with supraglottoplasty or otherwise, gleaned from an extensive review of the literature which provided evidence or the lack of it in relation to...

How should I excise sinonasal tumours, open or endoscopic? En bloc or piecemeal?

Sinonasal tumours often present late because initial symptoms mimic benign disease. They tend to produce more unilateral nasal symptoms, and patients with advance disease often describe paraesthesia and other cranial neuropathies. They only account for approximately 3% of upper aerodigestive...

Gum as a thickening agent in dysphagia management

Foods and fluids are commonly thickened with starch based thickeners in the management of dysphagia to prevent aspiration. Now gums are gaining popularity as thickeners as they are resistant to salivary amylase. This study compared the effect of human saliva...

Thyroid cancer: to dissect the neck or not?

This is a good review of the much-debated management of the neck in thyroid cancer. It discusses oncological goals that must be achieved whilst maintaining voice, swallowing and parathyroid function. A clear description is made of the common nodal basins...

Deglutition in pharyngolaryngectomy patients

Circular defects after total pharyngolaryngectomy present a reconstructive challenge. In this study, the authors compared the swallowing results after three reconstructive techniques: free forearm flap, free jejunal loop and folded pectoralis major flap. Forty-six patients were included and were evaluated...

Functional considerations in reconstruction after laryngectomy

With a plethora of different reconstructive options and techniques available after laryngectomy, it can be difficult to clearly see which give the lowest complication rates and best functional outcomes. This article aims to summarise the current evidence in swallowing and...

Hemilaryngopharyngeal Spasm (HeLPS)

The authors report an unusual case of hemilaryngopharyngeal spasm (HeLPS) with glossopharyngeal neuralgia with otalgia in a middle-aged female patient. Her symptoms included left-sided sharp, electric sensation like pain radiating from her left ear to the left side of her...

Association between dysphagia and sarcopenia: implications for assessment of older people

The onset of swallowing difficulties with progressive age is reported to occur in 13-35% of the elderly population. Sarcopenia is characterised by a decrease in muscle mass, strength and function. Sarcopenic dysphagia is a relatively new term. Its prevalence is...

Strengthen your communication: better conversations can reduce the risk of frailty

Our population is ageing and, with this, the incidence of frailty is increasing. Frailty is defined as increased vulnerability to stressors resulting in adverse outcomes. Stressors can include communication and swallowing difficulties, yet these are poorly recognised. Management of communication...

Demonstrating unobservable effects of therapy through PROMS: a review

Ultimately, healthcare should meet the needs of the people it is designed for. One way of measuring this is using patient-reported outcome measures (PROMS). These tools capture the patient’s perspective and have been described as demonstrating the unobservable effects of...

Erwin Geising and the fall of the Third Reich

It’s mid 1944. The allies have landed at Normandy, the Germans have abandoned Rome and are retreating from the Russians on the eastern front. The Fuhrer was in way over his head and out of his depth. Watching this series...