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Untreated reflux can cause inflammation, scarring, narrowing and precancerous changes in the oesophagus and larynx, and may increase the risk of asthma and sleep apnoea.Transnasal oesophagoscopy (TNO)-guided secondary tracheoesophageal puncture (TEP) under local anaesthesia
Here, the authors describe a convenient use of the transnasal oesophagoscope to create a new tracheoesophageal puncture in the outpatient clinic setting. Tracheoesophageal puncture (TEP) with voice prosthesis insertion is a reliable and effective technique for surgical voice restoration (SVR)...Retrieval of an aspirated voice prosthesis in the awake laryngectomised patient
In this article, the authors describe a simple and effective technique for extracting an aspirated voice prosthesis from within the tracheobronchial tree in the awake laryngectomised patient using the Ambu® aScopeTM 4 Broncho endoscope. Surgical voice restoration remains the dominant...Michelle – Chevalier Jackson’s choking doll: Simulation in paediatric airway management 100 years ago
Simulation has become an indispensable tool in modern paediatric airway management as it offers clinicians the opportunity to practise complex procedures in a safe, controlled environment [1], although challenges will always remain in replicating the true anatomical proportions and tactile...
THRIVE: redefining airway management in endoscopic oesophageal surgery
Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) is no longer just a tool to help anaesthetists secure a difficult airway. Thanks to the work of authors like Yang and colleagues, it is being revolutionised to provide apnoeic oxygenation during endoscopic...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...How I lost my hearing aid…and other patient experiences
All audiologists, I am sure, would claim that they give full explanations of hearing aid controls and use of the devices at all fitting appointments. However, we know that patients do not always absorb all that they are told and...
Transnasal oesophagoscopy in head and neck cancer: an update
The role of transnasal oesophagoscopy (TNE) in the management of head and neck cancer patients is evolving. Until 1990, oesphagoscopy required specialist endoscopists, general anaesthesia or sedation. This review succinctly summarises updates in the evidence for TNE in: i) Screening...
Button batteries – how can we reduce harm to children?
This article explores the history of button batteries and how clinicians and industries alike could reduce the harm to children following ingestion. Following ingestion, if lodged, button batteries cause an alkaline reaction leading to necrosis of mucosa. Significant oesophageal injury...
Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture
Placement of voice prosthesis at the time of trachea-oesophageal puncture is well described using 20-French prostheses. There is debate about the optimal size of the prosthesis with work in the 1980s and 1990s supporting larger prostheses. The rationale was that...
Eosinophilic complications during dupilumab therapy
Dupilumab is a humanised monoclonal antibody that targets type 2 inflammation by blocking IL-4 and IL-13 signalling. Reported adverse events from its use include injection site erythema, conjunctivitis, arthralgia and hypereosinophilia. The potential for more severe eosinophilic-related complications such as...
