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Clinical management: 
a personal view

When Nigel Beasley approached me to write on my experience of clinical management, I was a little surprised. I see myself as primarily a clinician, but have had increasing involvement with clinical management within my Trust. I am now in...

‘Want an upgrade?’ Moral distress in audiology

Ethical practice in audiology has become a hot topic in recent years, particularly in the independent sector where sales can be linked to commissions. Andrea Simpson has explored this issue in her research and shares her insight into the drivers...

Endoscopic Dacryocystorhinostomy

Epiphora, or abnormal tearing, occurs because of blockage in the lacrimal drainage system, which impairs normal tear channeling into the nose. Dacryocystorhinostomy (DCR) is used to treat patients diagnosed with lacrimal sac or nasolacrimal duct obstruction (NLDO). External DCR was...

On-call in ENT Surgery

The On-call in ENT Surgery, as part of the On-call Series, is written explicitly as the “survival guide” for all junior doctors starting out in ENT or as “a tool to aid consolidation of knowledge gathered by more senior ENT...

Primary ossicular chain reconstruction in open-cavity mastoidectomy

The authors performed a retrospective analysis of 21 patients who had undergone primary reconstruction of the ossicular chain during canal-wall-down mastoidectomy. The ossiculoplasty technique used consisted of removal of the malleus head and division of tensor tympani, and rotation of...

The ‘bus stop’ incision for bone-anchored hearing aid placement: a step-by-step approach to soft tissue preparation

There have been many descriptions of soft tissue preparation in the era when subcutaneous tissue was routinely removed with the Nijmegen technique [1] or with the dermatome [2]. More descriptions continue to evolve with the advent of tissue preservation techniques,...

Put the maxilla in the right place

This is a paper from Singapore where they attempted to validate the position of the maxilla in the sagittal plane against several reference lines arising from the position of the forehead in orthognathic surgery. The position of the maxilla was...

Evidence-based practice: management of sudden sensorineural hearing loss

What is the current evidence for medical management of sudden sensorineural hearing loss? Jessica Choong and Stephen O’Leary present a review of the current evidence of treatments options. Sudden sensorineural hearing loss (SSNHL) causes significant distress and, in many cases,...

Laryngopharyngeal reflux - would mucolytics help?

With laryngopharyngeal reflux (LPR) being such a common presenting complaint to ENT clinics, who would not want to have more, effective treatment options for patients suffering with this annoying condition? In their small randomised, controlled trial, Chae et al put...

Hyposalivation: a review of current and future treatments

Hyposalivation remains a stubbornly difficult condition to treat, but novel therapies may not be far away. Saliva has many essential functions, including aiding digestion and swallowing, lubrication, maintaining tooth integrity and antibacterial activity. When patients experience reduced saliva production (hyposalivation),...

Targeted focal parathyroidectomy

Leanne Hamilton and Louise Clark describe their technique for helping to localise parathyoid adenomas. Surgically this can be difficult, so careful preoperative evaluation using imaging as described can help minimise difficulties intraoperatively when identifying the parathyroid adenoma. Preoperative imaging has...

Assessment and management of dysphagia in the elderly

This article covers dysphagia in older patients, which is an important topic due to an ageing population, and a relatively common symptom that we see in clinic. Dysphagia could be due to presbyphagia secondary to changes in head and neck...