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Can the threshold for drain removal after selective lateral neck dissection be safely raised to an output volume of less than 100 mL in a 24-hour period?
Closed-suction drains are routinely used by most head and neck surgeons after selective lateral neck dissections (SLNDs). A recent survey of more than 360 head and neck surgeons found that more than 60% use a criterion of less than 30...
Reactive lesions of the contralateral vocal cord – excise or leave?
It is well recognised that benign lesions of one vocal cord can give rise to reactive lesions of the contralateral vocal cord directly opposite to the primary lesion. These contralateral reactive lesions (CRLs) are thought to arise due to impact...
Advances in diagnosis and management of allergic rhinitis
This article reviews advances in the diagnosis and management of allergic rhinitis. Recent advances in the diagnosis of allergic rhinitis include testing of local immunoglobulin E (IgE), urinary test to diagnose aspirin hypersensitivity and optical rhinometry to assess degree of...
A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth
It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...
Does cholesteatoma surgery affect school performance?
While much focus has been placed on short-term complications associated with cholesteatoma, a lack of knowledge remains about the impact suffering from cholesteatoma in childhood may have on educational outcome. The aim of the study was to investigate whether suffering...
What can we tell about swallow physiology from a bedside clinical assessment?
Knowledge about swallowing physiology has greatly increased with the use of instrumental assessments such as videofluoroscopy (VFS). The authors of this paper performed an analysis of data obtained from 60 stroke patients who were assessed via a clinical swallow examination...
In-office KTP laser excision of a vocal process granuloma
The KTP laser is increasingly being used in an outpatient setting – particularly in North America – to treat various laryngeal pathologies including papillomas, leukoplakia, dysplasia and vascular lesions. This article reports the use of the KTP laser in the...
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...
Nasal steroids do not cause ocular problems
This excellent, high quality and detailed systematic review from Australia dispels the myth propagated recently by some poorly designed studies that intranasal corticosteroids cause intraocular problems. A 40 year review of the usual databases found 665 articles and 19 were...
Surgical voice restoration after laryngopharyngectomy
Voice restoration is one of the key rehabilitative steps after laryngectomy or total laryngopharyngectomy (TLP). Patients who undergo TLP require reconstruction – increasingly commonly with microvascular free flaps. Despite their advantages in terms of fistula rates and swallowing outcomes, these...
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...
