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The delivery of ENT services in Mongolia: what are its obstacles?

Globally, the burden of ENT disease is great. Disabling hearing loss (DHL) for example, is reported to affect half a billion people worldwide. The majority of afflicted individuals live in lower and middle-income countries (LMIC) [1]. This article, a collaboration...

Developing ENT and audiology services in Southern Africa

Much has been said of the paucity of ENT and its related services in low- and middle-income countries. This article from a retired paediatric otolaryngologist discusses the progress that has been made locally to redress these health inequalities. He has...

Vicarious (nasal) menstruation

Hippocrates himself is known to have said that when a woman’s menses are due, but instead of the usual vaginal menstrual flow, she has a haemorrhage from the nose, then this is a sure sign of pregnancy [1]. Artist’s impression...

CO2 Laser Dohlmans: Does It Still Have A Role In Pharyngeal Pouch Management?

Background The commonest active management of a pharyngeal pouch is the division of the “interparty” wall using a stapling device [1, 2]. The technique is relatively straight forward to perform and theoretically should have less complications than other techniques such...

Training in the use of medical devices
– how should it be done?

Adequate training in novel medical devices is imperative, not only to ensure patient safety, but also to give clinicians the confidence to use the device in question. In this article, Andrea Gillies explains the philosophy of one of the equipment...

‘Bare below the elbows’

So it has finally happened. I have reached that stage of reactionary bewilderment known as middle age. As well having my finger nowhere near the pulse of contemporary culture, I am finding the siren charms of BBC Radio 2 and...

Call to action: dysphagia matters

Dysphagia profoundly impacts quality of life. Multidisciplinary research, like the POuCH study, aims to improve understanding, diagnosis and treatment. We take for granted the simple joys of life – meeting over a cup of coffee, breaking bread with friends or...

First signs of late nodal metastases

This is a retrospective review of 65 patients who had late metastases during follow-up after initial curative treatment. They analyse the detection methods of palpation, ultrasound, CT and subjective symptoms. Palpation detected the nodes in 31 patients, ultrasound in 17,...

Fibula free flap virtual or freehand planning and the efficiency of surgery

This is a systematic review from surgeons in Italy and Florida where, from an initial 799 potentially relevant articles, only six could be included. Efficiency was assessed by the mean ischemia time which, for the virtual group, was 73.8 minutes,...

Selective upper airway stimulation

Obstructive sleep apnoea (OSA) is one of the most common diseases in industrialised countries and is characterised by an intermittent obstruction of the upper airway during sleep. The standard treatment for OSA is continuous positive airway pressure (CPAP) therapy, which...

Surgical approach to trigeminal neuralgia

This article provides a summary of the operative techniques available for treating patients with trigeminal neuralgia who have medication resistant pain or medication intolerance. Microvascular decompression is performed via suboccipital craniotomy to find and resolve the underlying nerve compression. The...

Post-operative tonsillectomy bleeding with a normal clinical exam

Tonsillectomy is amongst the most common surgical procedures performed across the western world. For patients who report bleeding post-tonsillectomy, but have no clinical findings on examination, the management can be unclear. The accepted current management in most centres would be...