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From a dysphagia clinical trial to a multidisciplinary head and neck clinical pathway – the road to implementation

This paper describes the barriers and facilitators to establishing a structured and coordinated multidisciplinary care pathway for patients with head and neck cancer at a medical centre in the USA. The initiative was set in motion by the roll out...

To use or not to use: absorbable sutures for facial wounds

This systematic literature review looked at studies comparing facial skin closure with absorbable versus non-absorbable sutures. Studies not published in English or looking at areas other than the head and neck, and studies focused on suture technique rather than material...

Can and should vestibular schwannoma surgery be carried out via the endoscopic transcanal approach?

The extent and scope of endoscopic ear surgery has rapidly progressed in recent years, and this paper, from one of the leading proponents of this technique, reports on the outcomes of a case series of patients who have had total...

DISE as a rationalising tool for sleep apnoea surgery

This retrospective study on 85 adult obstructive sleep apnoea (OSA) patients provides further interesting information for sleep surgeons. These patients were all investigated with polysomnography (PSG) and drug induced sleep endoscopy (DISE). They all then underwent a simple uvulopalatoplasty with...

Socially appropriate part 1: assessing people with TBI

Social communication disorders are one of the most common and yet most under-addressed sequelae of a traumatic brain injury (TBI). Yet speech and language therapists report a lack of assessment tools and a lack of time to fully assess these...

Socially appropriate part II: therapy for people with TBI

Social communication is a complex behaviour comprising social and cognitive communication skills. Providing speech and language therapy (SLT) interventions for people with social communication difficulties following traumatic brain injury (TBI) requires the clinician to understand how ingredients from an evidence-based...

Management of frontal sinus fractures

Frontal sinus fractures are uncommon (associated with around 5-15% of facial fractures). The authors divide frontal sinus fractures into isolated anterior table fractures, fractures involving the frontal sinus outflow tract and posterior table fractures, discuss some of the recent relevant...

The hippo and the nose

Chronic rhinosinusitis with nasal polyps (CRSwNP) leads to histological changes including thickening of the basilar membrane and epithelial proliferation. Molecular mechanisms underlying these changes are still not fully clear. A signalling pathway called the hippo with Yes‐associated protein (YAP) as...

Imaging of the parathyroid glands in primary hyperparathyroidism: where do we stand?

Primary hyperparathyroidism (PHPT) refers to an intrinsic parathyroid gland abnormality that produces excessive secretion of parathyroid hormone. PHPT is diagnosed biochemically, and surgical excision of the abnormal parathyroid tissue represents the only definitive cure. Historically, the standard operative management of...

Is dissection of level IV necessary in patients with negative neck oral cancer?

Supraomohyoid neck dissection (SOHND) refers to the removal of lymph nodes contained in levels I-III and is currently referred to as a selective neck dissection levels I-III. This type of neck dissection has been frequently used in the management of...

The debate: endoscopic vs microscopic ear surgery – meta-analysis of outcomes

Although the endoscopic approach to ear surgery has become more common in clinical practice, the debate about its role versus the traditional microscopic approach continues in many ENT units. This meta-analysis from the Mount Sinai ENT department in New York...

Should we be doing earlier MRIs in sudden sensorineural hearing loss?

There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....