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Anxiety and acronyms – musings of an otolaryngologist
Personal protective equipment (PPE) has been a focus of attention and concern for healthcare workers around the globe during the COVID-19 pandemic. Neil Tolley discusses some of the issues. I write this article in mid-May when, were it not for...Clinical leadership and management: developing world ENT
I have been asked to share some of the initiatives I have been involved with to address ENT-related challenges in Africa and the developing world. Developing countries constitute the majority of the world’s landmass (Figure 1), are home to >50%...RNID’s campaign to restore NHS earwax removal services in the UK
Wax removal in the UK has become a topic of intense discussion. Here, Crystal Rolfe discusses the RNID’s findings and approach to tackling the issue. Earwax build-up can cause painful and distressing symptoms – a 2022 RNID survey found people...
Stimulation for a good night’s sleep
This article was an interesting read. It is an update from the authors’ original paper printed in the NEJM in 2014 regarding the results of an implantable pulse generator (IPG) for stimulating the hypoglossal nerve in response to respiration. This...
AM and the neck
Infections with atypical mycobacteria (AM) are increasing, especially with the decline in BCG immunisation. The most frequent presentation is a lymphadenopathy in an immunocompetent child. This poses a difficult diagnostic challenge if the clinician is not aware of this entity....
Diagnosis of osteonecrosis of the jaw
Although the management of osteonecrosis of the jaw is usually provided by colleagues in maxillofacial surgery, it is essential for ENT surgeons to effectively diagnose the various presentations of this condition. Affected bone that is exposed and necrotic may remain...
Early DCR may be better than delayed in acute dacrocystitis?
Traditionally, acute dacrocystitis has been treated conservatively with antibiotics, analgesia and warm compresses, with surgery reserved for later when the infection has subsided. This meta-analysis looks at early vs. late endonasal dacrocystorhinostomy (DCR) in the treatment of acute dacrocystitis, looking...
Neuromodulation in drug resistant epilepsy
Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...
Management of patients with advanced otosclerosis
This paper discusses the management options of advanced otosclerosis. There are several definitions for advanced otosclerosis in the literature but, more recently, the diagnosis of advanced otoscletosis has been reserved for patients who have less than 30% aided speech discrimination...Acoustic shock: definitions and clinical aspects
Acoustic shock, a previously little-known and poorly understood clinical entity, came to the public’s attention in 2019 due to a high-profile legal case of a musician at the Royal Opera House. In this fascinating article, Andrew Parker and William Parker...
‘Close’ surgical margin in oral tongue redefined, 2.3mm is as good as 5mm
Gold standard treatment of squamous cell carcinoma (SCC) of the oral tongue remains surgical resection of the primary tumour with negative margins. The primary goal is the complete excision of the tumour with no residual cancer cells left behind. A...
