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Otolaryngology Head and Neck Surgery: Clinical Reference Guide – Sixth Edition
When I began my ENT training, the revered ‘Pasha’ textbook was one of the first recommendations given to me by senior colleagues who were in the throes of FRCS revision. This revamped edition serves to improve a book which was...
Rationales to explore the neck in penetrating injuries
Penetrating neck injuries in the UK are more commonly associated with low velocity objects such as knives and blades as opposed to gunshots. To explore the neck requires careful consideration of the need to do so in line with Burgess...
Associated findings in MRI used for detecting acoustic neuroma
Presently, gadolinium enhanced magnetic resonance imaging is the ‘gold standard’ for investigating acoustic neuroma. There are often ‘incidental’ findings that may or may not be significant. In this study of 109 scans, the authors noted an uptake of 0.9% for...
Use of topical steroids and antibiotics, compared to systemic antibiotics in the treatment of acute rhinusinusitis
Acute rhinusinusitis is mainly initiated by viral infections. Bacterial infection is usually superadded. The inflammatory cascade upregulates the pro-inflammatory mediators resulting in pain, nasal obstruction and nasal discharge. Local application of steroids and antibiotics could provide a higher concentration of...
Role of oral and intranasal steroids in the management of otitis media with effusion
Inflammation is considered an important factor in the pathogenesis and continuation of otitis media with effusion. Theoretically, this may support the use of steroids, oral or intranasal in the management of this condition. This study comprised three well matched groups...
Diagnostic performance of non-echo-planar diffusion weighted MRI in detection of suspected cholesteatoma
Even though a ‘second look’ remains a gold standard for detection of residual cholesteatoma after intact canal wall techniques, non-echo-planar diffusion weighted MRI is considered a reasonable alternative to avoid further surgery. However, to establish or exclude a cholesteatoma de...
Medialisation laryngoplasty can relieve pain related to voice use
Odynophonia, or pain associated with voice use, is a relatively uncommon manifestation of glottal insufficiency related to vocal fold motion impairment (VFMI). Its incidence is approximately 15% in patients with vocal fold paresis. Medialisation laryngoplasty (ML) was popularised by Isshiki...
Chronic facial pain: types and long-term treatment
This publication discusses the details and differences between chronic tension type headache and migraine and followed a cohort of 240 patients over 36 months. The authors applied strict criteria to distinguish between chronic tension headache and migraine, these essentially being...
Possibility of noise induced hearing loss during middle ear suction for secretory otitis media
Emission of high intensity sound is dangerous to the cochlea and can result in noise induced hearing loss (NIHL). Removal of middle ear fluid is common in everyday practice and the possibility of inducing NIHL is seldom considered and not...
The anatomy and actual number of branches of the sphenopalatine artery: surgical implications
Endoscopic sphenopalatine artery ligation or cauterisation is nowadays the main treatment for epistaxis unresponsive to medical therapy. However, on review of the literature, there appears to be confusion relating to the anatomical nomenclature of the sphenopalatine artery branches and more...
Factors affecting the occurrence of salivary fistula after total laryngectomy
It is generally believed that patients should be fed by nasogastric tube for 7-10 days after undergoing total laryngectomy or laryngopharyngectomy to avoid the occurrence of post-operative salivary fistula. This study challenges this belief and looks into various factors that...
