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How long after head and neck cancer diagnosis do patients need opioids?

With the advances in the management of head and neck cancer (HNC), patients tend to survive longer after their diagnosis. These people face the burden of chronic pain management which is strongly associated with HNC. A HNC team in Portland...

Allergen immunotherapy and allergic rhinitis – EAACI guideline 2017

Allergic rhinitis (AR) is a common chronic childhood disease with considerable social burden and impact on quality of life, frequently necessitating treatment with various combinations of antihistamines and corticosteroids. The allergen immunotherapy (AIT), sometimes known as desensitisation therapy, can modify...

Do ENT surgical patients need VTE prophylaxis?

In the UK, current NICE guidance for venous thromboembolism (VTE) prevention does not give specific advice about patients undergoing otolaryngology/head and neck surgery (OHNS). This systematic review provides up-to-date information based on available, although limited, evidence about the incidence of...

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...

Can smaller cancer centres deliver high quality care for patients with laryngeal cancer?

There is a continuing conflict between treating patients as close to their homes as possible and centralising specialised services, taking into consideration the critical mass and the multi-disciplinary expertise available. This is a report of outcomes in the treatment of...

Outcomes of reirradiation for recurrent head and neck SCC

Recurrent squamous cell carcinoma of the head and neck is often a challenge to manage when radiotherapy has previously been administered as a component of the initial treatment. Salvage surgery is usually the preferred modality of treatment, but for unresectable...

Microgravity: an extreme environment for otolith organs

Motion sickness in a car can be upsetting for all involved. Transferring this concept into a tiny cabin bound for space could have devastating consequences. Are the processes involved in ‘space motion sickness’ the same as motion sickness? How do...

Pedicle calcification – an uncommon problem

This paper from Germany describes an uncommon phenomenon of pedicle calcification in three cases. In patients from two centres that had fibula free flap reconstruction from January 2010 to January 2016, 68 cases had pedicle calcification and three cases were...

Temporal bone trauma

Introduction Temporal bone injuries represent one of the more complex management problems presenting to the otolaryngologist. This is largely due to difficulties in assessment and the frequent delays in referral, often as a result of other injuries demanding more immediate...

‘The Sun does not forget a village just because it is too small’ – African proverb

Solar powered hearing aids In the middle of the morning of January 24, 2002, I had been in Otse for only three days, a village of 3500 in the south of Botswana, when I heard a knock at the door....

Scientific advances in mapping syndromic hearing loss

From more than 22000 genes that we humans have, approximately 3000 genes are associated with human communication. There are tens of syndromes which have been identified to be accompanied by hearing loss. Disorders of almost every organ of the body...

Enhancing performance and well-being for surgeons: the science of life coaching

Life coaching has emerged as a powerful personal and professional development tool, particularly for individuals navigating high-stakes environments. Life coaching emphasises self-awareness, self-management and self-efficacy, including establishing desired outcomes, goal setting and developing skills and action plans to achieve them....