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An algorithm to distinguish between distant metastases and metachronous lung primary in patients with HPV-related oropharyngeal cancer

Distinguishing between distant metastases of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) and metachronous primary lung squamous cell carcinoma (SCC) is important as it has implications for treatment, prognosis counselling, and registry data. Although p16 immunohistochemistry (p16 IHC) is widely accepted...

Influence of Helicobacter pylori infection in otitis media with effusion

Otitis media with effusion (OME) affects 20% of children and 10% have a recurrent problem. The incidence of Helicobacter pylori infection in children ranges from 15 to 46%. This study investigates how the presence of Helicobacter pylori infection affects treatment...

How should I excise sinonasal tumours, open or endoscopic? En bloc or piecemeal?

Sinonasal tumours often present late because initial symptoms mimic benign disease. They tend to produce more unilateral nasal symptoms, and patients with advance disease often describe paraesthesia and other cranial neuropathies. They only account for approximately 3% of upper aerodigestive...

Salivary pepsin – a simple test for LPR?

A diagnosis of laryngopharyngeal reflux (LPR) can be made on the basis of characteristic symptoms and nasendoscopy findings. Objective tests exist for this condition; for example, 24-hour dual-channel pH-metry which is considered to be the gold standard. Such tests are,...

Don’t be too apologetic: disclosing communication difficulties

People who stutter are frequently considered less intelligent or less confident, and are often discriminated against. These negative perceptions have been found to differ slightly across different cultural groups. For Hebrew speakers in Israel, having a stutter can have a...

IIb nodes in a node-negative neck

This is an 11-year retrospective study of 389 patients who underwent 527 supraomohyoid neck dissections in a clinically node-negative (cN0) neck between November 2012 and November 2023. Oropharyngeal, maxillary, gingival and maxillary sinus tumours, along with those with a location...

The role of training programmes in protecting patients

ENT trainees are fully registered doctors who have responsibilities to comply with the requirements of Good Medical Practice. This includes ensuring that they put the interests of their patients at the heart of their practice. This duty is complementary to...

The ear-brain connection in cochlear implant users: learning to listen again

While the cochlear implant (CI) has been a tremendous success in restoring hearing to deaf individuals, the implantation outcome still varies across CI users [1]. Some demographic factors, such as duration of deafness, and peripheral factors, such as electrode placement,...

What happens to donated hearing aids?

According to the WHO, only 3% of people in developing countries who require hearing aids have one. Over the years many people, organisations and companies have donated old hearing aids to charities. Bhavisha Parmar, an audiologist who volunteered with Sound...

Migration and training: a British-Nigerian surgeon’s perspective

Less than 4% of doctors on the UK’s medical register describe their ethnicity as African or part African, yet there are myriad driving forces behind the migration of medical trainees from Africa to the UK and other developed countries. Ekpemi...

In conversation with Dr Helen Bevan: Approaching change in the NHS with a new mindset

Dr Helen Bevan has been a leader of large scale change in the English National Health Service (NHS) for more than 20 years and was recently recognised as one of the 60 most influential people in the history of the...

Silent sinus syndrome: which approach offers the best outcome?

Silent sinus syndrome (SSS) is a rare condition with patients presenting as spontaneous, painless enophthalmos, hypoglobus, orbital asymmetry, and maxillary sinus collapse on the ipsilateral side. The orbital resorption occurs secondary to negative pressure created in the maxillary sinus by...