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Measuring the ‘impact’ of preoperative immunonutrition

Using preoperative nutritional supplements as part of ‘enhanced recovery’ in surgical patients is not a new concept. This interesting paper looks at the latest development in optimising patients undergoing head and neck oncological surgery. Immunonutrition (Nestle’s ‘Oral Impact’ in this...

Bones, stones and surgical moans: rethinking PTH dynamics in parathyroid surgery

Intraoperative parathyroid hormone (IOPTH) testing has revolutionised minimally invasive unilateral parathyroidectomy (MIP) as the gold standard treatment for primary hyperparathyroidism, replacing old-timey four-gland exploration. IOPTH testing ensures reliable excision of all hypersecreting glands, including those pesky hard-to-find ones, without relying...

Sniffing out the evidence – COVID-19 and loss of sense of smell and taste

Louis Pasteur once observed: “In the fields of observation chance favors only the prepared mind.” Professor Hopkins was certainly prepared when a few anecdotes of smell problems started to accumulate early in the pandemic’s course. Post-viral olfactory loss is nothing...

Deaf identity in audiology services: exploring the significance and implications

Dr Celia Hulme, a culturally Deaf * sign language user, draws from her personal experience and extensive PhD research on Deaf signers’ experiences with audiology services. *In this article, the convention of using an uppercase ‘D’ is used to denote...

The future of inner ear drug delivery

The techniques for delivering drugs to the inner ear system are evolving. Jeffrey Harris considers the myths, the facts and the potential for drug delivery innovations and how they can improve tomorrow’s hearing outcomes. The inner ear’s delicate membranous structure,...

Surgery of the Thyroid and Parathyroid Glands - Third Edition

Surgery of the Thyroid and Parathyroid Glands - Third Edition is an excellent text for trainee and specialist surgeons with an interest in head and neck endocrine surgery. The organisation of the book simply makes sense, showing progression from the...

Head and neck high dependency unit - an alternative to ITU?

Close observation of the airway is a primary requirement for patients undergoing major head and neck surgery. It is also necessary for patients with upper airway infection and trauma. Wound care, drains, feeding and analgesia also require specific attention. Whilst...

A new bio-glue for neurosurgical wound closures

Dural closures need to be tight to prevent cerebrospinal fluid leaks. Traditional wound closure techniques involve sutures and DuraSeal which is the only FDA approved polyglycol hydrogel sealant with proven safety and efficacy profile. This article describes a new sealant,...

Multiple free flaps for head and neck cancer

Most patients with advanced head and neck cancers now undergo microvascular free flap reconstruction. This is mainly as flaps facilitate complete tumour and margin removal by providing reliable wound coverage and better restoration of form and function. However despite this,...

Early vs late activation of cochlear implant device

Device activation after cochlear implant surgery was typically performed after wound healing, and varies anytime from three to four weeks after surgery. Nowadays, activation is performed as early as two to three days after surgery. The authors evaluated the effect...

Pediatric Audiology: Diagnosis, Technology, and Management - Second edition

In the current NHS climate of pressure on patient throughput, offset against new technology – and plasticity - driven practice, we need to use time and skills effectively. This book is a comprehensive guide to practical applications in paediatric audiology....

What blood tests should be requested to investigate vocal cord paralysis?

Patients who are discovered to have a vocal cord palsy with no obvious cause on history or examination routinely undergo investigations to exclude an underlying pathology. Cross-sectional imaging of the relevant recurrent laryngeal nerve is required, but considerable variability has...