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Bile acids and pharyngeal malignancy

Laryngopharyngeal reflux is a commonly described condition. There is strong evidence linking gastro-oesophageal reflux with oesophageal carcinomas. Gastric refluxate consists of gastric acid, pepsin and bile acids. The roles of pepsin and acidic conditions in the development of laryngopharyngeal carcinoma...

Resection margins in head and neck surgery

Although an increasing proportion of head and neck malignancies are treated with non-surgical modalities, when surgery is undertaken an incomplete clearance results in significantly worse prognosis. However, the intraoperative assessment of an adequate margin is difficult. The personal practice of...

Work and the risk and carcinoma of the larynx

This is a census on the national cancer registry in France to detect professions at a higher risk of squamous cell carcinoma of the larynx. During the period 2001-2016 there were 244 registered cases of cancer of the larynx. Amongst...

A multidisciplinary approach to the management of frontal sinus fracture

Frontal sinus fractures account for about 5% of all facial trauma. Fractures of the posterior wall may result in cerebrospinal fluid (CSF) leak and meningitis, while obstruction of the outflow tract can cause sinusitis and mucocele formation. However, there are...

Lower respiratory involvement in allergic rhinitis and chronic sinusitis

The recent ARIA (Allergic Rhinitis and its Impact on Asthma) project has generated interest in simultaneous involvement of the lower respiratory airway in cases of chronic rhinosinusitis and allergic rhinitis. This study takes into account the extent of pulmonary function...

Great gains in groups: language led dementia

The number of people living with dementia is increasing as our population increases and delivering relevant and timely services can be a challenge. Group intervention provides a method of delivering services to a larger number of people and can have...

Does middle turbinate resection affect olfaction in endoscopic transsphenoidal surgery?

The middle turbinates (MT) are sometimes partially resected during endoscopic transnasal transsphenoidal pituitary surgery to improve surgical access. Some outfracture the middle turbinates instead. This article presents results of the first prospective randomised study, investigating the effects of such surgery...

The changing spectrum of cancer of the oropharynx: dilemmas and future directions

The association of HPV in oropharyngeal cancer has identified a ‘new disease’, with its unique biologic behaviour, and challenges for clinicians in selecting therapeutic combinations offering maximum efficacy and minimum morbidity or long-term sequela currently under study in clinical trials....

Patient-reported outcome measures: what do the people say?

Patient-reported outcome measures (PROMs) assess and quantify health outcomes from the patient’s perspective. Defining these questionnaires as outcomes indicates that they are psychometrically sensitive to change. This article describes three PROMS: namely the Patient Reported Outcome Measurement Information System (PROMIS),...

Is major ear surgery financially viable?

It is difficult to ignore the present reality in the NHS that understanding clinical coding is perhaps of more relevance to the practising clinician than the human genome! Clinician engagement is becoming more essential to protect patient care and maximise...

Management of oral white patches with malignant potential

This paper focuses on a rare but aggressive form of leukoplakia with malignant potential and is an important reminder of the need for specialist management to those in allied specialties such as ENT that may initially be referred these oral...

An update on HPV and the vaccination

In recent years, the role of HPV in the development of oropharyngeal cancers has become apparent. Hannah Fox and Vin Paleri contend that while we may not always be able to cure oropharyngeal cancers, vaccination offers our best hope for...