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Recurrent ENT infections in children – is it a sign of primary immunodeficiency disease?

ENT clinicians often come across children with recurrent ear, sinus and pulmonary infections. These recurrent infections, albeit common in childhood, can represent an early sign of primary immunodeficiency diseases (PIDD). PIDD is an underdiagnosed group of genetic disorders involving absent...

All videoswallows are not performed equally…

Videofluoroscopy is one of the main instrumental tools used to assess swallowing biomechanics and physiology. In the UK, it is mainly within the remit of speech and language therapists (SLT) to perform videoswallows but there is considerable variability in both...

How reliable are PTH levels for the prediction of hypocalcaemia after thyroid surgery?

Hypoparathyroidism is one of the most common complications of thyroid surgery. There is significant controversy in calcium management practices post thyroid surgery. The drop in PTH levels has been used to predict the likelihood of hypocalcaemia after thyroid surgery. But...

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...

Benefits of bilateral cochlear implants

In an ideal world, if you could increase the clinical use of bilateral cochlear implant (CI) treatment, would you? If you’re interested in exploring the clinical benefits of bilateral CIs, or how reviews can directly inform patient care, this systematic...

You’re under arrest, you damned post-tonsillectomy bleed!

Tonsillectomy is a common, well-tolerated procedure most commonly performed in children for recurrent tonsilitis and sleep apnoea. Post-tonsillectomy bleeding (PTB) is a relatively uncommon complication that poses significant risks to patients and high rates of readmission and reintervention. Institutional guidance...

What’s the appetite for clinical risk?

The first Professor and Chair of Medical Professionalism at RCSI and BSHS, Dubhfeasa Slattery provides an overview of how a desire for better healthcare at all levels can be harnessed and nourished, leading to a potential life-long interest in reducing...

Current applications and advancements in clinical OAEs

During the past 80 years, British hearing scientists and audiologists have made important contributions to the scientific investigation and clinical application of otoacoustic emissions (OAEs). As early as 1946, Thomas Gold conducted pioneering research in the Cavendish Laboratory at Cambridge...

Active middle ear implants and bone-anchored hearing systems

The implantable hearing device market has grown significantly over recent years. But as conventional hearing aids improve and cochlear implant candidacy widens, what is the role for active middle ear implants and bone anchored hearing systems, and how should we...

Application of balloon dilatation in chronic eustachian tube dysfunction

Chronic eustachian tube dysfunction prevails in 1% of the adult population and can predispose to middle ear disease. There are subjective and objective features of this condition that can affect quality of life. The common methods to treat eustachian tube...

Epley Manoeuvre: number of times it is required and its diagnostic value

Benign paroxysmal positional vertigo is a common condition but if inadequately treated or wrongly diagnosed, can prolong the distressing symptoms of momentary dizziness, nausea and visual disturbances which can be due to other causes and deteriorate quality of life. Studies...

Tongue twisters to evaluate speech disorders

This interesting study compared errors in tongue twisters produced by adult patients with dysarthria with those produced by age-matched healthy controls. Audio recordings of all patients while they were vocalising tongue twisters were studied. The authors marked one word prominently...