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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...
Importance of the time interval between surgery and postoperative radiation therapy in head and neck cancer
The ideal time to start postoperative radiation therapy (PORT) in head and neck cancer patients has been an issue of debate. In the USA, the National Comprehensive Cancer Network (NCCN) recommends initiating radiotherapy within six weeks from surgery. The six-week...
Consider PCR testing in culture negative necrotising otitis externa
Necrotising otitis externa (NOE) often does not yield identification of a causative organism to treat although in 90% of cases it is a member of the pseudomonas species. The incidence of fungal NOE is not to be forgotten and this...
The effect of sleep deprivation on auditory processing
This article caught my eye for personal and professional reasons. As a full time ENT trainee working 24-hour on-calls, I also have young children who have never slept through the night and don’t respect weekends or days off. My FRCS...
Management of necrotising otitis externa
Although uncommon, necrotising (previously malignant) otitis externa (nOE) can be very aggressive, particularly if not managed appropriately. In this study the authors perform a retrospective review of 25 patients admitted with nOE over a four year period at a tertiary...
Using evidence and international consensus to guide treatment of thyroid nodules
The authors of this practical review paper highlight a growing issue within thyroid surgery, where high-quality ultrasound has increased the detection of subclinical nodules: what do we do with the patient presenting with an ‘incidental’ thyroid nodule? This has both...
Choosing our tools: assessing language in dementia
Language led dementia, also known as primary progressive aphasia (PPA), is an emerging area of practice in speech and language therapy. Given that the diagnosis centres around the key diagnostic feature of language, whereby language impairment is the most prominent...
Is there a role for facial nerve decompression in Ramsay Hunt syndrome?
This is an interesting paper. The authors recommend a transmastoid facial decompression for patients with complete facial nerve paralysis with House Brackman HB 5/6 who do not show any sign of recovery after two weeks of treatment following a diagnosis...
Future practice: tele-rehabilitation in speech and language therapy
It is known that our population is ageing, resulting in an increase in the number of people living with progressive neurological conditions such as Parkinson’s disease. Health services endeavour to deliver specialist and personalised care to all these people, often...
Otosclerosis - to scan or not to scan?
In an era of insidiously reducing thresholds for investigating patients, Maxwell and colleagues pose an important question: is high-resolution computed tomography (HRCT) prior to stapes surgery for otosclerosis worthwhile? Their practice typically considers HRCT for cases of suspected otosclerosis presenting...
Can we get some satisfaction (in aphasia therapy)?
Patient satisfaction is associated with improved health outcomes, yet using surveys to collate information on satisfaction is limited by the types of questions asked. Satisfaction remains a broad concept but asking respondents more open questions allows service users to define...
