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What is the evidence for duration of antibiotic prophylaxis in head and neck free-flap cases?

The topic of this systematic review is one which is commonly heard in discussions between microbiologists and head and neck surgeons – what is the evidence for antibiotic prophylaxis in clean-contaminated free-flap cases, and crucially, how long should antibiotics be...

Suspect the unsuspecting in thyroid cancer

This article reminds readers of how often invasive thyroid disease can appear, as the symptomatology is minimal. Noticeable airway symptoms appear after 50% of the airway is involved and surgeons can often fall in the unsuspecting trap of discovering locally...

Allergy and the ear

Allergic disease is commonly associated with asthma, eczema and rhinosinusitis. The authors reviewed possible associations between allergy and otologic diseases. The authors first explored the possible association between allergy with otitis media with effusion (OME) and found the majority of...

Allergy testing in children with beta-lactam hypersensitivity

The beta-lactam antibiotic is commonly used in treating ENT infections in childhood. However, its use can be limited by reported hypersensitivity or allergy to the antibiotic. This is largely attributed to the previous development of skin rashes while being on...

Medialisation laryngoplasty can relieve pain related to voice use

Odynophonia, or pain associated with voice use, is a relatively uncommon manifestation of glottal insufficiency related to vocal fold motion impairment (VFMI). Its incidence is approximately 15% in patients with vocal fold paresis. Medialisation laryngoplasty (ML) was popularised by Isshiki...

Management of the neck in maxillary sinus carcinomas

Primary malignant tumours of the sinonasal tract account for less than 10% of head and neck cancers, of which the maxilla is the second most common subsite and squamous cell carcinoma (SCC) is the most prevalent histological type. Maxillary SCCs...

What is the prognostic value of lymph node yield and density in head and neck cancer?

Neck dissection in addition to surgery of the primary site is commonly recommended in head and neck cancer treatment. However, there has been no consensus on the number of nodes that need to be removed to constitute a sufficient neck...

Beware of GPA as a cause of subglottic stenosis

Up to 92% of patients with granulomatosis with polyangiitis (GPA) have concurrent ENT manifestations of the disease. Whilst we are familiar with sinonasal and middle ear presentations of GPA, subglottic stenosis (SGS) is another important and potentially life threatening manifestation....

Treating benign positional paroxysmal vertigo

Benign positional paroxysmal vertigo (BPPV) is one of the most common causes of dizziness. Its treatment is the repositioning of displaced otoliths by the canalith repositioning manoeuvre (CRM). Post manoeuvre restrictions are commonly given to the patient. Their benefit has...

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...

DVT prophylaxis in cranial procedures

Deep vein thrombosis (DVT) is a result of disturbed balances in blood flow patterns, blood clotting factors promoting coagulation and vessel wall endothelial injury. The subsequent disruption of coagulation and fibrinolysis mechanisms lead to venous clot formation and propagation. The...

Sinonasal inverting papilloma: who is at risk of recurrence?

This study from a tertiary sinus surgery unit, describes some useful information in the follow-up of sinonasal inverted papilloma patients - in particular those likely to recur - and discusses the optimal staging systems to use to attempt to predict...