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A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth
It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...
Type 2 diabetes and BPPV
Previous research has shown an association between BPPV and certain medical conditions such as hypertension, hyperlipidaemia and type 1 diabetes. The authors in this retrospective observational study investigated the interaction between BPPV and type 2 diabetes by examining the ‘role...
Time to endoscopic sinus surgery and outcomes
A well written prospective study, which demonstrates that patients who require endoscopic sinus surgery, should be operated on without long delay since this achieves better and more sustained outcomes. There were 1493 patients undergoing primary nasal surgery who had completed...
Are organ-preserving treatment strategies for T3 laryngeal cancers reducing patient survival?
This article presents the 10-year results of a single institution’s treatment of advanced laryngeal cancer. The institution established a protocol based on the Dutch Head and Neck Society consensus document on laryngeal cancer diagnostics and treatment published in 1991. This...
Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture
Placement of voice prosthesis at the time of trachea-oesophageal puncture is well described using 20-French prostheses. There is debate about the optimal size of the prosthesis with work in the 1980s and 1990s supporting larger prostheses. The rationale was that...
When should that child’s wet ear be operated on?
The team from Birmingham have provided a meta-analysis to answer the question of when to perform a type 1 tympanoplasty on chronic paediatric perforations (under 18 year olds). Forty-five studies were included which resulted in 2609 cases. Closure rate at...
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...
Local dexamethasone infiltration in tonsillectomy
Intravenous dexamethasone is routinely given during tonsillectomy for its effects on postoperative pain and nausea. This Chinese randomised study divided 240 children undergoing tonsillectomy into three groups, receiving either no steroid, intravenous dexamethasone, or the same amount of dexamethasone infiltrated...
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...
Current management of facial fractures in the preadolescent
This article reviews the trends in management of preadolescent facial fractures – a challenging population due to the need to consider growth, dynamic changes in dentition, and evolving fracture patterns. In summary, conservative management is preferred in all fractures in...
Chronic facial pain: types and long-term treatment
This publication discusses the details and differences between chronic tension type headache and migraine and followed a cohort of 240 patients over 36 months. The authors applied strict criteria to distinguish between chronic tension headache and migraine, these essentially being...
