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No soup for you…! Early identification of postoperative perforation increases the success of conservative management

Iatrogenic perforation of the hypopharynx or cervical oesophagus is a well-recognised life-threatening complication. Previous studies have demonstrated that conservative management with broad-spectrum antibiotics and withholding oral feeding may avoid morbidity associated with surgical repair. This study addresses when conservative management...

Plunging new depths for the treatment of ranulas

Within our scope of practice, we encounter a number of salivary gland pathologies, including the sublingual gland. Clinical signs are often subtle, and even with meticulous surgical management, morbidity can easily occur. Textbooks advocate excision of the gland as the...

Applying ‘Sal classification’ to parotid cytology to replicate the success of the Thy classification system

The usefulness of the Thy classification in thyroid gland disease has led to attempts to generate a similar cytology classification for parotid lesions. However, the accuracy of fine-needle aspiration cytology in salivary gland disease is more variable because of the...

Passive smoking and rhinosinusitis

One would expect that subjects exposed to more passive smoke would have a significantly increased level of rhinosinusitis. This study looked at a reasonable number of sinusitis and control subjects (404 and 165) using hair nicotine as an assessment of...

The unknown primary again

In this retrospective study of 35 patients, the authors followed a systematic protocol for the detection and management of malignant cervical lymph nodes without an apparent primary lesion. Although their one, three and five year survival results are consistent with...

Outpatient solution for a Patulous tube?

Definitive diagnosis and management of Patulous Eustachian tube (PET) is unsatisfactory. Several different treatment methods are currently used for PET which itself indicates no satisfactory solution. The objective of this study was to compare the outcomes of two different treatment...

Reliability of Koos classification

Vestibular schwannoma (VS) tumour size has been considered the primary determinant of hearing outcomes and facial nerve function according to several published studies. Varying methods are used to estimate the size and volume of the VS with very little consensus...

Genetic testing in congenital hearing loss

Advances in genetic testing over the last decade have reduced the cost and time such testing required and increased understanding of the genes involved in conditions like congenital hearing loss. This study from Atlanta looks at genetic testing from a...

Treatment outcomes and dose rate effects following gamma knife stereotactic radiosurgery for vestibular schwannomas

Gamma knife radiosurgery (GKRS) is one of the definitive stereotactic radiotherapy treatment modalities for vestibular schwannoma (VS) management. Its efficacy depends on the cobalt-60 source which has a half-life of 5.26 years. According to the study authors, the actual rate...

Endolymphatic pressure disturbances precede endolymphatic hydrops on MRI in definitive Ménière’s disease

The diagnosis of Ménière’s disease is clinical, and the authors tried to verify if endolymphatic hydrops (EH) could be demonstrated on MRI. In this prospective study, they analysed 3D3T FLAIR MRI images of 32 ears with definitive Ménière’s disease (DMD)...

Which bit of our brains do we need to recognise fear, disgust and happiness?

Recognising other people’s emotions is a useful life skill for human interaction in both social and vocational situations. Yet there remains significant debate about which areas of the brain are required to enable us to read and understand these facial...

Greener pastures? Reflections from UK ENT surgeons now practising abroad

Ever considered practising ENT abroad? Here are some experiences of previously UK-based ENT surgeons who took the plunge and are now plying their trade in distant lands. Andrew McCombe ENT ConsultantDate of migration: December 2015Place of work: Mediclinic City Hospital,...