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New ventilation technique FCV: improvement for patient, anaesthetist/intensivist and surgeon

Per-oral surgical access to the larynx can be hampered by the presence of an endotracheal tube. Various systems have been developed for tubeless ventilation, but these all carry a risk of aerosolisation of secretions with obvious inherent risks. We hear...

Being a doctor abroad – comparing the Greek healthcare system with the NHS

Healthcare systems and training programmes vary significantly across the world. By learning about other healthcare systems, we can identify blind spots in our own system and continue to improve training. Sofia Anastasiadou, an ENT Registrar in South West England, describes...

Treating middle ear conditions in developing countries

This month’s journal issue discussed global health in otolaryngology with this paper focusing on the management of chronic middle ear disease in the developing world. Chronic suppurative otitis media (CSOM) is more common in developing countries. The reason for this...

Nasal sidewall reconstruction

Expert reconstruction of nasal sidewall defects requires careful selection of techniques across nasal layers, balancing aesthetics, structural support and patient needs. When reconstructing a nasal skin defect, a variety of factors should be taken into account in order to achieve...

Machine learning and the future of otolaryngology

If you are over 30 years of age, you have witnessed a technology revolution that has grossly affected how we live: computers have come from being an oddity to an everyday feature in our households and places of work; the...

Effects of age on neuro-physiological processing of speech at brainstem level

Degenerative changes associated with ageing may affect processing of spectral and temporal cues in speech at cortical and subcortical levels, even though these individuals may have normal audiometric thresholds. These changes are more likely to be picked up by speech...

Swallow this: management of dysphagia in progressive neurological conditions

Whether the person with the swallowing difficulty has an acquired or progressive neurological condition, understanding the aetiology will allow the speech and language therapist assessing the swallow to have a better understanding of the likely implications for future swallow management...

Monstrous craws and horrid butchery: a concise history of thyroid surgery

Prior to the foundation of our speciality, thyroid surgery had a dubious reputation and universally dismal outcomes. Jenny Walton casts a critical eye over this dark chapter. Diseases of the thyroid gland have been referenced in historic texts for well...

A review of topical treatments for chronic rhinosinusitis

Topical nasal treatment is considered the mainstay treatment for chronic rhinosinusitis (CRS). The authors reviewed the effectiveness of saline irrigation, topical corticosteroids, topical antibiotics and topical antifungals in the treatment of CRS. Large volume saline irrigation was found to be...

Results of hypoglossal-facial nerve anastamosis techniques for facial palsy

Preserving facial nerve function is of prime importance in acoustic neuroma surgery. A comprehensive knowledge of anatomy, experience and surgical precautions can reduce the incidence significantly. Important considerations are when and how to repair if injury occurs. Several options include:...

Anterolateral thigh cutaneous flap or radial forearm free flap for tongue defect reconstruction?

Free flap reconstruction is the gold standard in tongue reconstruction, aiming to restore function such as swallowing, cosmesis and speech. The anterolateral thigh cutaneous flap and the radial forearm free flap are among the most popular free flaps used for...

Outpatient closure of CSF leaks: a good idea or a step too far?

After day-case septoplasty, day case thyroidectomy, now day case CSF leak repair – has the pendulum moved too far? The authors put forward a convincing case for what, only 10 years ago, would have sounded like a provocation. They quote...