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The hidden dementia in motor neurone disease

It is now well recognised that people with motor neurone disease (also known as amyotrophic lateral sclerosis) are at risk of developing frontotemporal dementia. It can be difficult to recognise the symptoms of cognitive decline in this group due to...

Nasal deformity following CPAP injury

Nasal continuous positive airway pressure (nCPAP) is commonly used as a non-invasive alternative to endotracheal intubation and tracheotomy to provide respiratory support to very low birth weight (VLBW) (<1500 g) neonates. Nasal injury is a well recognised complication and figures...

Precautions to be taken in cosmetic facial surgery

In this comprehensive write-up on precautionary measures to be taken when doing cosmetic surgery on our patients, the authors begin by emphasising that facial plastic surgery is no longer limited to celebrities and the privileged. It has extended into everyday...

Performing ethnic aesthetic rhinoplasty

This article reviews principles of performing rhinoplasty in non-Caucasian patients, exploring patient expectations based on differences in race, ethnicity and culture. One of the main challenges is a lack of well-established ideal facial measurements for different non-Caucasian groups. The authors...

Cough no more?

The challenge of the ‘unexplained chronic cough’ that just will not go away is a challenge that frustrates many of us. Often patients have seen respiratory, upper GI and eventually they see you as the last resort! Is behavioural therapy...

A move away from bony free flaps in reconstruction

Techniques for facial reconstruction have come on in leaps and bounds since the world wars. The use of titanium implants is more recent and the technology for manipulating the metal and how we use it is rapidly developing. Here the...

Preserving hearing in NF2 patients

Neurofibromatosis type 2 (NF2) is known to result in bilateral hearing loss, even when there is no significant tumour growth. The cause is postulated to be multifactorial: stretching and compression of the cochlear nerve by the tumour, impairment of labyrinthine...

Voice issues in transgender individuals

Recently, former decathlete and TV personality, Bruce Jenner, admitted that he is transgender, thereby becoming the most famous and vocal advocate for transgender issues. Transgender refers to female to male or male to female identification. In either case, voice modification...

How effective are our two-week-wait guidelines in picking up head and neck cancer?

With a 30% increase in the incidence of head and neck cancer since 1999 in the UK, it is important that the two-week wait referral guidelines safely encompass all risk factors but also render these urgent referrals based on signs...

A review of DISE classification systems

This article looks at the wide variety of classification systems currently available for interpreting drug induced sleep endoscopy (DISE).The fact that there are so many classification systems, suggests that there is: A) a lot of disagreement about how DISE should...

Gadolinium enhanced MRI and the diagnosis of Ménière’s disease

Despite various criteria applied over the years to diagnose Ménière’s disease since the concept of endolymphatic hydrops was first observed in postmortem examinations of patients in 1938, the diagnosis still remains mainly clinical. To visualise endolymphatic hydrops in MRI imaging,...