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Persistent dysphonia due to cricothyroid muscle dystonia – should we be requesting laryngeal EMGs for non-resolving ‘functional’ dysphonia?

This article is an interesting report of a case of persistent voice problems affecting a 43-year-old physician that significantly compromised her ability to converse and communicate at work. Specifically, she had a fluctuating voice quality that would ‘choke off’, combined...

Difficult consultations with HPV-positive oropharnyeal cancer patients

The aetiological role of human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OPSCC) is well established, and its incidence has massively increased over the last decade, whilst the incidence of HPV-negative OPSCC is declining. Although we know that HPV-positive OPSCC...

Botulinum toxin injection for bilateral recurrent laryngeal nerve paralysis

All traditional surgical treatments for bilateral recurrent laryngeal nerve (RLN) paralysis are essentially a balance between maximising airway patency and ensuring adequate phonation / airway protection. This paper highlights the potential role of botulinum toxin (Botox) injection into the cricothyroid...

Treating keloid scarring with pressure clips following excision: does it work?

Keloid scars can pose a difficult management problem. Whilst not harmful in themselves they can be cosmetically unappealing and lead to social embarrassment and resulting isolation, and following surgical excision they often reoccur. Mechanical pressure is an adjuvant to surgical...

Facial reconstruction with polyethylene implants

Planning reconstructive surgery for complex craniofacial defects challenges even the most experienced of surgeons. In most cases surgery is undertaken to improve anatomical functioning. However the anatomical structure of these regions is also critical to facial aesthetics and patient satisfaction...

Evidence based guidelines for ONS treatment in occipital neuralgia

Occipital neuralgia (ON) can flummox otolaryngologists especially when it follows mastoid surgery. The paroxysms of sharp, electrical pain originating from the occiput can extend along the posterior aspect of the scalp and even up to the mastoid. Although the aetiology...

Does stress and anxiety worsen idiopathic sudden hearing loss outcomes?

There have been suggestions that the natural course of the idiopathic sudden sensorineural hearing loss (ISSNHL) is not affected by intensive therapy. There is speculation as to whether unknown factors affect the treatment prognosis. This is a retrospective study of...

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...

Communication patterns during audiological rehabilitation history taking

Nature of communication among patients, their communication partners and hearing healthcare professionals is an important part of audiological rehabilitation and can have some influence on the patient outcome. As history taking quite often forms the first instance of communication between...

Who finds it hard to swallow?

Early identification of dysphagia in inpatients on acute stroke wards has been recommended as best practice guidelines in many countries. However, several institutions fail to use formal dysphagia screening protocols and rely on informal detection by nurses and doctors. This...

Bothersome ‘burping’ – speech therapy may help

Most people experience belching as a normal phenomenon, often after eating or drinking carbonated drinks in particular. However, separate to this normal physiological phenomenon, some people experience belches that can occur much more frequently (up to 20 times a minute)...

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...