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New MRI technique assesses treatment response in skull base osteomyelitis

This paper describes another useful imaging technique to monitor Necrotising Otitis Externa (NOE). Echoplanar diffusion weighted magnetic resonance (DW MR) shows high signal on the ‘ADC map’ with active disease and this reduces in signal intensity as symptoms improve. This...

The effects of polypharmacy in the elderly

Another pill to cure the ill? Alec Lapira discusses the warning signs of polypharmacy in the elderly population. Polypharmacy in the elderly Polypharmacy – defined as the use of five or more medications – occurs in 20–37% of older people...

Radiology and sinus disease: “the ever-evolving landscape”

Computed tomography (CT) remains the imaging modality of choice in assessment of patients with symptoms of chronic rhinosinusitis resistant to conservative treatment. In the last 10 years, CT technology has seen significant advances with the development and integration of multi-detector...

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...

Recurrent seroma in cochlear implanted patients

Little is known about why some patients experience recurrent seromas over the implant package and in the absence of any cause, antibiotics are frequently prescribed as a precaution to protect the implant from infection. A tertiary referral centre selected five...

Pharyngoplasty for palatal snoring

This prospective Belgian study looked at the benefits of barbed reposition pharyngoplasty in the management of patients with isolated unilevel palatal snoring. This technique involves using a barbed suture and repositioning the palatopharyngeal muscle in a more lateral and anterior...

What are the consequences of facial palsy on working life?

Facial palsy (FP) has multiple causes, including iatrogenic or idiopathic paralysis, trauma and tumours. Whilst for certain aetiologies, such as Bell’s palsy, recovery of function is expected, many patients will experience permanent symptoms due to incomplete recovery of the facial...

Hearing rehabilitation after vestibular schwannoma surgery

Hearing rehabilitation is a key focus of the management of patients with vestibular schwannoma. But how do we rehabilitate hearing when the cochlear nerve has been damaged by tumour, irradiation, or resective surgery? Mathieu Trudel, Scott Rutherford and Simon Lloyd...

Minimally invasive techniques for benign salivary gland obstruction

Salivary gland obstruction is a common condition – it is recognised by a complaint of intermittent meal-time swelling of the affected salivary gland and can be accompanied by recurrent infections. Imaging can identify the nature and location of an obstruction...

Post-operative tonsillectomy bleeding with a normal clinical exam

Tonsillectomy is amongst the most common surgical procedures performed across the western world. For patients who report bleeding post-tonsillectomy, but have no clinical findings on examination, the management can be unclear. The accepted current management in most centres would be...

Rationales to explore the neck in penetrating injuries

Penetrating neck injuries in the UK are more commonly associated with low velocity objects such as knives and blades as opposed to gunshots. To explore the neck requires careful consideration of the need to do so in line with Burgess...

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...