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Increasing tongue strength to reduce dysphagia: what is the potential benefit of a device driven exercise?

Weakness in tongue muscle strength and laryngeal elevation is known to have an adverse impact on swallowing function. Various swallowing exercises are often recommended to improve function of these important structures with the goal of preventing aspiration and improving swallow...

Speculating on saliva during endoscopy

It has been noted that the presence of saliva in the pharynx and larynx during flexible endoscopic evaluation of swallowing (FEES) can be an indicator of increased risk of aspiration and consequent pneumonia, as well as weight loss and malnutrition....

Take a breath between mouthfuls

Pulse oximetry provides a measure of the percentage of oxygen in the blood. The usual range of readings on pulse oximetry is 97-99%. Older people may have lower pulse oximetry readings than younger people, and young women have higher readings...

Lymph node metastases in papillary thyroid cancer

This retrospective Korean cohort study looked at the risk factors associated with bilateral lateral lymph node metastases in patients with unilateral papillary thyroid cancer. There were 11 patients who met the inclusion criteria across an 11-year period from 2009 to...

Swallowing the risk: managing dysphagia in aged care

The risk of dysphagia increases with age and the prevalence of dysphagia in aged care facilities is 41–52%. Dysphagia increases the risk of aspiration, asphyxiation, malnutrition, pneumonia and ultimately death. Modifying food and fluids, by providing mashed or pureed foods...

Swallow toxicity score (DIGEST) and its clinical utility in oncology practice

The Dynamic Imaging Grade of Swallowing Toxicity (DIGEST, graded from 0–4) was developed as a tool for clinicians to grade dysphagia from modified barium swallow studies (MBSS). The purpose is to provide a common terminology for adverse events of pharyngeal...

Surgical technology and operating room safety failures: lessons from vascular and general surgery

Background – surgical technology and otolaryngology An estimated 234 million major surgical procedures are performed annually worldwide. This requires the interaction of multidisciplinary teams with varying contributions of surgical technology and therefore makes surgical procedures prone to multiple sources of...

Objective versus subjective – again!

The use of objective measurements of nasal airflow has a long history; however, its clinical application remains, at most, patchy. The main reason for that has been the lack of convincing studies showing a good correlation between the findings of,...

The delivery of ENT services in Mongolia: what are its obstacles?

Globally, the burden of ENT disease is great. Disabling hearing loss (DHL) for example, is reported to affect half a billion people worldwide. The majority of afflicted individuals live in lower and middle-income countries (LMIC) [1]. This article, a collaboration...

The totally implantable cochlear implant

*The authors are in alphabetical order – both authors are first authors on this publication A groundbreaking fully implantable cochlear implant marks the start of a new era in hearing restoration – discreet, continuous and free from external hardware. The...

Awake transnasal laryngeal and pharyngeal biopsy in the unsedated patient

In an attempt to improve the efficiency and flow of patients through a busy ENT clinic, technology now allows the ENT surgeon to consider biopsies in the outpatient setting on a more regular and controlled basis. This can avoid the...

Practical training courses for otolaryngology trainees

In this extended Trainee Matters, it’s a pleasure to present a trio of excellent articles with a theme of practical training courses for otolaryngology trainees. Miss Rachel Edmiston, Professor Nirmal Kumar and colleagues have written a valuable guide to setting...