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Do ENT surgical patients need VTE prophylaxis?
In the UK, current NICE guidance for venous thromboembolism (VTE) prevention does not give specific advice about patients undergoing otolaryngology/head and neck surgery (OHNS). This systematic review provides up-to-date information based on available, although limited, evidence about the incidence of...
Vestibular paroxysmia, diagnostic controversy clarified?
Historically, the cause of vestibular paroxysmia (VP) had been attributed to neurovascular compression of the eighth cranial despite the observation that such compression is very common in asymptomatic subjects. This paper, part of International Classification of Vestibular Disorders (ICVD) by...
How do you solve a problem like Dysphagia?
When a patient is referred to a speech and language therapist for the management of swallowing difficulties, multiple options are available to address these issues. The choice is based on a detailed assessment of the patient’s swallowing physiology and function....
Stenting and sinus surgery
Stents are used in sinus surgery with the aim of maintaining patency of sinus cavity avoiding restenosis from inflammation or scarring. The exact indication for stenting in sinus surgery however is still debated. The authors discussed the potential role of...
CT-scan instead of rigid bronchoscopy in paediatric foreign body aspiration?
Many centres would still use rigid bronchoscopy as the gold standard for possible foreign body aspiration (FBA) in children. Evidence is growing that CT scanning in these situations is a reliable alternative, especially as rigid bronchoscopy (RB) still carries a...
Advances in diagnosis and management of allergic rhinitis
This article reviews advances in the diagnosis and management of allergic rhinitis. Recent advances in the diagnosis of allergic rhinitis include testing of local immunoglobulin E (IgE), urinary test to diagnose aspirin hypersensitivity and optical rhinometry to assess degree of...
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...
