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Role of sentinel lymph node biopsy in managing papillary thyroid cancer

Although studies have shown that the presence of lymph nodes metastases in papillary thyroid carcinoma does not alter survival, other studies have shown that it increases morbidity and mortality and that the presence of cervical lymph node metastasis at diagnosis...

Voice therapy is an effective treatment for presbyphonia

The quality of an individual’s voice often declines with age. This deterioration occurs firstly as a result of vocal fold atrophy secondary to histologic alteration of the vocal fold mucosa as well as atrophy of the laryngeal musculature. Phonatory efficiency...

The hot nose

Capsaicin nasal spray can offer moderate to significant symptomatic relief to 70-80% of patients with idiopathic rhinitis (IR). Efficacy was also shown in lab studies. Nasal hyper reactivity (NHR), absence of allergy / infective rhinosinusitis, age limits (18-60), no anatomical...

Laser for active mucosal chronic otitis media

Active mucosal chronic otitis media (COM) is a condition characterised by otorrhoea secondary to chronic inflammation of the middle ear and mastoid mucosa associated with granulations and a tympanic membrane perforation. Surgical intervention is often required, but concurrent mastoidectomy with...

Myringoplasty in a bottle?

Management of large traumatic TM perforations can involve observation and water precautions or surgical repair. Closure rates for larger perforations can be 8-12 weeks and occurs for between 38-79%. Animal and human studies have shown that exogenous application of epidermal...

Preoperative imaging for thyroid cancer according to 2015 ATA guidelines

The 2015 American Thyroid Association (ATA) management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer suggest that thyroid sonography with survey of the cervical lymph nodes should be performed in all patients with known or suspected thyroid...

The middle way: treating idiopathic facial nerve palsy

Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...

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...

Suspect the unsuspecting in thyroid cancer

This article reminds readers of how often invasive thyroid disease can appear, as the symptomatology is minimal. Noticeable airway symptoms appear after 50% of the airway is involved and surgeons can often fall in the unsuspecting trap of discovering locally...

Time to endoscopic sinus surgery and outcomes

A well written prospective study, which demonstrates that patients who require endoscopic sinus surgery, should be operated on without long delay since this achieves better and more sustained outcomes. There were 1493 patients undergoing primary nasal surgery who had completed...

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...

CSF leak – endoscopic or open repair?

Cerebrospinal fluid (CSF) rhinorrhoea is well known to the ENT surgeon. It commonly occurs secondary to a predisposing event such as accidental or iatrogenic trauma. When it occurs spontaneously, it can be associated with benign intracranial hypertension. The commonest CSF...