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Prophylactic gastrostomy tubes in advance of chemoradiotherapy for advanced head and neck malignancies – are they worthwhile?

It is well recognised that radical chemoradiotherapy (CRT) for head and neck cancers can significantly affect swallowing, especially if radiotherapy is delivered to the hypopharynx and/or both sides of the neck. As such, prophylactic gastrostomy tubes are often advocated in...

Blood-sampling prognostic predictors for Bell’s palsy

Bell’s palsy is generally defined as an acute-onset unilateral idiopathic mononeuropathy in the facial nerve. It is of unknown aetiology, however, inflammation is considered a major cause. Electroneurography assessing nerve excitability is the most reliable examination for predicting prognosis of...

AI in ENT practice

Artificial intelligence (AI) technologies are becoming increasingly prevalent in our lives and there has been both enthusiasm and caution for using AI in healthcare. A recent article in the Journal of the American Medical Association reported on a trial examining...

Extranodal extension following surgical resection of HPV-positive oropharyngeal cancer – is adjuvant radiotherapy alone sufficient?

Human papillomavirus (HPV) is a known aetiological factor in oropharyngeal squamous cell carcinoma (OPSCC). HPV-positive OPSCC is recognised to have a more favourable prognosis than HPV-negative disease. Treatment deintensification for HPV+ OPSCC has therefore been an area of research focus...

Robotic surgery for squamous cell cancer: the new frontiers

Although the da Vinci platform was FDA approved for early-stage oropharyngeal cancers, the indications have expanded. In this article, John Hardman explains how surgeons, with greater understanding of the strengths and limitations of robotic surgery, have systematically set out to...

Robotic assisted orbital surgery (RAOS) – a novel approach to orbital malignancy surgery

Robotic technology in ENT surgery has been used in certain areas of head and neck cancer care but, in this article, we hear of an exciting development from the team at Guy’s & St Thomas’. Advances in surgical robotic technology...

Streamlining ENT pathways

Laryngopharyngeal reflux (LPR) may present with severe extra-gastrointestinal symptoms – including a persistent cough, vocal problems, asthma or difficulty swallowing – that can be incorrectly attributed to ENT problems because patients and GPs alike assume they stem from colds, allergies or over-using the voice.

Accurately diagnosing reflux to direct personalised treatment

Laryngopharyngeal reflux (LPR) frequently causes severe extra-gastrointestinal symptoms – such as a persistent cough, vocal problems, asthma or difficulty swallowing – that can be easily confused with a common cold and allergies.

Paediatric ENT trauma

Managing trauma in children often strikes terror in doctors who do not deal with children regularly. Kate Stephenson explains the approach to a child who has suffered ENT trauma and specific things to look for in children. ENT injuries are...

How to deliver bad news better

Delivering bad news well takes experience and time. The Ida team recommend the SPIKES protocol; providing structure for relaying bad news, giving confidence to those delivering it, and leaving recipients feeling cared for and informed. It’s among the most distressing...

Outcomes for transoral vestibule approach thyroid surgery

Ed’s choice explores a systematic review examining one of the recent innovations in head and neck surgery. It may come as a surprise to some that within a few years of the first published cases of transoral vestibule thyroidectomy, an...

Can surgery make you a better driver?

Obstructive sleep apnoea is a condition that can have far reaching health, economic and safety implications for the individual inflicted with the condition, as well as those in their immediate and wider surroundings. Having the freedom to drive taken away...