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Does Tranexamic acid reduce intraoperative bleeding during FESS?

Intraoperative bleeding during FESS can reduce visibility and obscure important landmarks. This can result in longer operative times, increase risks of complications and even lead to incomplete surgery. Tranexamic acid is a drug which prevents fibrinolysis and stabilises blood clots....

Diagnostic criteria for haemodynamic orthostatic dizziness

Over the past several years, the Bárány Society has been developing an International Classification of Vestibular Disorders (ICVD) in order to standardise diagnosis and nomenclature for both clinical and research purposes. Many in vestibular practice would be familiar with the...

Treatment of incus lysis with hydroxyapatite bone cement

Middle ear implants provide a suitable alternative for some patients with a certain degree of sensorineural or mixed hearing loss, not wanting a hearing aid. Vibrant SounBridge® (VSB) middle ear implant (MEI), of Med-El®firm, is one such implant. In this...

Speech analysis via mobile phone – is there an app for that?

Experienced ENT surgeons will often be able to discern the likelihood of significant laryngeal pathology in a patient referred with dysphonia by the sound of their voice during the initial history-taking phase of a consultation. With the move earlier in...

The medially-invasive cholesteatoma: a case series

In this small case series, Casazza et al describe their management of seven cases of complex cholesteatoma presenting during a 16-year period. Patients were included if imaging confirmed restricted diffusion and an endophytic, medially-destructive disease involving the otic capsule, petrous...

What characterises dysphagia in unilateral vocal fold impairment?

The closure of the vocal folds during swallowing is known to contribute to airway protection along with epiglottic inversion and closure of the false vocal folds. It is therefore plausible to expect that unilateral vocal fold impairment without complete closure...

Strength of evidence in otolaryngology research – do women make the difference?

Clinicians around the world understand the need for research and publication of gathered evidence to inform practice and improve patient outcomes. The introduction of the Oxford Centre for Evidence-based Medicine (CEBM) Levels of Evidence guideline in 2011, has been invaluable...

THRIVE: redefining airway management in endoscopic oesophageal surgery

Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) is no longer just a tool to help anaesthetists secure a difficult airway. Thanks to the work of authors like Yang and colleagues, it is being revolutionised to provide apnoeic oxygenation during endoscopic...

Reducing pulse rate in videofluoroscopy: less is not best!

Recently, there has been increasing discussion in clinical meetings about the use of ionising radiation in swallowing assessments and the associated cancer risks. This is therefore a timely publication to inform discussions around whether reducing pulse rate from 30 pulses...

How are swallowing and voice affected following anterior cervical discectomy and fusion (ACDF)?

Anterior cervical discectomy and fusion (ACDF) requires an anterior transcervical approach (ACA) to allow decompression of the cervical spine and nerve roots. This approach is also occasionally used for corpectomy and osteophyte removal. Key neurovascular structures related to swallowing and...

Bones, stones and surgical moans: rethinking PTH dynamics in parathyroid surgery

Intraoperative parathyroid hormone (IOPTH) testing has revolutionised minimally invasive unilateral parathyroidectomy (MIP) as the gold standard treatment for primary hyperparathyroidism, replacing old-timey four-gland exploration. IOPTH testing ensures reliable excision of all hypersecreting glands, including those pesky hard-to-find ones, without relying...

The use of 3D videos to improve patient engagement with compensatory swallowing strategies

Patients with dysphagia are often asked to use compensatory techniques or manoeuvres to facilitate safe swallowing. For example, they may be taught to do a supraglottic swallow to minimise aspiration or a specific postural adjustment to support bolus flow. These...