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Importance of the time interval between surgery and postoperative radiation therapy in head and neck cancer

The ideal time to start postoperative radiation therapy (PORT) in head and neck cancer patients has been an issue of debate. In the USA, the National Comprehensive Cancer Network (NCCN) recommends initiating radiotherapy within six weeks from surgery. The six-week...

Chemo-radiation in elderly patients with head and neck cancers

Chemo-radiotherapy is the standard of care for organ preservation in stage three and four oropharyngeal cancer, prospective data on patients over 65 has not been available as they are usually excluded from randomised trials. This paper reviews the experience of...

Seeking medical attention with tonsillectomy complications depends on who you are. Lessons from the USA

In the current UK model, NHS care is free at point of access so there are no perceived economic barriers to seeking attention with postoperative complications. This study from the US examines surgical and emergency room databases from across California,...

Prophylactic swallowing exercises in head and neck cancer

Clinicians working in head and neck cancer will be familiar with the increased interest in prophylactic swallowing exercises to reduce the devastating impact of dysphagia experienced by patients undergoing radiation or chemo-radiation therapy. This study from Denmark is one of...

Gardasil vaccination – an effective adjuvant therapy for RRP?

The clinical manifestations of recurrent respiratory papillomatosis (RRP) can vary hugely from individual to individual. Whilst some affected children will outgrow the disease, a subset of patients will experience frequent recurrences and require multiple surgical procedures over the course of...

Hearing loss in the young and self-esteem

How can those involved in the care of children with hearing loss identify those at risk of low self-esteem? This study provides some guidance. Overall differences from hearing peers in terms of communication skills, physical appearance and social maturity place...

The effect of sleep deprivation on auditory processing

This article caught my eye for personal and professional reasons. As a full time ENT trainee working 24-hour on-calls, I also have young children who have never slept through the night and don’t respect weekends or days off. My FRCS...

Review: Cochlear Implantation in SSD?

Contra lateral routing of signals (CROS) using hearing aids and bone conduction devices has been the conventionally accepted modality for the treatment of single sided hearing impairment. The CROS hearing aid has been found to improve speech understanding in noise,...

Treating middle ear conditions in developing countries

This month’s journal issue discussed global health in otolaryngology with this paper focusing on the management of chronic middle ear disease in the developing world. Chronic suppurative otitis media (CSOM) is more common in developing countries. The reason for this...

The snotty child?

This article is interesting for those of us who see children regularly in secondary care but rarely see them with chronic rhinosinusitis. The authors remind the reader of the EPOS guidelines for diagnosis of CRS in children: two or more...

Valsalva manoeuvre treatment of otitis media with effusion in adults

Otitis media with effusion (OME) is common in children but has a low prevalence in adults. There is some evidence to advocate middle ear inflation as a successful treatment for children with OME. This form of treatment is also recommended...

Doing it for the people: how to do speech and language therapy

This review article distils 58 studies, collating information from people with aphasia, their families and clinical speech and language therapists summarising the seven habits of highly effective aphasia therapists. Habit 1: Effective therapists invest time in and prioritise relationships with...