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Should patients with dysphagia be allowed water freely?
Patients with dysphagia often experience dehydration as a consequence of “nil by mouth” or having to consume thickened fluids due to aspiration of thin fluids. However, not all incidents of aspiration develop into an infection. Factors that contribute to aspiration...
The sleep nasendoscopy learning curve
There seems to be no accepted way of surgically assessing patients with sleep disordered breathing (SDB). Because of this, clinicians fall roughly into three camps: those who just use one operation for all patients, those who have given up surgery...
Nasal nitric oxide – an inflammatory marker in paediatric allergic rhinitis?
Nasal nitric oxide (nNO) is mainly produced in the paranasal sinus mucosa and was shown in some studies to have increased expression in allergic rhinitis (AR). Although it represents a potential non-invasive tool for AR measurement, there remains no consensus...
To drain or not to drain
These two separate papers neatly tie together the same ideas. The first, a retrospective study of 107 patients and 116 procedures over a 10-year period who underwent a CSF leak repair, 82.2% without a lumbar drain and 17.8% with. The...
Anticoagulated patients and epistaxis
This systematic review looks at the increasing complexity in this space as anti-thrombotics become more sophisticated and move away from the more well understood management of warfarinised patients. After a thorough search, 29 papers were found to be relevant and...
Associated findings in MRI used for detecting acoustic neuroma
Presently, gadolinium enhanced magnetic resonance imaging is the ‘gold standard’ for investigating acoustic neuroma. There are often ‘incidental’ findings that may or may not be significant. In this study of 109 scans, the authors noted an uptake of 0.9% for...
Personal music systems are causing hearing loss
Sitting next to a teenager on a train with their iPod turned up loud enough for the entire carriage to hear is annoying, most will agree. Perhaps I might educate them about the risks of ‘music’ (if you can call...
Marshmallows for swallowing assessments!
The complaint of ‘food sticking in my throat’ is one many of us will have heard several times in clinical practice. The authors of this study report the prevalence of this symptom to be between 5-8% in the general population...
Self-report of hearing aids handling difficulties
The authors have raised an interesting subject concerning the ability of customers to self-assess their hearing aid handling skills. Previous studies showed that 96% of customers when asked if they are able to manage their hearing aids answered ‘yes’. However,...
Approach to the orbital floor: which is better?
During skeletal surgery sufficient exposure is key – often a direct approach through the overlying tissues is the easiest route. In the face, however, as the scar would be readily visible, approaches are designed to hide this. Surgical access to...
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...
