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Prudent audiology

Introduction In January 2014, Professor Mark Drakeford, Minister for Health and Social Services, defined Prudent Healthcare as, “Healthcare that fits the needs and circumstances of patients and actively avoids wasteful care that is not to the patient’s benefit.” ‘Prudent’ healthcare...

Key Clinical Topics in Otolaryngology

I am a ST6 registrar and, to review this book, I decided to use it as my primary revision guide for the exam and it did not disappoint. This book has all the hallmarks of a great adjunct for the...

Swallow this: management of dysphagia post-stroke

We know that between 50% and 80% of people who have had a stroke present with swallowing difficulties that may be associated with even a small lesion of the cortical or subcortical brain regions. This article provides an up-to-date overview...

Wellbeing – a Scandinavian perspective

The Swedish concept of ‘fika’ is a state of mind and can help to promote wellbeing in teams. But what is it, and how can it help? It is an interesting thought that being well is not the same as...

Outcome measurements WG5. Developing a core outcome set of measures for tinnitus

Alain Londero presents a large-scale collaboration that invites clinicians and patients to develop a minimum standard for assessing the efficacy of tinnitus treatments. This will become an international recommendation for all clinical trials of tinnitus. WG5 is working towards a...

ENT in this issue...Anaesthetics and ENT

Nick Crombie, BMedSci BMBS FRCA FIMC RCSEd RCPathME, Associate Medical Director (Governance); Consultant Trauma Anaesthetist; Honorary Researcher, National Institute for Health Research SRMRC: Clinical Lead for Resuscitation Services, QEHB, UK. E: Nicholas.Crombie@uhb.nhs.uk Plastic surgeons think we do endless crosswords. Orthopaedic...

How well are we managing epistaxis cases?

Epistaxis constitutes 34.5% of all emergency admissions to otolaryngology departments nation-wide. Presently there are no detailed consensus guidelines for this commonest emergency, and there is tremendous variation of practice. Quite often, non-ENT trained doctors manage this emergency. This paper reviews...

Hereditary haemorrhagic telangiectasia

This is a very nicely written overview of this difficult condition by two expert rhinologists with a tertiary practice. The genetic basis, pathophysiology, diagnosis, natural history and available management options are all discussed. Clearly there is a large spectrum of...

Use of tranexamic acid in ENT surgery

Postoperative bleeding in otolaryngologic procedures causes delayed discharge, requires re-admission and adds considerably to the cost of patient care. Whether the anti-fibrinolytic activity of tranexamic acid should be used routinely to prevent haemorrhagic complications after ENT operations is speculation but...

A useful adjuvant treatment for SNAC or IP

5-Fluorouracil (5FU) is a topical preparation used in the treatment of various dermatological, ocular and gynaecologic malignant and pre-malignant conditions, and this literature review looks at the efficacy of 5FU in treating inverted papilloma and sinonasal tumours. The authors cite...

Olfaction in CRS

Conventional teaching tells us that hyposmia in chronic rhinosinusitis is due to mechanical obstruction of the olfactory cleft. But it might be that the story is slightly more complicated than that. Olfactory dysfunction is a common feature of chronic rhinosinusitis...

A surgeon’s perspective on the challenges facing cochlear implantation in children

Cochlear implantation in children offers a different set of challenges and goals to adult practice. In this article, Iain Bruce, Professor of Paediatric Otolaryngology in Manchester, UK, explains some of the current clinical and research challenges in paediatric cochlear implantation,...