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Vocal cord dysfunction and dysfunctional breathing: an evolving clinical paradigm

Patients frequently present to the ENT department with breathing difficulties. The entity of ‘vocal cord dysfunction’ (also known as paradoxical vocal cord movement, inducible laryngeal obstruction, and many other names) is increasingly well recognised. Ravi Thevasagayam gives us an overview....

Cochlear implants for children

The field of cochlear implants in children has expanded remarkably over 40 years. Elizabeth Tyszkiewicz reflects on success and current challenges and calls for a national review of outcomes for young adults who received their implants in childhood. Aleena is...

When patient choice stands in the way of patient-centredness

In the field of hearing care, there is increasing focus on ensuring patient autonomy and choice. Greater participation in decision making is supposed to result in better patient satisfaction. A study conducted in ENT and audiology clinics paradoxically suggests that...

Chronic cough hypersensitivity syndrome

We all have patients who give us a ‘heartsink’ feeling; for many of us, the coughing patient is exactly such a situation. In this overview, Bhaskar Ram and Sangeeta Maini outline their approach to diagnosis. Declan Costello, Editor. Introduction Chronic...

The changing spectrum of cancer of the oropharynx: dilemmas and future directions

The association of HPV in oropharyngeal cancer has identified a ‘new disease’, with its unique biologic behaviour, and challenges for clinicians in selecting therapeutic combinations offering maximum efficacy and minimum morbidity or long-term sequela currently under study in clinical trials....

Facial pain: the differential diagnosis in an ENT clinic

The patient presenting with facial pain can be a heartsink. Fear not – Bhaskar Ram and Sangeeta Maini are here with a succinct overview of the common non-sinogenic causes of facial pain and headache, and how to manage them. Facial...

Gastric inlet patch – an under-diagnosed cause of globus

A gastric inlet patch (GIP) is an island of heterotopic gastric mucosa found commonly in the proximal oesophagus just below the upper oesophageal sphincter. It is often underdiagnosed due to its location. Its importance and clinical relevance can be underestimated...

Muscle tension dysphagia: an underdiagnosed problem

In this article, the authors introduce the description of swallowing problems which have been recently attributed to muscle tension dysphagia (MTDg). The authors are clear that this is a diagnosis of exclusion, and it is important to rule out other...

Recent advances in the diagnosis of silent reflux

The vexed topic of reflux always generates much discussion, particularly when it comes to testing. We hear about a non-invasive assay that is gaining in popularity. Voice disorders impact around four percent of the UK population and can significantly hamper...

A cognitive therapy programme for hearing impairment: reducing avoidance and mental distress

Cognitive behavioural therapy (CBT), a psychotherapeutic treatment method, is most commonly used to treat anxiety and depression. Newly published results from a controlled, clinical study demonstrate that an adapted CBT programme is useful for several common challenges in aural rehabilitation;...

Vestibular rehabilitation therapy: diagnosis based strategies

In his second article on this topic (see here for the first article), Richard E Gans explains how to use vestibular rehabilitation therapy to treat vestibular patients, and demonstrates why this method of diagnosis based strategies has proved so successful....