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Time to professionalise medical leadership
For a profession proud of its adherence to an evidence base, medicine has been remarkably slow to acknowledge and to act on the evidence which underpins the value of good leadership to patients and the healthcare system. Mr Robert Francis...
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...
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...
The stubborn polyp cases are ‘different’
The widely different behaviour of nasal polyp disease between patients is a major feature of rhinology practice and makes counselling of patients difficult when approaching their first operative intervention. Setting aside aspirin sensitivity (Samter’s triad), which is known to be...Management of single-sided deafness in adults: a bone conduction solution
Single-sided deafness (SSD) presents a limited number of methods for management, and not all of them meet the patient’s expectations. The aim of this article is to set out the available bone-conduction treatment methods for managing single‑sided deafness in adults....
