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Prognostic value of neutrophil-to-lymphocyte ratio in HPV-positive oropharyngeal cancer

The authors propose that high neutrophil-to-lymphocyte ratio (NLR) is associated with poor disease-free survival (DFS) in patients with human papillomavirus positive (HPV+) oropharyngeal cancer (OPC). This is a retrospective study that compared the outcomes of 43 patients treated for HPV+...

Shifting paradigms – how a visionary can change a specialty

The Tarabichi-Stammberger Ear and Sinus Institute came about because of a close working relationship and friendship between two senior figures in the specialty. Professor Muaaz Tarabichi tells us the story. My first meeting with Heinz Stammberger was in 1988 in...

The costs of applying to ENT specialty training

Training doctors is costly. In the UK, medical school costs an estimated £230,000 made up of £163,000 in government grants and £65,000 in student loans [1]. Repayment of the student loan begins once the graduate earns above a certain threshold,...

Continuous Ambulatory Vestibular Assessment (CAVA)

This article presents initial test findings using a novel system called CAVA - Continuous Ambulatory Vestibular Assessment. Akin to the 24-hour ECG tape to identify cardiac arrhythmias, this system aims to continuously monitor the presence of a nystagmus pattern in...

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 many uses of human amnion

Human amnion has historically been the focus of much myth and superstition. To be born with the ‘caul’ intact was considered lucky and the caul was often manufactured into clothing. In 1910 foetal membranes were first used in skin transplantation...

Postinfectious olfactory disorders

Recovery of olfactory function following URTI is frequent, even many years after the infectious insult. Upper respiratory tract infection is the commonest cause of olfactory loss. Many treatment options exist including topical steroids, vitamin B, acupuncture, and zinc, which can...

Can comorbidities predict complications after total laryngectomy? Utility of the Modified Frailty Index (mFI) score

Decision making regarding appropriate treatment for laryngeal cancer is complex. Patients undergoing total laryngectomy experience significant changes in anatomy and physiology and are at risk for significant postoperative complications. These patients represent a group with significant comorbidities. In addition, patients...

Balloon dilatation is an effective adjunct

This is a good study design, sufficiently powered, comparing medical management to balloon sinus dilatation. All patients had failed medical management and were thoroughly assessed preoperatively with Lund-Mackay score confirming abnormal CT findings, SNOT 20 index score, chronic sinusitis score...

Safety of outpatient thyroid and parathyroid surgery

This study examined the safety and outcomes of matched groups of patients, undergoing either inpatient thyroid / parathyroid surgery or being discharged within eight hours of surgery. There were 2,362 patients in each group who were matched by a ‘propensity...

Take-home tinnitus care – Sound Relief App

Tinnitus is a condition that affects over 300 million people worldwide. Typically it manifests as a ringing or buzzing in the ears and while there is not yet a cure there are many ways for patients to manage their tinnitus....

Revolutionising medical writing: the power of language models in the clinic

Artificial Intelligence (AI) is taking the world by storm at the moment. We hear how AI might influence the letters we write in clinic. As a clinician, the process of writing a clinical letter can be time-consuming and challenging. It...