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Plunging new depths for the treatment of ranulas

Within our scope of practice, we encounter a number of salivary gland pathologies, including the sublingual gland. Clinical signs are often subtle, and even with meticulous surgical management, morbidity can easily occur. Textbooks advocate excision of the gland as the...

European position paper on drug induced sedation endoscopy (DISE)

DISE is a controversial topic but a practice that is largely accepted in the UK. There has been much variation about the technique, and how to interpret the results. For this reason, a collection of European DISE bigwigs aimed for...

Surgery safety checklists

The time-outs were based on pre-flight checklists adopted by airline pilots and were instituted in all accredited hospitals and ambulatory care centres in the United States in 2003. The guidelines originate from general surgery and are not specific for the...

Implications of tonsillectomy in very young children

This is a comprehensive study comprising 157 children who underwent tonsillectomy below the age of two years, mainly for sleep-disordered breathing (86.6%) and recurrent tonsillitis (7%). With relatively recent understanding of OSAS, the indications for tonsillectomy in children under two...

Is posterior epistaxis really ‘posterior’?

In absence of any clear bleeding points seen on the septum, it is generally presumed that the epistaxis is posterior, especially when simple cauterisation of the septum does not help and may progress to sphenopalatine ligation. In this publication, the...

Lingual tonsils and obstrucive sleep apnoea syndrome (OSAS)

Obstructive sleep apnoea can be due to narrowing of the retrolingual space by hypertrophic lingual tonsils. The authors studied 11 patients (five males and six females with a mean age of 44.3 years and a mean BMI of 28.6). All...

Surgical and non-interventional management of laryngomalacia

In this elaborate review article, the authors have described various aspects of laryngomalacia and its surgical management with supraglottoplasty or otherwise, gleaned from an extensive review of the literature which provided evidence or the lack of it in relation to...

We should all use ultrasound-guided core needle biopsy when investigating salivary gland lesions

Ultrasound core needle biopsy of salivary glands is an excellent diagnostic tool in terms of accuracy (both sensitivity and specificity), technical performance, and safety profile. This paper provided an update of the previous meta-analysis of the same question, which found...

What is balloon eustachian tuboplasty (BET)?

Eustachian tube dysfunction (ETD) is the result of a combination of factors that interfere with the mucosal functional or cartilaginous structures. Failure to open the eustachian tubes can cause aural pain, pressure in the ears, muffled hearing, crackling/popping sounds in...

Occurrence of cancer in asymmetrical tonsillar enlargement in adults

With significant increase in head and neck cancer in the last decade, attributed to HPV, fast-track referrals from primary care have markedly increased, adding further to the burden on the NHS. Whether or not unilateral tonsillar enlargement alone, without red...

A comparison of same day with staged bilateral cartilage graft tympanoplasty for tubotympanic CSOM

This randomised, controlled study compares the tympanoplasty outcomes in two groups of patients: one undergoing bilateral tympanoplasty on the same day (18 patients, 36 ears) and the other having the same procedure done on different days, with a gap of...

Lateral wall augmentation for patulous eustachian tube

The problem more commonly attributed to the eustachian tube is lack of its patency rather than it being unduly patulous. This lesser recognised condition is due to loss of peritubal fat volume resulting in concavity of the lateral wall and...