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Patient positioning for transnasal flexible laryngoscopy

The position of a patient’s head during flexible nasendoscopy to visualise the larynx does not usually require much consideration – adequate views are almost always obtained with a patient sitting in a neutral position. Occasionally however, there will be patients...

Visual distraction helps patients tolerate flexible laryngoscopy

With the arrival of flexible fibreoptic laryngoscope some 35 years ago, the examination of the laryngopharynx has become remarkably easier and saves immense time and costs since the days of mirror examination when this examination was not truly satisfactory in...

Is flexible nasendoscopy really aerosol generating?

Amid the COVID-19 pandemic, the safety of office-based laryngoscopy has been a source of considerable concern, speculation and debate. Flexible nasendoscopy is a key diagnostic tool in the assessment of the ENT patient, however most healthcare providers consider this to...

Should we do oesophagoscopy during panendoscopy?

Panendoscopy entails a complete evaluation of the upper aerodigestive tract, and consists of oral inspection, direct laryngoscopy, bronchoscopy, oesophagoscopy, or some combination of these procedures. Despite many advances in imaging over the years, a skilled surgeon’s eyes remain superior in...

Reflected glory: the race to claim the laryngeal mirror

“None of today’s young doctors can start to imagine the feeling of professional helplessness and despair that prevailed before the invention of the laryngeal mirror. Thousands of people died, whom we were not able to help, or even bring relief...

History of innovation in ENT

Innovation seems to have been in the strapline of every meeting, conference and course for the last few years. You would be forgiven for thinking it is a new a concept, but as Neil Weir beautifully details, innovation has been...

Endoscopic findings and prediction of outcome in unilateral vocal cord paralysis

Unilateral vocal cord paralysis which is not due to irreversible causes such as malignancy, systemic disease or trauma varies considerably in terms of full recovery and restoration of voice. Usually electromyography is used to make possible predictions, but this facility...

What is the relationship between swallowing difficulties and underlying mental health issues?

People living with dysphagia often experience mental health difficulties. This study aimed to identify whether pre-existing anxiety and depression impacted patient scores on a patient-reported swallowing outcome measure, the Eating Assessment Tool (EAT-10) where a score of ≥3 is indicative...

Laryngeal evaluation during COVID-19 using transcervical ultrasonography

In light of the COVID-19 pandemic, the authors highlight their protocol of transcutaneous laryngeal ultrasonography as an alternative to flexible fibreoptic laryngoscopy when appropriate. This is to reduce the risk of aerosolisation posed by laryngoscopy. Ultrasonography is a rapid, non-invasive...

Laryngology Clinical Reference Guide

On receiving this book, it was rather reminiscent of preparing for my FRCS as it is from the series of the infamous ‘Pasha’. It is therefore laid out in the same manner i.e. thin pages and more text than pictures....

In-office KTP laser excision of a vocal process granuloma

The KTP laser is increasingly being used in an outpatient setting – particularly in North America – to treat various laryngeal pathologies including papillomas, leukoplakia, dysplasia and vascular lesions. This article reports the use of the KTP laser in the...

Retrograde cricopharyngeal dysfunction (RCPD) - inability to burp: treatment with Botox injection

As unusual as it may sound, some people have great difficulty burping. We hear of one approach to tackling this problem. Retrograde cricopharyngeal dysfunction (RCPD) is a condition presenting with inability to burp, resulting in gaseous distension of the digestive...