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Gastro-oesophageal reflux and cricopharyngeal dysfunction – how do they link?

It has been hypothesised that cricopharyngeal muscle hypertrophy develops as a response to chronic gastro-oesophageal reflux disease. The cricopharyngeus muscle is an important component and contributor to the upper oesophageal sphincter that creates a barrier between the pharynx and oesophagus....

Food impaction in children is associated with eosinophilic oesophagitis

There is an increasing amount of evidence to suggest that chronic oesophageal inflammation and motility disorders play a more significant role in oesophageal food impaction (EFI) in children compared to structural defects. The authors conducted a retrospective study of children...

Laryngopharyngeal reflux (LPR) in posterior laryngitis

The authors of this study investigated the prevalence of acid reflux in the proximal oesophagus and functional gastrointestinal symptoms in patients with posterior laryngitis. They analysed plasma motilin as well as health-related quality of life (HRQOL) questionnaires before and after...

Transnasal oesophagoscopy (TNO) and balloon dilatation under a local anaesthesia

Many of us are becoming more and more familiar with the use of transnasal oesophagoscopy. It has a number of well-described uses in the outpatient setting and is well tolerated by our patients. Yakubu Karagama describes taking this technique a...

No soup for you…! Early identification of postoperative perforation increases the success of conservative management

Iatrogenic perforation of the hypopharynx or cervical oesophagus is a well-recognised life-threatening complication. Previous studies have demonstrated that conservative management with broad-spectrum antibiotics and withholding oral feeding may avoid morbidity associated with surgical repair. This study addresses when conservative management...

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...

Marshmallows for swallowing assessments!

The complaint of ‘food sticking in my throat’ is one many of us will have heard several times in clinical practice. The authors of this study report the prevalence of this symptom to be between 5-8% in the general population...

Risk of second primary cancer among patients with head and neck cancers

Patients with head and neck squamous cell carcinoma (HNSCC) have an elevated risk of developing a second primary malignant neoplasm (SPMN). These are of increasing concern because the number of survivors of HNSCC has been growing owing to early detection...

Management of benign oesophageal strictures

Benign strictures of the upper oesophagus and pharynx, while not very common, can be a challenging condition to successfully manage. The authors of this article provide us with a detailed description of their technique for using the CO2 laser, balloon...

Differing types of pharyngeal pouch

This article raised an eyebrow on the grounds that apparently more than one type of pharyngeal pouch exists! They differ in terms of aetiology, site and approach to treatment, therefore awareness of them is advised to ensure the appropriate surgical...

Bothersome ‘burping’ – speech therapy may help

Most people experience belching as a normal phenomenon, often after eating or drinking carbonated drinks in particular. However, separate to this normal physiological phenomenon, some people experience belches that can occur much more frequently (up to 20 times a minute)...

Pediatric Otolaryngology Practical Clinical Management

The pleasing thud of this book dropping through my letterbox was tempered by mild anxiety. I’d just accepted an adult ENT job with a paediatric on-call, and my trusty Graham, Scadding and Bull was nearly a decade out of date....