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The use of a tactical throat mic guitar amp system to improve communication in theatre in the COVID era

During the COVID-19 (SARS-CoV2) pandemic, current guidelines dictate that surgical teams wear appropriate personal protective equipment (PPE) in theatre. Currently this is, at a minimum, an FFP3 respirator, a visor, fluid repellent gown and gloves [1]. Many surgeons, particularly in...

Inspiratory peak flow and tracheostomy

The evaluation of the degree of laryngeal obstruction to indicate a tracheostomy has always been a subjective decision. The authors correlated the visual laryngeal obstruction by flexible nasolaryngoscopy and the peak inspiratory flow using a pocket peak inspiratory flowmeter. Twenty-two...

Swallowing and breathing: speech and language therapy

Swallowing difficulties are a common comorbidity in just over a quarter of people living with chronic obstructive pulmonary disease (COPD). Given the associated risks of aspiration and exacerbation of COPD symptoms, speech and language therapists (SLTs) can offer valuable guidance...

New ventilation technique FCV: improvement for patient, anaesthetist/intensivist and surgeon

Per-oral surgical access to the larynx can be hampered by the presence of an endotracheal tube. Various systems have been developed for tubeless ventilation, but these all carry a risk of aerosolisation of secretions with obvious inherent risks. We hear...

An update on laryngeal reinnervation

Laryngeal paralysis remains very difficult to treat, but reinnervation offers many attractions. Laryngeal paralysis presents a unique and varied problem that requires a patient centred approach and a range of treatment options depending on laryngeal and patient factors. There is...

Nasal peak inspiratory flow (NPIF) as a diagnostic tool for differentiating decongestable from structural nasal obstruction

Identification of the cause of nasal obstruction is critical before surgical intervention such as septoplasty. This study assesses changes in nasal peak inspiratory flow (NPIF) as a tool for discriminating decongestable versus structural obstruction. A cross-sectional study of 52 patients...

What characterises dysphagia in unilateral vocal fold impairment?

The closure of the vocal folds during swallowing is known to contribute to airway protection along with epiglottic inversion and closure of the false vocal folds. It is therefore plausible to expect that unilateral vocal fold impairment without complete closure...

Vocal cord dysfunction and dysfunctional breathing: an evolving clinical paradigm

Patients frequently present to the ENT department with breathing difficulties. The entity of ‘vocal cord dysfunction’ (also known as paradoxical vocal cord movement, inducible laryngeal obstruction, and many other names) is increasingly well recognised. Ravi Thevasagayam gives us an overview....

Assessment of viral aetiology in the formation of nasal polyps

The exact aetiology of nasal polyposis is not yet established although it is believed that allergic, infectious, mechanical, immunological and biochemical factors may be involved. Using the technique of polymerase chain reaction, this study assesses the role of human adenovirus,...

Development of a new negative-pressure ventilatory support device: Exovent

The pandemic has driven innovation in ways that we have not seen for many decades. Intensive care medicine and ENT have been at the forefront of these advances, and our good friends David Howard (never one to put his feet...