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Work and the risk and carcinoma of the larynx

This is a census on the national cancer registry in France to detect professions at a higher risk of squamous cell carcinoma of the larynx. During the period 2001-2016 there were 244 registered cases of cancer of the larynx. Amongst...

What’s the appetite for clinical risk?

The first Professor and Chair of Medical Professionalism at RCSI and BSHS, Dubhfeasa Slattery provides an overview of how a desire for better healthcare at all levels can be harnessed and nourished, leading to a potential life-long interest in reducing...

Risk factors for post laryngectomy fistula

This is a meta-analysis looking at the postoperative pharyngocutaneous fistula rates following total laryngectomy. The authors ended up with 34 studies with about 2500 patients. The most striking finding was that preoperative radiotherapy was a significant risk factor as well...

New aminoglycosides with reduced ototoxicity risk

Aminoglycoside antibiotics are widely used for infections affecting patients of all ages and at different sites, however they carry a risk of ototoxicity, nephrotoxicity and rarely peripheral neuropathy. Preventing ototoxicity is crucial to the maintenance of auditory function and quality...

Risk factors for post tonsillectomy bleeds

This paper reviews post-tonsillectomy bleeding in 692 patients and attempts to tease out risk factors. The overall bleed rate of 11.6% seems very high. The return to theatre rate was 2.6%. The paper identifies male patients and adult patients as...

Is there increased cardiovascular risk with macrolide antibiotics?

This month’s Ed’s Choice delightfully reviews the potential cardiovascular consequences of long-term macrolide use in the treatment of chronic rhinosinusitis. This used to be one of my ‘go-to’ topics of conversation at home after a bad day at work, although...

Risk factors in free flap failure

This is a retrospective analysis from China of 881 free flaps over nearly four years, 49 of which were ‘taken back’, 26 of which were lost, giving a 97% success rate. The commonest cause of flap failure was venous thrombosis....

Modified barium swallow studies: what is the radiation risk?

A modified barium swallow study (MBSS), also called a videofluoroscopy swallowing study uses ionising radiation to assist the clinician in visualising swallowing biomechanics from the oral cavity to the oesophagus. This procedure is currently one of the best methods used...

Facial paralysis risk factors in benign parotid surgery

The literature shows that the risk of facial paralysis following benign parotid surgery can be as high as 57% for temporary weakness and 7% for permanent facial nerve damage. It is generally thought that the factors involved may be related...

Risk factors for loco regional recurrence for oral SCC

Over 250,000 cases of oral squamous cell carcinomas are diagnosed annually worldwide with 128,000 registered deaths. The authors of this study are from a single institution in Germany and have conducted a retrospective audit of 517 patients with oral SCC...

Risk factors for pharyngocutaneous fistula after laryngectomy

Pharyngocutaneous or salivary fistula is a feared complication following laryngectomy, causing significant morbidity, prolonged hospital inpatient stay / cost and mortality. Previous radiotherapy / chemoradiotherapy is a well recognised risk factor and leads many surgeons to recommend onlay pectoralis major...

Do nasogastric tubes affect aspiration risk?

A nasogastric tube (NGT) is frequently used for patients who are at risk of endotracheal aspiration of oral diet. However, this cannot eliminate the aspiration of saliva. The incidence of aspiration pneumonia in patients with NGT therefore remains high. Some...