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Vicarious (nasal) menstruation

Hippocrates himself is known to have said that when a woman’s menses are due, but instead of the usual vaginal menstrual flow, she has a haemorrhage from the nose, then this is a sure sign of pregnancy [1]. Artist’s impression...

The making of a paediatric airway surgeon: In conversation with David Albert

Michael Kuo interviews David Albert to find out what drew him to paediatric airway surgery, the mentors who shaped his surgical approach, and to ask his advice for budding young paediatric airway surgeons. David Albert. When did you first get...

Are we making progress on tinnitus?

One of the aspects of tinnitus that drew me into it becoming a major theme of my clinical and research work was how little work had been done when I began to see patients in the mid 1980s. This struck...

Anaesthesia for free-flap surgery

Adel Hutchinson is one of those calm and controlled anaesthetists for whom nothing seems too difficult. In this article, she describes the key perioperative factors for one of the highest complexity operations in ENT; free-flap surgery. It makes good reading...

The effects of polypharmacy in the elderly

Another pill to cure the ill? Alec Lapira discusses the warning signs of polypharmacy in the elderly population. Polypharmacy in the elderly Polypharmacy – defined as the use of five or more medications – occurs in 20–37% of older people...

Coblation for laryngeal granulomas

Laryngeal granulomas remain notorious for their tendency to recur after surgical removal. Although high rates of complete remission have been reported with use of the potassium-titanyl-phosphate (KTP) laser, this equipment is expensive and not available in all units performing ENT...

Improving cochlear-implant performance in the short- and medium-term

Can bespoke cochlear implant programming strategies reduce the variability seen in patient performance with an implant? Bob Carlyon reviews the current situation and gives us a glimpse of the future. Although many cochlear implant (CI) patients understand speech well in...

Multiple free flaps for head and neck cancer

Most patients with advanced head and neck cancers now undergo microvascular free flap reconstruction. This is mainly as flaps facilitate complete tumour and margin removal by providing reliable wound coverage and better restoration of form and function. However despite this,...

Impact of the updated cancer staging system on HPV-positive disease

The AJCC cancer staging manual was updated in 2017 (8th edition). It is used in the MDT setting for planning treatment and assessing prognosis for individual patients, and is also widely used internationally in clinical trials. Unlike previous iterations of...

Sex and the Nose

For regular attentive readers of our little magazine, JRY will need no introduction. The word ‘polymath’ barely does him justice: a Colonel in the Medical Corps with an MPhil in poetry and apparently one of the “50 coolest people in...

Using psychological behaviour change theory in vestibular practice

Fiona Barker explains the importance of recognising and understanding how habitual behaviours in vestibular patients can affect treatment outcomes, and how we as audiologists can support and encourage patients to modify these behaviours and perhaps address our own professional behaviours...

Neural plasticity and aural rehabilitation

Neural plasticity refers to an ability of the brain and central nervous system to change their structure and function or their reorganisation in response to environmental cues, experience, learning, behaviour, injury and / or diseases and treatments. Neural plasticity is...