ENT features
Tone deafness and perfect pitch
If you think you are tone deaf, do not despair. Singing tuition should help but it is probably too late to hope to develop perfect pitch. Consultant otolaryngologist and keen musician, Chris Aldren, discusses the complex and fascinating subject of...
Why is a Raven like a writing desk? Some reflections on countertenors and castrati
The countertenor voice has seen a resurgence in popularity in the last 50 years. Nicholas Clapton is one of the foremost performers and teachers of his generation, and he tells us here about the link between countertenors and the (fortunately...
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....
Singing after laryngectomy: Shout at Cancer
Thomas Moors is an ENT junior doctor with a background in music and singing. Combining these interests, he has set up a charity to help patients who have had a laryngectomy. He has achieved considerable public attention, and he tells...
'If music be the food of love, play on'
Christopher Aldren Consultant Otolaryngologist, Wexham Park Hospital, UK. Chris playing at Cambridge garden party 2003. Chris with wife and sons Tom and Alex in family quartet. Chris leading the Doctors Orchestra at the Cadogan Hall in London. Christopher Aldren, Consultant...
Chronic rhinosinusitis management: back to the future?
Immunology is a dim and distant medical school memory to many ENT surgeons, but the increasingly complex immunology of chronic rhinosinusitis is fascinating (honestly!). Medical management options in CRS no longer just involves saline and steroids, and we need to...
Staphylococcus aureus as a cause of refractory chronic rhinosinusitis
Staphylococcus aureus has long been linked to chronic rhinosinusitis, particularly recalcitrant cases. In this article, Alkis Psaltis describes how newer techniques have shown higher rates of S. aureus infection than were previously thought, and explains how the bacteria are able...
The role of macrolide antibiotics in chronic rhinosinusitis
The use of long-term antibiotics in the treatment of chronic rhinosinusitis is a contentious issue, not only because of the increasing problem with antibiotic resistance but also because of the potential cardiac risks, including sudden death. In this article, Anders...
Timing of surgery in chronic rhinosinusitis: does it matter?
While many patients with chronic rhinosinusitis respond to medical treatment, some do not. The next step for these patients is surgery, but how soon should this be offered? Sooner rather than later seems to be the answer, as Claire Hopkins...
The common frontal sinusotomy (Lothrop) and chronic rhinosinusitis
As our understanding of the pathophysiology of CRS evolves, so do our treatment strategies. It is accepted that in many cases, the main role of surgery is to allow better penetration of topical therapies to the sinus cavities. What, then,...
Recalcitrant chronic rhinosinusitis: What to do next?
Whilst the majority of patients with chronic rhinosinusitis (CRS) will significantly improve with treatment, we are sometimes left with a ‘hard-core’ of nasal cripples who fail to improve despite our best efforts. How can we deal with these patients? Valerie...
Facial pain: the differential diagnosis in an ENT clinic
The patient presenting with facial pain can be a heartsink. Fear not – Bhaskar Ram and Sangeeta Maini are here with a succinct overview of the common non-sinogenic causes of facial pain and headache, and how to manage them. Facial...
