Adjuvant radiotherapy for T4N0 laryngeal cancers treated with laryngectomy

A total laryngectomy remains the gold standard for the initial treatment of advanced (T4) squamous cell carcinomas of the larynx without evidence of distant disease. Adjuvant radiotherapy (RT) is also recommended for such cancers. In the absence of other adverse...

Tonsillectomies are a pain in the neck!

You thought tonsilitis was bad? Having your tonsils removed, now that’s a hard pill to swallow. Very well, you’ll no longer have to fear the CENTOR, but how do we make recovery as pain-free as possible? Pantabtim and colleagues set...

Dysphagia services in the emergency department

The emergency department acts as the first port of call for many individuals with wide-ranging diagnoses and conditions, several of whom may potentially present with dysphagia. It is not a usual environment in which speech and language therapists regularly work,...

How rare is vocal fold paralysis after spinal and epidural anaesthesia – should we be more concerned?

The authors present an unusual case of right vocal fold paralysis. Their patient was a 38-year-old woman who experienced new onset dysphonia following neuraxial anaesthesia (NA) for a caesarean section. Flexible nasendoscopy showed a right VFP with fixation in the...

Transoral laser microsurgery (TLM)

This review article describes the surgical technique of transoral laser microsurgery (TLM) for the piecemeal removal of tumours of the upper aerodigestive tract using carbon dioxide laser. This technique gained acceptance after Wolfgang Steiner published his paper on the treatment...

Poking the bear: learning to drain quinsy on a mannequin head

Simulation in medicine has gained significant traction in both undergraduate and postgraduate training over the last couple of decades or so – the benefits to all involved are clear. The airline industry models for human factors and crew resource management...

Reducing pulse rate in videofluoroscopy: less is not best!

Recently, there has been increasing discussion in clinical meetings about the use of ionising radiation in swallowing assessments and the associated cancer risks. This is therefore a timely publication to inform discussions around whether reducing pulse rate from 30 pulses...

How are swallowing and voice affected following anterior cervical discectomy and fusion (ACDF)?

Anterior cervical discectomy and fusion (ACDF) requires an anterior transcervical approach (ACA) to allow decompression of the cervical spine and nerve roots. This approach is also occasionally used for corpectomy and osteophyte removal. Key neurovascular structures related to swallowing and...

How common is oropharyngeal dysphagia amongst the adult population?

It is well known that oropharyngeal dysphagia (OD) is a symptom arising from many different aetiologies or disease conditions and that it is a significant morbidity affecting people’s quality of life. Establishing the prevalence of OD is complicated by the...

What is the relationship between swallowing difficulties and underlying mental health issues?

People living with dysphagia often experience mental health difficulties. This study aimed to identify whether pre-existing anxiety and depression impacted patient scores on a patient-reported swallowing outcome measure, the Eating Assessment Tool (EAT-10) where a score of ≥3 is indicative...

THRIVE: redefining airway management in endoscopic oesophageal surgery

Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) is no longer just a tool to help anaesthetists secure a difficult airway. Thanks to the work of authors like Yang and colleagues, it is being revolutionised to provide apnoeic oxygenation during endoscopic...

COVID-19 and dysphagia in critically ill patients: a reflection of some findings

Dysphagia was a common occurrence in patients admitted to intensive care units (ITU) during the pandemic. This paper explores data from 26 ITUs over 12 months during 2020-2021. Findings from 235 patients admitted with Delta and subsequent Covid variants who...