How do you solve a problem like Dysphagia?

When a patient is referred to a speech and language therapist for the management of swallowing difficulties, multiple options are available to address these issues. The choice is based on a detailed assessment of the patient’s swallowing physiology and function....

Paediatric pituitary surgery - is it lagging behind?

Endoscopic sellar surgery, especially for adenomas, is a relatively safe, straightforward surgery with (mostly) reproducible results and few complications. However, the evolution of pituitary surgery was a long process, starting from open/transfrontal approaches all the way to transsphenoid to the...

Rationales to explore the neck in penetrating injuries

Penetrating neck injuries in the UK are more commonly associated with low velocity objects such as knives and blades as opposed to gunshots. To explore the neck requires careful consideration of the need to do so in line with Burgess...

Associated findings in MRI used for detecting acoustic neuroma

Presently, gadolinium enhanced magnetic resonance imaging is the ‘gold standard’ for investigating acoustic neuroma. There are often ‘incidental’ findings that may or may not be significant. In this study of 109 scans, the authors noted an uptake of 0.9% for...

Low risk options following failure of intratympanic gentamicin for Meniere’s

This article is a useful summary of the options available when intratympanic gentamicin (ITG) fails to adequately control vertigo episodes in Meniere’s patients. The authors describe the anatomical reasons that may impede drug delivery to the round window with the...

Performing a labyrinthectomy

This article takes the reader through the two main approaches for a labyrinthectomy for intractable Meniere’s disease. These are the traditional trans-mastoid and the less well known trans-canal. They state that according to the House clinic, the selection criteria for...

Blocked nose in children with allergic rhinitis

Nasal obstruction is a classic symptom in children with allergic rhinitis. While the nasal obstructive disorders including septal deformity, turbinate hyperplasia and adenoidal enlargement are widely recognised in adult nasal blockage, their relationship with paediatric allergic rhinitis however, is scarcely...

Which is the best graft for myringoplasty?

This is a systematic review and meta-analysis of retrospective studies for type 1 tympanoplasty (myringoplasty) surgery comparing temporalis fascia and cartilage autograft materials for reconstruction. Inclusion criteria was patients with more than 50% perforated tympanic membrane with intact ossicular chain....

Results of hypoglossal-facial nerve anastamosis techniques for facial palsy

Preserving facial nerve function is of prime importance in acoustic neuroma surgery. A comprehensive knowledge of anatomy, experience and surgical precautions can reduce the incidence significantly. Important considerations are when and how to repair if injury occurs. Several options include:...

Paper patching for aural fullness

This Belgian prospective study reported on the effect of paper patching on aural fullness of unknown aetiology. It looked at 22 patients who complained of aural fullness without any middle ear pathology. The patients were divided into a treatment group...

Anterolateral thigh cutaneous flap or radial forearm free flap for tongue defect reconstruction?

Free flap reconstruction is the gold standard in tongue reconstruction, aiming to restore function such as swallowing, cosmesis and speech. The anterolateral thigh cutaneous flap and the radial forearm free flap are among the most popular free flaps used for...

Parental role in childhood speech disorder intervention

Several studies have indicated that parents play an effective role in the management of early communication disorders like stuttering and language delay in children, especially when they are supported by clinicians. This comprehensive review attempted to study published literature regarding...