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From a dysphagia clinical trial to a multidisciplinary head and neck clinical pathway – the road to implementation

This paper describes the barriers and facilitators to establishing a structured and coordinated multidisciplinary care pathway for patients with head and neck cancer at a medical centre in the USA. The initiative was set in motion by the roll out...

A trial of house dust mite sublingual tablet in children with allergic rhinitis

The house dust mite (HDM) is one of the commonest causative agents in allergic rhinitis (AR), affecting patients across all demographics. Recently, sublingual immunotherapy (SLIT) has been shown in clinical trials and meta-analysis to be effective compared to placebo in...

Superstructure-preserving stapes surgery in otosclerosis

Stapedectomy is a well-established procedure for otosclerosis but it has a small risk of a non-hearing ear, which can be devastating for patients. The development of a procedure which is safer and with a less steep learning curve for junior...

Inter-aural hearing preservation in cochlear implantation

Hearing preservation during cochlear implantation is becoming increasingly important, although results can be unpredictable. NICE are in the process of updating their guidance in the UK and it is possible that those with better hearing than the current candidates will...

Double suspension sutures for obstructive sleep apnoea

This study examines the benefit of an operation that targets the lateral pharyngeal wall. The double suspension sutures are, in essence, a suture through the palatopharyngeus muscle which is then tied around the hamulus in the retro molar area. This...

Are ENT surgeons better placed to perform cosmetic ear, nasal and facial procedures?

Cosmetic surgery is an essential component of plastic surgery training and is required in order to CCT. However, the training opportunities in plastic surgery in UK are limited. The current operative requirements for plastic surgery trainees are 100 procedures during...

Using evidence and international consensus to guide treatment of thyroid nodules

The authors of this practical review paper highlight a growing issue within thyroid surgery, where high-quality ultrasound has increased the detection of subclinical nodules: what do we do with the patient presenting with an ‘incidental’ thyroid nodule? This has both...

Management of patients with advanced otosclerosis

This paper discusses the management options of advanced otosclerosis. There are several definitions for advanced otosclerosis in the literature but, more recently, the diagnosis of advanced otoscletosis has been reserved for patients who have less than 30% aided speech discrimination...

Treating middle ear conditions in developing countries

This month’s journal issue discussed global health in otolaryngology with this paper focusing on the management of chronic middle ear disease in the developing world. Chronic suppurative otitis media (CSOM) is more common in developing countries. The reason for this...

Grading dysphagia as a toxicity in treating head and neck cancer

Common Terminology Criteria for Adverse Events (CTCAE) is a system used by clinicians to grade the toxicity of oncology treatments in a standardised manner. Dysphagia is perhaps the most common long-term toxicity of head and neck cancer treatment. Currently, a...

Prominauris: Which surgical technique to use?

Otoplasty accounted for 3.2% of all plastic surgical interventions, and 2.6% worldwide in 2015. Patient satisfaction ranges above 95% for prominent ear correction despite the myriad of available techniques in the literature associated with highly variable outcomes. The authors split...