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What is the optimum duration of voice rest after microlaryngoscopy procedures?
Recent survey data looking at the opinions and practices of otolaryngologists in the US and the UK demonstrate that there is a wide variation in recommendations made for voice rest after vocal fold surgery. In the US, the most common...
Outpatient closure of CSF leaks: a good idea or a step too far?
After day-case septoplasty, day case thyroidectomy, now day case CSF leak repair – has the pendulum moved too far? The authors put forward a convincing case for what, only 10 years ago, would have sounded like a provocation. They quote...
Cystic fibrosis – sinus surgery delays chronic Gram-negative lung infection
This prospective clinical follow-up study is of 106 patients with cystic fibrosis in Copenhagen. Morbidity and mortality in CF are significantly associated with pulmonary colonisation and infection, usually with Gram-negative bacteria. Initially this can be well treated with antibiotics until...
Use of topical steroids and antibiotics, compared to systemic antibiotics in the treatment of acute rhinusinusitis
Acute rhinusinusitis is mainly initiated by viral infections. Bacterial infection is usually superadded. The inflammatory cascade upregulates the pro-inflammatory mediators resulting in pain, nasal obstruction and nasal discharge. Local application of steroids and antibiotics could provide a higher concentration of...
What is the evidence for contralateral tonsillectomy in TORS for known unilateral tonsil malignancy?
The concept of field changes by carcinogens within the upper aerodigestive tract is well established with reported rates of synchronous tumours of 4% and second primaries of 36%. The tonsil in particular has the highest rate of synchronous tumours, postulated...
Stenting and sinus surgery
Stents are used in sinus surgery with the aim of maintaining patency of sinus cavity avoiding restenosis from inflammation or scarring. The exact indication for stenting in sinus surgery however is still debated. The authors discussed the potential role of...
The hot nose
Capsaicin nasal spray can offer moderate to significant symptomatic relief to 70-80% of patients with idiopathic rhinitis (IR). Efficacy was also shown in lab studies. Nasal hyper reactivity (NHR), absence of allergy / infective rhinosinusitis, age limits (18-60), no anatomical...
More difficult than meets the eye: learning to use communication skills
People with communication difficulties are more at risk of accidents and mistreatments than others. Addressing the skills of the communication partners (the medical professionals) is one way of tackling this issue. This study describes innovations in training for fourth year...
Voice change after total thyroidectomy with intact laryngeal nerves – a common but temporary problem
It has been reported that up to 87% of patients have a degree of voice dysfunction after thyroidectomy, even when the laryngeal nerves are preserved. Postoperative inflammation, laryngeal oedema due to vascular congestion, direct damage to the cricothyroid muscles and...
Differing types of pharyngeal pouch
This article raised an eyebrow on the grounds that apparently more than one type of pharyngeal pouch exists! They differ in terms of aetiology, site and approach to treatment, therefore awareness of them is advised to ensure the appropriate surgical...
Role of oral and intranasal steroids in the management of otitis media with effusion
Inflammation is considered an important factor in the pathogenesis and continuation of otitis media with effusion. Theoretically, this may support the use of steroids, oral or intranasal in the management of this condition. This study comprised three well matched groups...
