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Techniques of Botulinum Toxin Injections in the Head and Neck

The foreword begins with a saying by George Bernard Shaw, “all great truths begin as blasphemies”. This certainly was the case with medical application of Botox initially, however, botulinum toxin now has an accepted role and is widely used in...

Otolaryngology Prep and Practice

Jennifer Shin and Michael Cunningham from Boston, USA have published an impressive book with 37 chapters in 1226 pages. It aims to enable the reader to retain ENT knowledge by presenting it in a way that enforces application of knowledge,...

Is there a limitation for excising parapharyngeal tumours transorally?

The parapharyngeal space is a complex anatomical space bounded medially by the oropharynx and laterally by the mandible. It is conceptualised as an inverted pyramid extending from base of skull above to the hyoid bone below. The space is divided...

Ultrasound-guided core biopsy of neck lumps as first-line investigative modality supersedes fine needle aspiration cytology in the diagnosis of neck lumps

Ultrasound-guided fine needle aspiration cytology (USFNAC) when applied as initial investigation often proves non-diagnostic, the incidence being as high as 50% in a recent audit. In this study, the authors applied ultrasound-guided core biopsy (USCB) to neck lumps over 1cm...

Salivary pepsin – a simple test for LPR?

A diagnosis of laryngopharyngeal reflux (LPR) can be made on the basis of characteristic symptoms and nasendoscopy findings. Objective tests exist for this condition; for example, 24-hour dual-channel pH-metry which is considered to be the gold standard. Such tests are,...

Avoiding the sweaty cheek

Frey’s syndrome is a common (10-40%) and important complication following parotid surgery. Gustatory sweating during oral stimulation can be embarrassing as it is accompanied by flushing and a sensation of heat. This is as a direct result of regenerated parasympathetic...

Predicting life-threatening complications in deep neck space infections

Deep neck space infections, arising usually from tonsils and lymph nodes in children and dental source and salivary glands in adults can be life threatening. It is therefore important to recognise the variables which indicate immediate intervention to prevent fatalities....

Risk factors for pharyngocutaneous fistula after laryngectomy

Pharyngocutaneous or salivary fistula is a feared complication following laryngectomy, causing significant morbidity, prolonged hospital inpatient stay / cost and mortality. Previous radiotherapy / chemoradiotherapy is a well recognised risk factor and leads many surgeons to recommend onlay pectoralis major...

Plunging new depths for the treatment of ranulas

Within our scope of practice, we encounter a number of salivary gland pathologies, including the sublingual gland. Clinical signs are often subtle, and even with meticulous surgical management, morbidity can easily occur. Textbooks advocate excision of the gland as the...

Gum as a thickening agent in dysphagia management

Foods and fluids are commonly thickened with starch based thickeners in the management of dysphagia to prevent aspiration. Now gums are gaining popularity as thickeners as they are resistant to salivary amylase. This study compared the effect of human saliva...

Head and Neck Ultrasonography Essential and Extended Applications – 2nd Edition

This is a very well-written and much-needed second edition to the original book. The author focuses on the head and neck ultrasonography from an ENT surgeon’s perspective. The text is very reader-friendly. The book focuses on the basic and extended...

Predictors of diabetes insipidus post-hypophysectomy

Transient diabetes insipidus (DI) after pituitary surgery is not uncommon and its diagnosis fairly obvious. Permanent DI is rare and often depends on the neurosurgeon’s experience. This retrospective study describes a large series of patients with majority undergoing endoscopic transsphenoidal...