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Does speech and language therapy provide value for money?

Within the NHS (and outside it), managers, commissioners and consumers will consider value for money as a key component in making a decision about whether to pay for speech and language therapy (or any other service for that matter). Yet...

Functional considerations in reconstruction after laryngectomy

With a plethora of different reconstructive options and techniques available after laryngectomy, it can be difficult to clearly see which give the lowest complication rates and best functional outcomes. This article aims to summarise the current evidence in swallowing and...

Pretend placements: simulation is as good as the real thing

Clinical placements are now, more than ever during the COVID-19 pandemic, a huge time and personnel commitment. Recently, allied health students have had huge changes to their placements, often undertaking them entirely remotely. This article describes a novel method of...

What is the right balance to strike in the management of anaplastic thyroid cancer?

This is a pragmatic article on a difficult and much debated subject. Management of anaplastic thyroid cancer (ATC) can feel like making decisions between a rock and a hard place, and this article suggests one path to help navigate some...

Swallow this: management of dysphagia in progressive neurological conditions

Whether the person with the swallowing difficulty has an acquired or progressive neurological condition, understanding the aetiology will allow the speech and language therapist assessing the swallow to have a better understanding of the likely implications for future swallow management...

Visual distraction helps patients tolerate flexible laryngoscopy

With the arrival of flexible fibreoptic laryngoscope some 35 years ago, the examination of the laryngopharynx has become remarkably easier and saves immense time and costs since the days of mirror examination when this examination was not truly satisfactory in...

Cycle helmets protective against facial injuries?

This is a meta-analysis completed by a maxillofacial unit on the South Coast of England. Nine studies from an initial literature review of 102 were included in the analysis. Cycling has been reported as the cause of 3-20% of facial...

Inspiratory peak flow and tracheostomy

The evaluation of the degree of laryngeal obstruction to indicate a tracheostomy has always been a subjective decision. The authors correlated the visual laryngeal obstruction by flexible nasolaryngoscopy and the peak inspiratory flow using a pocket peak inspiratory flowmeter. Twenty-two...

Can comorbidities predict complications after total laryngectomy? Utility of the Modified Frailty Index (mFI) score

Decision making regarding appropriate treatment for laryngeal cancer is complex. Patients undergoing total laryngectomy experience significant changes in anatomy and physiology and are at risk for significant postoperative complications. These patients represent a group with significant comorbidities. In addition, patients...

Tongue twisters to evaluate speech disorders

This interesting study compared errors in tongue twisters produced by adult patients with dysarthria with those produced by age-matched healthy controls. Audio recordings of all patients while they were vocalising tongue twisters were studied. The authors marked one word prominently...

Discharge planning

For a specialty such as ENT in which so many procedures are performed as day case surgery, there is a pressing need for objective discharge criteria to facilitate safe decision making post-op. This review strikes a good balance between prescriptive...

Should intratympanic steroids be the first line treatment for sudden sensorineural hearing loss?

This article looked at whether intratympanic steroids (ITS) provide more benefits over systemic steroid therapy (SST) as initial therapy in patients with idiopathic sudden sensorineural hearing loss (ISSHL). This meta-analysis study, based on published RCTs, concluded that ITS treatment exhibited...