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Life Down Under: an overview of the Sydney Endoscopic Ear Fellowship
As we emerge from the impact of the COVID-19 pandemic on the first half of 2020, trainee colleagues will be looking to their future once again. Options may include fellowships, and we are delighted to have Dr Andrew Ma share...Grasping opportunities and taking chances: an accidental journey to the perfect destination
Here, Jonathan Parsons tells us more about his journey from clinical audiologist to setting up a social enterprise in the National Health Service. My route to Exeter and to a social enterprise has had several twists and turns and not...
Combination PPI and intralesional steroid treatment for recurrent laryngeal granuloma
The existence of a wide range of treatments for recurrent laryngeal granulomas (repeat surgery, high-dose proton pump inhibitor (PPIs), surgery with botulinum toxin injection, botulinum toxin injection alone, etc) is a testament to the refractory nature of this condition, with...
Sleep apnoea got your heart in your throat? Perhaps it’s time to ditch the CPAP and fetch the scalpel
The link between obstructive sleep apnoea (OSA) and cardiovascular disease (CVD) is clear. Its well-established association with essential hypertension is thought to link OSA to an increased risk of atherosclerotic and hypertensive sequelae. However, data on the long-term impact of...True Cut – a dramatic biopsy from the world of surgery
True Cut is a stage play that asks: “What happens when things go wrong in healthcare?” It brings the hidden world of the operating theatre onto the theatre stage. ENT surgeon, David Alderson, talks about how the play came about....2020 Unmasked - By Paul Howard Surridge
Throughout human existence, metaphorical masks have been worn to conceal emotional and physical imperfections, whether imagined or real. We mask the way we look; we mask the way we feel. We’re vulnerable creatures, psychologically wired to present socially acceptable characteristics...Time to professionalise medical leadership
For a profession proud of its adherence to an evidence base, medicine has been remarkably slow to acknowledge and to act on the evidence which underpins the value of good leadership to patients and the healthcare system. Mr Robert Francis...
Role of ultrasonography-guided fine-needle aspiration in management of the neck after chemoradiotherapy
Primary chemoradiotherapy (CRT) is a well-established treatment for locally advanced head and neck squamous cell carcinoma (HNSCC). However, not every patient has a complete response to this treatment modality, necessitating eventual salvage neck dissection. Some patients with persistent adenopathy following...
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...
A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth
It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...
Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture
Placement of voice prosthesis at the time of trachea-oesophageal puncture is well described using 20-French prostheses. There is debate about the optimal size of the prosthesis with work in the 1980s and 1990s supporting larger prostheses. The rationale was that...
