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Instrument assessment preferable over standard beside swallow to determine prevalence of aspiration
Aspiration does not trigger the protective cough response in some patients. The patient’s response may vary according to fluid viscosities and volume. The authors of this prospective study investigated the prevalence of aspiration and response to aspiration of different viscosities...
Laryngeal cleft in a 66-year-old man!
This is a fascinating case report of a 66-year-old man who presented with a carcinoma of the piriform sinus. During chemoradiotherapy, he developed dyspnoea, dysphagia and aspiration pneumonia. His chemoradiotherapy was stopped and he underwent a pharygnolaryngectomy. When the surgical...
Strategies to improve early development of vocabulary post-cochlear implantation
Cochlear Implantation (CI) is now the standard of care for rehabilitation of children with bilateral severe to profound sensorineural hearing loss. It improves the children’s linguistic input and helps them to develop language. The literature published so far has shown...
Are we all in the matrix?
In the entirety of training and in further practice, we are instilled with the premise of patient-centred care and individualised management plans based on informed consent. The question in the new age of telehealth/e-health is how to mimic that personalisation...
Day case orthognathic surgery
This paper analyses whether patient safety is maintained when orthognathic surgery is performed as an outpatient. This Swedish paper reviewed 165 patients, 107 of whom were to have what was termed outpatient care, and of which 101 (94%) were able...
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...
We should all use ultrasound-guided core needle biopsy when investigating salivary gland lesions
Ultrasound core needle biopsy of salivary glands is an excellent diagnostic tool in terms of accuracy (both sensitivity and specificity), technical performance, and safety profile. This paper provided an update of the previous meta-analysis of the same question, which found...
Preoperative CT checklist (using the ‘CLOSE’ mnemonic) improves identification of anatomical variants for endoscopic sinus surgery
Computed tomography (CT) scans of the paranasal sinuses act as roadmaps for endoscopic sinus surgery (ESS) and careful inspection preoperatively warns the operating surgeon of critical anatomical variants. This study aimed to investigate if implementation of a pre-ESS CT checklist...
Obstructive sleep apnoea: Does maxillomandibular advancement work?
This is a paper from the Netherlands reviewing 62 patients who underwent maxillomandibular advancement for moderate to severe obstructive sleep apnoea. The authors observed a 71% success rate with mean apnoea hypopnea index (AHI) reduction of 69%. There was no...
Risk factors for loco regional recurrence for oral SCC
Over 250,000 cases of oral squamous cell carcinomas are diagnosed annually worldwide with 128,000 registered deaths. The authors of this study are from a single institution in Germany and have conducted a retrospective audit of 517 patients with oral SCC...
Close monitoring of patients for delayed hyponatremia post-transsphenoidal surgery
he incidence of delayed hyponatremia is 16-28% and usually accounts for unplanned readmission of the patient within 30 days after transsphenoidal surgery. One of the surrogate measures of quality of care adopted by the government and regulatory agencies is 30-day...
