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Enhanced recovery following surgery for head and neck cancer – the current evidence

Enhanced recovery after surgery (ERAS) programmes are now well established in many surgical specialities as a means of reducing postoperative complications and length of stay in hospital. Whilst many head and neck teams have interventions used to aid postoperative recovery,...

Active smoking predicts poor outcome in HPV positive oropharyngeal squamous cell carcinoma

Tobacco smoking is a well-known risk factor in human papilloma virus (HPV)-negative head and neck squamous cell cancer. Its effects include increased risk of treatment failure, distant metastases and reduced overall survival. HPV has been increasingly implicated as a causative...

3D endoscopy in pituitary adenoma surgery

Endoscopic approach for pituitary adenoma surgery is well recognised. There has been recent refinement of 3D endoscopy technology which improves on the depth of vision offered and more compact delivery. This may improve visualisation of the critical structures involved in...

An alternative device for obstructive sleep apnoea

Continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnoea (OSA), primarily due to the vast amount of short-term evidence in the medical literature it has accrued. The enduring obstacle to CPAP from becoming a treatment option...

Socially appropriate part 1: assessing people with TBI

Social communication disorders are one of the most common and yet most under-addressed sequelae of a traumatic brain injury (TBI). Yet speech and language therapists report a lack of assessment tools and a lack of time to fully assess these...

What are the risk factors for new onset tinnitus?

Factors associated with tinnitus have mainly been studied cross-sectionally. Tinnitus is associated with hearing loss, noise exposure, ototoxic medication, head and neck trauma, smoking and depression and anxiety. Only a few studies exist that report on risk factors for developing...

Peptest Q&A

Untreated reflux can cause inflammation, scarring, narrowing and precancerous changes in the oesophagus and larynx, and may increase the risk of asthma and sleep apnoea.

The power of (younger versus older) lips

The Directional into Velocity of Articulators (DIVA) model theorises that we require both auditory and sensory feedback - from our articulators - in order to ensure we are able to produce precise and powerful articulatory movements. This study aimed to...

How effective and safe is audiologist-led screening of acoustic neuroma in patients with asymmetrical hearing loss and unilateral tinnitus?

About two out of 100 patients presenting with asymmetric hearing and unilateral tinnitus have acoustic neuroma. The traditional method in which these patients first attend a clinician and then undergo screening through an MRI, can be expensive and prolong the...

Tonsillectomy in or out?

Although tonsillectomy is the most common surgical act performed in ENT practice, there is still some concern about the safety of outpatient or day surgery scheduling, especially in adults. Although this has been common practice in many departments for some...

Do nasogastric tubes affect aspiration risk?

A nasogastric tube (NGT) is frequently used for patients who are at risk of endotracheal aspiration of oral diet. However, this cannot eliminate the aspiration of saliva. The incidence of aspiration pneumonia in patients with NGT therefore remains high. Some...

DVT prophylaxis in cranial procedures

Deep vein thrombosis (DVT) is a result of disturbed balances in blood flow patterns, blood clotting factors promoting coagulation and vessel wall endothelial injury. The subsequent disruption of coagulation and fibrinolysis mechanisms lead to venous clot formation and propagation. The...