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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...

Impact of lingual pumping in Parkinson’s patients with dysphagia

Dysphagia in Parkinson’s disease (PD) is one of the most important causes of mortality in these patients. Swallowing difficulty in Parkinson’s disease is associated with lingual pumping or festination, anterior escape, premature loss of bolus, oral and pharyngeal retention, multiple...

Are upper respiratory symptoms and macroscopic changes in children always due to gastro-oesphageal reflux?

In children, symptoms such as chronic cough, wheezing, stridor, voice changes, persistent asthma and dental erosion are often presumed to be due to gastro-oesophageal reflux and empirical treatment with PPIs is offered. Usual investigations, such as a barium meal, gastroscopy...

Perception of verticality during attacks of Ménière’s

Ménière’s disease (MD) affects the cochlea and all peripheral vestibular receptors. The perception of verticality, a function of the utricle, is evaluated by the subjective visual vertical (SVV) test. The authors studied SVV in two groups of MD patients: a)...

Two for the price of one - multiple parotid neoplasms

With advancing years come many benefits, but one drawback is the acquisition of parotid (or thyroid) neoplasms. Conventional teaching is that most are benign and slowly enlarge, and not infrequently are found bilaterally as in Warthin’s. Pleomorphic adenomas are also...

How common is oropharyngeal dysphagia amongst the adult population?

It is well known that oropharyngeal dysphagia (OD) is a symptom arising from many different aetiologies or disease conditions and that it is a significant morbidity affecting people’s quality of life. Establishing the prevalence of OD is complicated by the...

The hidden dementia in motor neurone disease

It is now well recognised that people with motor neurone disease (also known as amyotrophic lateral sclerosis) are at risk of developing frontotemporal dementia. It can be difficult to recognise the symptoms of cognitive decline in this group due to...

Intermediate risk factors SCC tongue

This retrospective review from Japan assessed 89 patients who underwent surgery for squamous cell carcinoma of the tongue, specifically they reviewed the evidence of perineural and vascular invasion (27.0% and 23.6%). Their results suggest, not unsurprisingly, that perineural and vascular...

No difference upper or lower lip

This is a retrospective review from the Netherlands over a 20-year period to 2009 of squamous cell carcinoma (SCC) of the lip. In total, 979 cases of the lower lip were identified and 126 of the upper lip, with men...

Surgical anatomy for central auditory device implantation

This cadaveric study by researchers in the USA and Japan examined the cerebellopontine angles with the aid of the surgical microscope and 45o endoscope via the retrosigmoid and translabyrinthine approach. Using fibre dissection technique, the ascending auditory pathways between the...

3D printed temporal bones for drilling are here!

It was only a matter of time before the 3D printer was used to help us with simulated temporal bone (TB) drilling. This group printed three paediatric TB models and evaluated their quality. They were found to be of ‘high...

Serum urea and epistaxis

This was a small retrospective review from Swansea looking at 278 patients who attended a teaching hospital Accident and Emergency department with a diagnosis of epistaxis. Only 119 of these patients had their serum urea measured. The investigators found that...