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Learning from reimplantation

The Irish implant centre in Dublin undertook a retrospective study of their reimplantation cases to look at what lessons could be learnt. Device failures fall into two classes: hard and soft failures. Hard failures are implant malfunction or altered performance....

Patient factors associated with spontaneous CSF leak

This article highlights the role of obesity, sleep apnoea and raised intracranial pressure as linked pathologies in the aetiology of the spontaneous cerebrospinal fluid (sCSF) leak. The authors link sCSF leak with obesity and comment on sCSF leak incidence increasing...

Narrow band imaging in laryngopharyngeal reflux

Narrow band imaging (NBI) is a tool on the Olympus endoscopic systems that uses blue and green wavelengths to enhance visualisation of mucosal vasculature. It has been used to aid in the early diagnosis of upper aerodigestive tract cancers. A...

Speech in noise hearing difficulties

The phenomenon of speech understanding in noise in normal hearing people attracts the interest of researchers continuously. This study’s aim was to further explore the possible reasons behind these difficulties. The participants were 50 adults that reported having normal hearing...

Surgical management of refractory osteoradionecrosis

This is a French single-centre, 10-year experience of 55 surgical resection and reconstruction procedures. They claim an overall effectiveness rate of 92.3%. A total of 36 segmental and 19 marginal mandibulectomies were performed. A variety of free flaps were used,...

Hierarchy of orthognathic surgical stability

This study was designed as “an overview” of secondary studies and analysed 15 articles. Two procedures were considered highly unstable: a bilateral sagittal split osteotomy for clockwise rotation of the mandible with bi-cortical screw rigid internal fixation, and posterior maxillary...

Bright young things: executive functioning in younger, older and aphasic people

Executive function comprises several higher order cognitive processes such as planning, organisation, adaptation, maintenance, monitoring and decision making. It is thought that difficulties in cognitive flexibility in people with aphasia are associated with difficulties in executive function rather than the...

Diagnosing complications of acute mastoiditis in emergency situations

In many cases, acute mastoiditis is manageable with intravenous antibiotics and hospitalised care. However, the decision whether to intervene surgically remains crucial and reliance is based on radiological findings – CT scans for bony changes and MRI for possible intra-cerebral...

Is posterior epistaxis really ‘posterior’?

In absence of any clear bleeding points seen on the septum, it is generally presumed that the epistaxis is posterior, especially when simple cauterisation of the septum does not help and may progress to sphenopalatine ligation. In this publication, the...

Salivary pepsin – a simple test for LPR?

A diagnosis of laryngopharyngeal reflux (LPR) can be made on the basis of characteristic symptoms and nasendoscopy findings. Objective tests exist for this condition; for example, 24-hour dual-channel pH-metry which is considered to be the gold standard. Such tests are,...

Do parents sleep better after paediatric adenotonsillectomy?

Paediatric adenotonsillectomy for sleep disordered breathing (SDB) is amongst the commonest surgical procedures performed in ENT. In the outpatient clinic, parents routinely express their concern about their child’s breathing but the impact of sleep disordered breathing on the parent is...

More than words: looking at all the evidence

Evidence based practice (EBP) is a three-pillared approach whereby information on the research evidence, factors relating to the patient and clinical experience are all considered to inform a care decision. Unfortunately, there is frequently very little research evidence to inform...