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The effects of polypharmacy in the elderly
Another pill to cure the ill? Alec Lapira discusses the warning signs of polypharmacy in the elderly population. Polypharmacy in the elderly Polypharmacy – defined as the use of five or more medications – occurs in 20–37% of older people...Anaesthesia for free-flap surgery
Adel Hutchinson is one of those calm and controlled anaesthetists for whom nothing seems too difficult. In this article, she describes the key perioperative factors for one of the highest complexity operations in ENT; free-flap surgery. It makes good reading...
Coblation for laryngeal granulomas
Laryngeal granulomas remain notorious for their tendency to recur after surgical removal. Although high rates of complete remission have been reported with use of the potassium-titanyl-phosphate (KTP) laser, this equipment is expensive and not available in all units performing ENT...Improving cochlear-implant performance in the short- and medium-term
Can bespoke cochlear implant programming strategies reduce the variability seen in patient performance with an implant? Bob Carlyon reviews the current situation and gives us a glimpse of the future. Although many cochlear implant (CI) patients understand speech well in...
Impact of the updated cancer staging system on HPV-positive disease
The AJCC cancer staging manual was updated in 2017 (8th edition). It is used in the MDT setting for planning treatment and assessing prognosis for individual patients, and is also widely used internationally in clinical trials. Unlike previous iterations of...Using psychological behaviour change theory in vestibular practice
Fiona Barker explains the importance of recognising and understanding how habitual behaviours in vestibular patients can affect treatment outcomes, and how we as audiologists can support and encourage patients to modify these behaviours and perhaps address our own professional behaviours...Neural plasticity and aural rehabilitation
Neural plasticity refers to an ability of the brain and central nervous system to change their structure and function or their reorganisation in response to environmental cues, experience, learning, behaviour, injury and / or diseases and treatments. Neural plasticity is...
Multiple free flaps for head and neck cancer
Most patients with advanced head and neck cancers now undergo microvascular free flap reconstruction. This is mainly as flaps facilitate complete tumour and margin removal by providing reliable wound coverage and better restoration of form and function. However despite this,...Endotypes in chronic rhinosinusitis: clinical relevance
Identifying endotypes enables personalised therapies that target specific pathophysiological processes, potentially resulting in better treatment outcomes for patients. The contemporary model of chronic rhinosinusitis (CRS) pathogenesis revolving around endotype, in combination with an expanding toolbox of diagnostics and therapeutics, enables...Labour rights violations in the manufacture of healthcare goods
Every year trillions of dollars are spent on medical supplies globally. The operating theatre is a significant proportion of this spend, typically accounting for a third of a hospital’s supply costs. When making purchasing decisions consideration is given to value...
Carnoy’s and the KOT
This is a retrospective review of 105 patients with keratocystic odontogenic tumours treated over a 23-year period with a mean follow up of 86 months. The recurrence rate was 11.4%. Permanent neuro-sensory deficit of the inferior alveolar nerve 16%. Younger...
