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Technology at the right time in the right place for people with communication difficulties

The ‘just-in-time’ (JIT) construct was developed as a business strategy for a major Japanese car company in the 1970s. It has now been applied to many other business models throughout the world. The JIT concept is where something is provided,...

Approach to the orbital floor: which is better?

During skeletal surgery sufficient exposure is key – often a direct approach through the overlying tissues is the easiest route. In the face, however, as the scar would be readily visible, approaches are designed to hide this. Surgical access to...

Are there benefits of prophylactic swallowing exercises for patients with head and neck cancer?

This randomised controlled trial aimed to establish the impact of prophylactic swallowing exercises in patients undergoing chemoradiation therapy for head and neck cancer. The primary outcome was the functional oral intake scale (FOIS), although secondary measures for feeding tube use,...

Predicting the prognosis of oral squamous cell carcinoma after salvage surgery

Loco-regional recurrence of oral cavity squamous cell carcinoma (OCSCC) continues to be a life-threatening and difficult clinical situation. Salvage surgery can result in significant morbidities, and survival following recurrence is generally poor. In this study from Ontario, Canada, prognostic factors...

Do you use the evidence or do you just know to do that?

In this day and age we generally consider healthcare practice to be evidence-based. Unfortunately there are not always the plethora of research articles available that address the dilemmas of day-to-day clinical practice. This piece of work considers what factors influence...

Predicting which oropharyngeal SCC HPV-positive patients should avoid de-escalated treatment

This study is timely for many reasons and raises very important questions in the management of the current rise in HPV-positive patients with oropharyngeal cancer (OPC). The uniqueness of this group within head and neck cancer in terms of favourable...

SPECT-CT imaging improves surgical efficiency in sentinel lymph node biopsy in melanoma

Sentinel lymph node biopsy is used in clinically lymph node negative, primary cutaneous melanoma. A combination of planer lymposcintigraphy using a radiolabelled colloid detected intra-op by gamma probe, and cutaneous injection of blue dye is used. However, with lymphoscintigraphy spillage...

Growing up smelling the roses

How often do we ask about sense of smell in children? Undoubtedly, the olfactory function is seldom formally assessed in the paediatric population, although evidence exists to suggest its potential links with handicap in children’s learning and development. This large...

Imagine a future without hearing loss

This article reflects on both the past 20 years and the next 20 years of research and service provision for children who are deaf or hard of hearing. The authors describe how universal newborn hearing screens have had a dramatic...

Persistent dysphonia due to cricothyroid muscle dystonia – should we be requesting laryngeal EMGs for non-resolving ‘functional’ dysphonia?

This article is an interesting report of a case of persistent voice problems affecting a 43-year-old physician that significantly compromised her ability to converse and communicate at work. Specifically, she had a fluctuating voice quality that would ‘choke off’, combined...

Difficult consultations with HPV-positive oropharnyeal cancer patients

The aetiological role of human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OPSCC) is well established, and its incidence has massively increased over the last decade, whilst the incidence of HPV-negative OPSCC is declining. Although we know that HPV-positive OPSCC...

How effective is vestibular rehabilitation in bilateral vestibular failure?

In patients with bilateral vestibular hypofunction (BVH), the outcome of vestibular rehabilitation is mixed. The aim of the study was to identify factors associated with outcome of vestibular rehabilitation (VR) in patients with BVH. A retrospective case notes review identified...