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Stepwise approach to manage palatal myoclonus successfully
Palatal myoclonic tinnitus (PMT) is a rare condition caused by rhythmic voluntary or involuntary movements of the soft palate, mainly the tensor veli palatini and levator veli palatine muscles. Patients usually present with a ‘clicky’ noise in the ear. Oral...
Patient positioning for transnasal flexible laryngoscopy
The position of a patient’s head during flexible nasendoscopy to visualise the larynx does not usually require much consideration – adequate views are almost always obtained with a patient sitting in a neutral position. Occasionally however, there will be patients...
Back to the future: aphasia therapy post stroke
When speech and language therapist first started working with people with stroke-related aphasia, they employed a general stimulation approach, the same with every patient they met. In the '70s this changed, and a more tailored approach was developed whereby therapists...
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,...
Your voice and your personality
Variations of vocal effort are a normal adaptation to difficult communication situations. However, persistence of these abnormal strategies can lead to various functional dysphonias. In this experiment, the authors tested 41 females aged 18-52. The subjects were asked to instruct...
Novel method for determining BCC margins
This correspondence describes a new technique for determining basal cell carcinoma (BCC) borders, to aid in obtaining clear peripheral resection margins. Whilst this can be straightforward in small well-defined nodular BCCs, some BCC subtypes are ill-defined or morphoeic, and resection...
Information to support decision-making: does it make sense online?
The internet has become a major source for health information, with many people preferring to use the internet to search for advice than speaking to health professionals. Yet much of the information available is very difficult to read for the...
Everyone has the right to say no
Despite the introduction of the Mental Capacity Act in 2005, healthcare professionals remain uncomfortable with individuals who choose not to follow medical advice - who make informed decisions to decline a treatment or management plans. This paper highlights that speech...
Complex Cochlear Implant Cases – Management and Troubleshooting
When working with cochlear implant (CI) recipients who are not responding as well as expected or their case incorporates new challenges for the audiologist, the common response is a quick panic, closely followed by a question: what do we do...
Do adhesions actually cause nasal blockage?
All of us who perform nasal surgery are familiar with the disappointing presence of nasal adhesions (NA) or synechiae in our postop patients. These can often lead to patients deriving less perceived benefit from their surgery than that which they...
An unrecognised anatomical variant which may help frontal sinus surgery
Anatomic variants in the frontal sinus have significant implications in endoscopic sinus surgery. In this illustrative study, the authors describe a newly-observed anatomical variant – a mucosa lined prism‑shaped space between the most superior part of the nasal septum and...
