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The electromagnetic larynx
Current treatment options for a bilateral vocal cord palsy (tracheostomy, posterior cordotomy, arytenoidectomy) are suboptimal, with a focus primarily on a static means of airway restoration at the expense of voice production and potentially swallow safety. This paper reports on...
Neuromodulation in drug resistant epilepsy
Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...
Increasing tongue strength to reduce dysphagia: what is the potential benefit of a device driven exercise?
Weakness in tongue muscle strength and laryngeal elevation is known to have an adverse impact on swallowing function. Various swallowing exercises are often recommended to improve function of these important structures with the goal of preventing aspiration and improving swallow...
X-ray vs. intraoperative testing for determining cochlear implant placement
Most cochlear implant centres confirm electrode position after surgery using X-rays to ensure optimal electrode placement. As well as transorbital view X-rays, this team check placement using impedance measures and neural response telemetry (NRT) performed intraoperatively. The former indicates whether...
Parapharyngeal space tumours – is the transoral approach effective?
Several approaches are described to the parapharyngeal space to permit resection of tumours in this region, with the most commonly employed approach being the transcervical route. The transoral approach remains somewhat controversial as it is felt that this approach can...
The lateral neck cystic mass – diagnostic dilemma. Can HPV status help?
Solitary cystic masses in the lateral neck can present a significant diagnostic dilemma as they can be metastases from tumours of the oro or nasopharynx. This retrospective paper detailed all patients presenting to a university hospital in Germany, from September...
Grading dysphagia as a toxicity in treating head and neck cancer
Common Terminology Criteria for Adverse Events (CTCAE) is a system used by clinicians to grade the toxicity of oncology treatments in a standardised manner. Dysphagia is perhaps the most common long-term toxicity of head and neck cancer treatment. Currently, a...
Transnasal endoscopic repair of CSF leaks
This Italian study was a retrospective review of 110 consecutive patients who underwent repair of their CSF leak via the transnasal endoscopic approach from 2003 to 2013. All surgery was performed by the same primary surgeon and patients with a...
Parathyroid pearls
This article serves to deliver some pearls of wisdom in parathyroid surgery for the ‘low volume parathyroid surgeon’. They have been divided into those relating to the preoperative diagnosis, imaging and localisation techniques and surgical difficulties. Recognised sources of error...
CSF leak – endoscopic or open repair?
Cerebrospinal fluid (CSF) rhinorrhoea is well known to the ENT surgeon. It commonly occurs secondary to a predisposing event such as accidental or iatrogenic trauma. When it occurs spontaneously, it can be associated with benign intracranial hypertension. The commonest CSF...
Management of the neck in maxillary sinus carcinomas
Primary malignant tumours of the sinonasal tract account for less than 10% of head and neck cancers, of which the maxilla is the second most common subsite and squamous cell carcinoma (SCC) is the most prevalent histological type. Maxillary SCCs...
