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Impact of lingual pumping in Parkinson’s patients with dysphagia

Dysphagia in Parkinson’s disease (PD) is one of the most important causes of mortality in these patients. Swallowing difficulty in Parkinson’s disease is associated with lingual pumping or festination, anterior escape, premature loss of bolus, oral and pharyngeal retention, multiple...

Shoulder function in patients undergoing neck dissection: its effects on work and leisure activities

Shoulder dysfunction is common after neck dissection and includes shoulder pain, limited abduction and scapular winging. Modifications of the radical neck dissection were designed to limit morbidity, however, even with accessory nerve-sparing neck dissections, shoulder dysfunction can be seen. Shoulder...

Predictors of complications in patients undergoing oral cavity cancer surgery

Surgical management of oral cavity cancers is complex, frequently involving extensive resections and complicated reconstructions. Quantification of risk in an individual patient may allow surgeons to more effectively identify patients at higher risk of complications and develop strategies for prevention,...

Identifying early flap failure

The holy grail of flap monitoring is an easy, reliable and predictive method to identify impending compromise. Does this paper provide it? Various methods have been used to improve our ability to monitor the viability of a flap and here...

The mark of the head and neck surgeon

Like Zorro, the head and neck surgeon leaves their mark. No more so than during parotid surgery. Various modifications have been put forward modifying the classic Blair incision. This latest modification camouflages the pre-tragal scar by running it on to...

An overview of microsurgical reconstruction of the head and neck worldwide

Microsurgical reconstruction is an integral part of the treatment following ablation for malignancy or trauma. Currently there are no clear treatment guidelines following tumour resection. This was recognised a few years ago and in 2008 various collaborative groups were founded...

Are upper respiratory symptoms and macroscopic changes in children always due to gastro-oesphageal reflux?

In children, symptoms such as chronic cough, wheezing, stridor, voice changes, persistent asthma and dental erosion are often presumed to be due to gastro-oesophageal reflux and empirical treatment with PPIs is offered. Usual investigations, such as a barium meal, gastroscopy...

Does teaching affect patient satisfaction?

Teaching practice on real patients has several advantages in terms of lower costs and genuine clinical material but it is often a concern that using real patients for undergraduate teaching may result in patient dissatisfaction and many patients would prefer...

Guidelines for management of orbital infections

Orbital infections predominantly affect the paediatric population and complications can be very serious. The cellulitis can be preseptal or orbital and the abscess can be confined within the periosteum or extend into the orbit. Cavernous sinus thrombosis can complicate the...

Perception of verticality during attacks of Ménière’s

Ménière’s disease (MD) affects the cochlea and all peripheral vestibular receptors. The perception of verticality, a function of the utricle, is evaluated by the subjective visual vertical (SVV) test. The authors studied SVV in two groups of MD patients: a)...

Horizontal nystagmus: vestibular neuritis or lateral canal BPPV?

A horizontal nystagmus due to lateral canal (LSC) BPPV that is present in the upright position, that changes direction with head turn in the horizontal plane has been termed ‘pseudo-spontaneous nystagmus’ (PSN) because it mimics that of vestibular neuritis. The...

Botox application for drooling shrinks salivary glands

The large majority of sialorrhoea (drooling) in paediatric patients is managed conservatively. However in severe cases, often where there is associated developmental delay or a motor disorder, medical and surgical techniques can be used to decrease salivary flow. Botulinum toxin...