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An update on laryngeal reinnervation

Laryngeal paralysis remains very difficult to treat, but reinnervation offers many attractions. Laryngeal paralysis presents a unique and varied problem that requires a patient centred approach and a range of treatment options depending on laryngeal and patient factors. There is...

What characterises dysphagia in unilateral vocal fold impairment?

The closure of the vocal folds during swallowing is known to contribute to airway protection along with epiglottic inversion and closure of the false vocal folds. It is therefore plausible to expect that unilateral vocal fold impairment without complete closure...

Nasal peak inspiratory flow (NPIF) as a diagnostic tool for differentiating decongestable from structural nasal obstruction

Identification of the cause of nasal obstruction is critical before surgical intervention such as septoplasty. This study assesses changes in nasal peak inspiratory flow (NPIF) as a tool for discriminating decongestable versus structural obstruction. A cross-sectional study of 52 patients...

Vocal cord dysfunction and dysfunctional breathing: an evolving clinical paradigm

Patients frequently present to the ENT department with breathing difficulties. The entity of ‘vocal cord dysfunction’ (also known as paradoxical vocal cord movement, inducible laryngeal obstruction, and many other names) is increasingly well recognised. Ravi Thevasagayam gives us an overview....

Dysphagia in complex laryngology – maintaining the balance

These authors from the speech and language therapy department at Imperial College Healthcare NHS Trust, describe their view of a patient-centred approach to managing dysphagia in complex laryngology. Careful consideration of the balance of airway, voice and swallow, which is...

Developing principles of swallow rehabilitation using novel animal modelling

Never let it be said that we don’t cover a wide range of topics. Camilla Dawson tells us about the crossover between swallowing in seals and in humans. Rehabilitation of swallow is complex, informed by anatomical and physiological systems and...

Assessment of viral aetiology in the formation of nasal polyps

The exact aetiology of nasal polyposis is not yet established although it is believed that allergic, infectious, mechanical, immunological and biochemical factors may be involved. Using the technique of polymerase chain reaction, this study assesses the role of human adenovirus,...

Development of a new negative-pressure ventilatory support device: Exovent

The pandemic has driven innovation in ways that we have not seen for many decades. Intensive care medicine and ENT have been at the forefront of these advances, and our good friends David Howard (never one to put his feet...

COVID-19 in China: the experience of an ENT team

In January, we first heard of COVID-19. As we currently do battle with it on our own shores, colleagues in China share their story with us as life there slowly and cautiously begins to return to normal and the country...

Some guidelines for treating rhinological patients during the COVID-19 pandemic

This is a very interesting and informative multinational European guide to the treatment of rhinology patients during the current pandemic, describing the safe delivery of a rhinological service to patients. Much of this has become well understood and standard practice...

Post-thyroidectomy vocal cord palsy: are there long-term sequelae?

This is a well written paper utilising the Hospital Episode Statistics dataset for all thyroidectomies performed in England between 2004 and 2012. The study had a very impressive 43,515 participants and only included young, fit patients undergoing thyroidectomy once for...

Anxiety and acronyms – musings of an otolaryngologist

Personal protective equipment (PPE) has been a focus of attention and concern for healthcare workers around the globe during the COVID-19 pandemic. Neil Tolley discusses some of the issues. I write this article in mid-May when, were it not for...