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Entrepreneurial aspirations for the otolaryngologist

Entrepreneurship is a process of identifying an idea and starting a business venture with this idea. It requires generation of a business model or plan that emphasises the value proposition for the customer. The model must identify the partners, resources,...

My experience of addiction

In this incredibly honest and thought-provoking article, we hear from an anonymous doctor who has struggled with addiction. The nature of addiction is a subject of interest to a broad range of scientific disciplines, from medicine to psychology, psychotherapy and...

‘Bare below the elbows’

So it has finally happened. I have reached that stage of reactionary bewilderment known as middle age. As well having my finger nowhere near the pulse of contemporary culture, I am finding the siren charms of BBC Radio 2 and...

Voice change after total thyroidectomy with intact laryngeal nerves – a common but temporary problem

It has been reported that up to 87% of patients have a degree of voice dysfunction after thyroidectomy, even when the laryngeal nerves are preserved. Postoperative inflammation, laryngeal oedema due to vascular congestion, direct damage to the cricothyroid muscles and...

What’s happened since the European position paper on nose and sinus tumours?

The management of malignant sinonasal tumours has gone through radical changes in recent years. Prof Valerie Lund gives us an update based on her upcoming talk at IFOS. In 2010 when we published the European position paper on ‘endoscopic management...

Did you ever meet Draffin on your travels?

Draffin’s rods or bipods are a well-known ENT instrument. Before their invention in 1951, the attendant anaesthetist or nurse was obliged to support the mouthgag during tonsillectomy. Their originator, David Alexander Draffin (born in 1917 in Ballybey, Co Monaghan), was...

Outcomes in rhinosinusitis

This review goes through the various different ways of assessing outcomes and describes the pros, cons and limitations of each. The different methods are described in the context of guidelines in diagnosis and management and compared with other conditions such...

Prevention better than cure?

This systematic review looks at methods of ‘barrier protection’ or ‘barrier-enforcing’ to minimise allergic rhinitis symptoms, using 15 RCTs. Whilst the authors admit that patient numbers were small in a number of these studies, generally it seems that barrier techniques...

Antibiotic prophylaxis in otolaryngologic surgery. Less is better!

Jan/Feb 2020 Editor’s Choice is a review of antibiotic prophylaxis in ENT and OMF surgery. It is not the first systematic review and meta-analysis published in the last two years. If anyone else has been offered a “potentially career-altering opportunity”...

Locked or unlocked?

This systematic review and meta-analysis from the Netherlands evaluates postoperative complications of mandibular fractures using locking and non-locking systems. It is suggested that postoperative complications of surgical treatment of mandibular fractures occur in 20-26% of patients, and it is thought...

Lymph node ratio in tongue cancer

This is an analysis of 88 patients treated in Switzerland between 2003 and 2012. All patients had a selective neck dissection and recurrence occurred in 25 patients. Overall and disease specific survival were 72% and 80%. They specifically looked at...

Safe distances in the infratemporal fossa

This analysis from China involved 50 enhanced CT datasets to reconstruct the skull, internal carotid artery and the internal jugular vein. The anatomical routes of these vessels were related to the styloid process, height of the pterygoid plates, distance from...