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Should we reconsider induction chemotherapy in advanced stage laryngeal cancer?

Use of chemo-radiotherapy for advanced laryngeal cancer led to a major shift in treatment as an alternative to total laryngectomy. Despite widespread adoption of chemoradiotherapy, survival rates have not improved and the original premise of matching neoadjuvant chemotherapy tumour response...

Unilateral vocal cord mobility impairment and laryngopulmonary physiology

The concept of iatrogenic recurrent laryngeal nerve injury following thyroid surgery is often considered with respect to voice change but its potential impact on airway physiology has thus far not been evaluated. A cross-sectional observational study reviewed 21 patients with...

The future role of technology in rhinology

Technology is moving our speciality forward very rapidly in all domains, but none more so than in rhinology. David Whitehead looks at current and future trends. How will a surgeon justify their position in a team where artificial intelligence (AI)...

Head injury and prolonged bed rest, but not inner ear disease, predict poorer outcome after Epley manoeuvre in posterior semicircular canal benign paroxysmal positional vertgo (P-BPPV)

This Japanese study included 197 patients with P-BPPV treated over a two and a half year period. The vast majority had idiopathic BPPV (n=157). The remaining 40 had secondary BPPV, eight following head trauma, 14 due to prolonged bed rest...

Vestibular migraine or BPPV?

There are close similarities between benign paroxysmal positional vertigo (BPPV) and vestibular migraine (VM) as both can be presented by positional nystagmus. Though BPPV remains the commonest cause of pure positional vertigo, VM can mimic this condition. This study is...

Clinical features of BPPV in Meniere’s disease

It is an observation that BPPV appears to be commonly associated with Meniere’s disease (MD). This five-year study compared features and treatment outcomes between patients presenting with MD in conjunction with unilateral BPPV and a group of BPPV patients without...

BPPV and bone mineral density

Over the years, attempts have been made to identify modifiable risk factors for BPPV. Due to the chemical composition of otoconia, the role of calcium metabolism and its associated conditions have been studied with no firm conclusions. The authors studied...

Type 2 diabetes and BPPV

Previous research has shown an association between BPPV and certain medical conditions such as hypertension, hyperlipidaemia and type 1 diabetes. The authors in this retrospective observational study investigated the interaction between BPPV and type 2 diabetes by examining the ‘role...

Paediatric obstructive sleep apnoea

As tonsillectomy rates for recurrent sore throats have declined, there has been increasing recognition of the importance of OSA in children. Not always diagnosed early – or in some cases at all – and with continuing debate as to how...

Bile acids and pharyngeal malignancy

Laryngopharyngeal reflux is a commonly described condition. There is strong evidence linking gastro-oesophageal reflux with oesophageal carcinomas. Gastric refluxate consists of gastric acid, pepsin and bile acids. The roles of pepsin and acidic conditions in the development of laryngopharyngeal carcinoma...

The theory of everything (tonsil)?

Tonsil sepsis can manifest as acute tonsillitis, a peritonsillar abscess (PTA) or rarely as an intra-tonsillar (ITA) abscess. Whilst the management of these conditions is familiar to ENT surgeons from early in training, perhaps little attention has been paid to...

Laryngeal Physiology for the Surgeon and Clinician – Second Edition

This second edition is a short (110 pages), succinct and concise book. I don’t usually like reading physiology textbooks, but I found this one very interesting. It is written in a manner which is easy to read and digest. It’s...