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Preoperative imaging for thyroid cancer according to 2015 ATA guidelines

The 2015 American Thyroid Association (ATA) management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer suggest that thyroid sonography with survey of the cervical lymph nodes should be performed in all patients with known or suspected thyroid...

Nasal steroids do not cause ocular problems

This excellent, high quality and detailed systematic review from Australia dispels the myth propagated recently by some poorly designed studies that intranasal corticosteroids cause intraocular problems. A 40 year review of the usual databases found 665 articles and 19 were...

Evidence based guidelines for ONS treatment in occipital neuralgia

Occipital neuralgia (ON) can flummox otolaryngologists especially when it follows mastoid surgery. The paroxysms of sharp, electrical pain originating from the occiput can extend along the posterior aspect of the scalp and even up to the mastoid. Although the aetiology...

Linking tooth extraction and snoring

One of the more contemporaneous theories about OSA is that extraction of teeth or other orthodontic treatment during the development of the facial skeleton leads to alteration of bony growth and therefore alteration of the final result. There is evidence...

When should that child’s wet ear be operated on?

The team from Birmingham have provided a meta-analysis to answer the question of when to perform a type 1 tympanoplasty on chronic paediatric perforations (under 18 year olds). Forty-five studies were included which resulted in 2609 cases. Closure rate at...

Is submandibular gland transfer effective in prevention of post irradiation xerostomia in head and neck cancer patients?

Post irradiation xerostomia is a common side effect of irradiation to the head and neck region, with up to 90% of patients reporting some symptoms. Submandibular glands account for 70% of resting saliva production. Surgically transferring the submandibular gland to...

Chemo-radiation in elderly patients with head and neck cancers

Chemo-radiotherapy is the standard of care for organ preservation in stage three and four oropharyngeal cancer, prospective data on patients over 65 has not been available as they are usually excluded from randomised trials. This paper reviews the experience of...

Prophylactic swallowing exercises in head and neck cancer

Clinicians working in head and neck cancer will be familiar with the increased interest in prophylactic swallowing exercises to reduce the devastating impact of dysphagia experienced by patients undergoing radiation or chemo-radiation therapy. This study from Denmark is one of...

Reducing pulse rate in videofluoroscopy: less is not best!

Recently, there has been increasing discussion in clinical meetings about the use of ionising radiation in swallowing assessments and the associated cancer risks. This is therefore a timely publication to inform discussions around whether reducing pulse rate from 30 pulses...

A future for unilateral deafness

Every year, we see several patients struggling with irreversible unilateral hearing loss that is non-responsive to sound amplification. This article emphasises that clinicians should not underestimate the functional and psychological impairment single-sided deafness can have on an individual, even though...

A surgeon’s perspective on the challenges facing cochlear implantation in children

Cochlear implantation in children offers a different set of challenges and goals to adult practice. In this article, Iain Bruce, Professor of Paediatric Otolaryngology in Manchester, UK, explains some of the current clinical and research challenges in paediatric cochlear implantation,...

Intratympanic treatments for subjective idiopathic tinnitus

Direct application of medication into the ear is long established, going back as far as written records. In the modern era, greater understanding of aural anatomy revealed that drugs instilled in the middle ear could potentially diffuse into the cochlea...