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What is Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE)?

THRIVE is a physiological mechanism for oxygenating and ventilating patients who are under general anaesthesia and who have diminished or absent respiratory effort [1]. Classical ventilation requires bulk flow of gases into and out of the lungs driven by chest...

What is the right balance to strike in the management of anaplastic thyroid cancer?

This is a pragmatic article on a difficult and much debated subject. Management of anaplastic thyroid cancer (ATC) can feel like making decisions between a rock and a hard place, and this article suggests one path to help navigate some...

Precision medicine in allergic rhinitis and chronic rhinosinusitis

Precision medicine (PM) with its ‘four Ps’ (personalised, predictive, preventive and participatory) is about appreciating differences between individuals when offering management options for health problems. Multiple groups interested in rhinology such as EPOS and ARIA supported a review of the...

Signia UK announces partnership with EARWAYS Medical Ltd for distribution

The EarWay® Pro by EARWAYS Medical is now available on the NHS Supply Chain Framework

Head and neck high dependency unit - an alternative to ITU?

Close observation of the airway is a primary requirement for patients undergoing major head and neck surgery. It is also necessary for patients with upper airway infection and trauma. Wound care, drains, feeding and analgesia also require specific attention. Whilst...

Sleep apnoea in children with craniofacial syndromes

Whilst snoring and obstructive sleep apnoea are relatively common diagnoses in paediatric ENT, children with craniofacial syndromes take the problem to the next level. Robert Nash and Michelle Wyatt describe the Great Ormond Street multidisciplinary approach to treating this complex...

Botulinum toxin injection for bilateral recurrent laryngeal nerve paralysis

All traditional surgical treatments for bilateral recurrent laryngeal nerve (RLN) paralysis are essentially a balance between maximising airway patency and ensuring adequate phonation / airway protection. This paper highlights the potential role of botulinum toxin (Botox) injection into the cricothyroid...

Anaesthesia for sleep nasendoscopy and snoring / obstructive sleep apnoea surgery

Surgery for sleep disordered breathing inevitably requires surgeon and anaesthetist to share the airway. Here, Edward Bick gives us the anaesthetic viewpoint, reiterating that communication is the key. A specific note is made of the anaesthetic technique for sleep nasendoscopy,...

The use of THRIVE in laryngology and phonosurgery

The team in Lewisham has been using THRIVE for our phonosurgical cases for about a year. Here, we discuss the pros, cons and potential pitfalls of setting up and using THRIVE as ventilation during anaesthesia rather than using an ML...

Do adhesions actually cause nasal blockage?

All of us who perform nasal surgery are familiar with the disappointing presence of nasal adhesions (NA) or synechiae in our postop patients. These can often lead to patients deriving less perceived benefit from their surgery than that which they...

Surgical management of sleep disordered breathing

Snoring and sleep-disordered breathing are often described as multi-level problems, and different surgical procedures are required to treat the various sites of airway narrowing and/or collapse. Jonathan Hobson gives us an eloquent run-through the various options available to the ENT...

Effects of air pollution and climate change on the upper airways

Dr Alexander Simidchiev is a specialist in internal medicine, pulmonary medicine and public health. He is the Co-Founder and President of Air for Health, a non-profit organisation aimed at educating medical professionals about the impact of air pollution and climate...