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What is the optimum duration of voice rest after microlaryngoscopy procedures?

Recent survey data looking at the opinions and practices of otolaryngologists in the US and the UK demonstrate that there is a wide variation in recommendations made for voice rest after vocal fold surgery. In the US, the most common...

Is there a ‘best’ ventilation tube?

Studies on grommet materials and sizes are not exactly new but this was a well-designed randomized study in Sweden with some useful findings. The extrusion rate and complications associated with four different ventilation tubes (grommets) were assessed prospectively in 400...

Complication rates for grommet insertion in H&N cancer patients

Otitis Media (OM) can be the direct result of H&N malignancy itself or secondary to treatment of malignancy. Both surgery and radiotherapy can cause lasting changes to the physiologic function of the ET, middle ear, tympanic membrane and ear canal....

Speech and language therapy is valuable for people at all stages of dementia

The number of people living with dementia is going to increase significantly over the coming 10-20 years. The authors of this article describe the breadth of the role of speech and language therapists (SLTs) working with people with dementia. They...

A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth

It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...

Managing high flow head and neck arteriovenous malformations (AVM)

Vascular malformations are lesions where the traditional network of capillaries linking arteries and veins are lacking. Patients usually present with bleeding, pain, disfigurement and tissue expansion and destruction. High flow lesions can be challenging to manage in the head and...

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...

Persistent dysphonia due to cricothyroid muscle dystonia – should we be requesting laryngeal EMGs for non-resolving ‘functional’ dysphonia?

This article is an interesting report of a case of persistent voice problems affecting a 43-year-old physician that significantly compromised her ability to converse and communicate at work. Specifically, she had a fluctuating voice quality that would ‘choke off’, combined...

Preoperative risk factors: when do you need to refer to the haematologist?

It is essential that clinicians are able to identify and assess which patients are in the high risk category for bleeding during ENT surgery. A full history, including medications, herbal remedies taken, any other medical co-morbidities and family history of...

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...

Age and the SSCC

This is a radioanatomical study on the CT scans of 385 temporal bones to measure some parameters of the superior semicircular canals (SCCC) including bony thickness, diameter and projection into the middle cranial fossa. All measurements were performed on a...

Difficult consultations with HPV-positive oropharnyeal cancer patients

The aetiological role of human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OPSCC) is well established, and its incidence has massively increased over the last decade, whilst the incidence of HPV-negative OPSCC is declining. Although we know that HPV-positive OPSCC...