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From a dysphagia clinical trial to a multidisciplinary head and neck clinical pathway – the road to implementation

This paper describes the barriers and facilitators to establishing a structured and coordinated multidisciplinary care pathway for patients with head and neck cancer at a medical centre in the USA. The initiative was set in motion by the roll out...

How to train adults with single-sided deafness and cochlear implants

Cochlear implantation (CI) in patients with single-sided deafness (SSD) has been carried out in Perth, Australia from 2008. It poses challenges to clinicians and patients who are trying to tune in the poorer ear while still having a normally hearing...

A novel scale for the assessment of tracheoesophageal voice quality – the SToPS

There is currently no assessment tool in widespread use that permits a valid and reliable perceptual assessment of voice quality following laryngectomy. Such a scale is needed to investigate the functional outcomes of surgical voice restoration and rehabilitation regimes. Existing...

Sarcopenia and dysphagia in older community-dwelling adults

The prevalence of dysphagia in community-dwelling older adults is reported to be around 15%. Outside of common neurological causes such as stroke, Parkinson’s disease and dementia, recent studies have suggested that sarcopenia may be an independent risk factor for the...

Elevated prevalence of late-onset dysphagia among head and neck cancer survivors and identifying risk factors

Dysphagia is one of the most common problems affecting head and neck cancer (HNC) survivors. There are few studies investigating late-onset dysphagia post-treatment. The authors set out to investigate the prevalence of dysphagia-related diagnoses and procedures five years’ post-treatment, changes...

Risks of tracheostomy in head and neck cancer

Tracheostomy is associated with several complications, with rates quoted as high as 8-45%, including: bleeding; displacement; obstruction; surgical emphysema; pneumothorax; fistulae and failure to decannulate. There are now many studies that confirm the increased length of stay and complications of...

Allergic rhinitis, the usual suspects

Allergic rhinitis (AR) is characterised by allergen binding to IgE on mast cells and basophils and subsequent histamine, prostaglandine D2 (PGD2) and cysteinyl leukotrienes (cysLTs) release causing early-phase response. This is followed by late-phase response mediated by eosinophils. Other cells,...

Prediction of morbidity and mortality in patients undergoing thyroid or parathyroid surgery

Major postoperative adverse events in thyroid or parathyroid surgery are uncommon. Various authors have developed risk indices to identify physical deficits in patients undergoing elective surgery. The literature is less clear about patients undergoing thyroid or parathyroid surgery. In this...

Thyroidectomy patient survey regarding voice outcomes

One of the common adverse effects following thyroid surgery is a change in voice, which may be related to iatrogenic injury to the recurrent laryngeal nerve or superior laryngeal nerve during surgery or by direct cancer involvement. The burden of...

What to do if adenotonsillectomy does not cure sleep apnoea in children?

This article reviews the management of children with persistent obstructive sleep apnoea (OSA) following adenotonsillectomy (AT). Risk factors for patients to have persistent disease include obesity, being Afro-Caribbean and existing co-morbidities such as craniofacial and neuromuscular disorders. Initial assessment of...

Telepractice for the delivery of paediatric feeding services

During the current COVID-19 pandemic, telepractice is being heralded as the safest service delivery mode for the majority of outpatient consultations. Patients are reviewed by their healthcare specialist through video consultations, thus avoiding the need for patients to leave their...

Predicting the need for salvage laryngectomy

The treatment of laryngeal cancer has seen a shift towards organ preservation strategies with non-surgical treatment offering equivalent survival outcomes. Nonetheless, salvage total laryngectomy (SLT) remains an important curative management option in cases of treatment failure or recurrence. The authors...