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Nature or nurture in surgical training

It’s Thursday in the UK, so that means time for another root and branch reform of medical training. If you’re not keen on the Greenaway Report (Shape of Training review) [1], don’t fret there’ll be another one along well before...

Feeling like a fraud — imposter syndrome: what it is and what to do about it

Have you ever been plagued by feelings of incompetence despite evidence to the contrary, then this article is for you. Dr Dunay Schmulian provides insight into imposter syndrome and what to do about it. Excerpt 1 Senior Audiologist: That was...

BPPV and pregnancy

This narrative review explores the limited evidence surrounding benign paroxysmal positional vertigo (BPPV) during pregnancy. Although BPPV is the most common vestibular disorder and is known to affect women more frequently than men, the literature specifically examining its occurrence in...

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...

The middle way: treating idiopathic facial nerve palsy

Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...

Voice outcomes following extended laser resections for laryngeal cancer

It is now widely accepted that the oncological and voice outcomes following transoral laser microsurgery for early T1a glottic cancers are equivalent to, if not superior to, traditional radiotherapy. Voice outcomes following more extensive resections have not been as frequently...

The vestibular system is not immune to chronic otitis media

It is well recognised that chronic otitis media (COM) is a risk factor for sensorineural hearing loss. Studies on the effect of COM on vestibular function have been beset by design biases. The authors designed a case control study to...

Does endoscopic sinus surgery for chronic rhinosinusitis improve COPD?

Chronic rhinosinusitis (CRS) can be associated with asthma, with a reported frequency of asthma in patients with CRS of up to 44%. COPD is another lung condition that can be associated with CRS. This longitudinal study reviewed the nasal and...

Can diet alone be used to treat laryngopharyngeal reflux?

In this crossover observational study, a low-fat, low-quick-release sugar, high-protein, alkaline, and plant-based diet was investigated as a single treatment for laryngopharyngeal reflux (LPR). Authors recruited 50 participants with demonstrated LPR on hypopharyngeal-oesophageal multichannel intraluminal impedance-pH-monitoring (HEMII-pH), off acid suppressive...

What are the airway, voice and swallowing outcomes of a mucosal-sparing surgical approach to improving the glottic airway in bilateral vocal fold immobility?

Bilateral vocal fold immobility (BVFI) causes significant breathing problems as well as voice and swallowing difficulties. Surgical interventions aim to enlarge the glottic outlet by altering or removing glottic structures which improve breathing but often lead to worsening dysphonia and...

The future of facial plastics and rhinoplasty

Interest in facial plastic surgery and in particular rhinoplasty has never been greater. From his wealth of experience in the field, Professor Palma outlines the potential problems of this increasing popularity and how they may be addressed, areas on which...

Alfred Alexander: a life in ENT, but mainly music

Your own voice clinic may be filled with teachers, elderly clergy and badly trained pub singers, but it wasn’t always like this... When I was first invited to write an article about opera and ENT for this edition of ENT...