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What blood tests should be requested to investigate vocal cord paralysis?

Patients who are discovered to have a vocal cord palsy with no obvious cause on history or examination routinely undergo investigations to exclude an underlying pathology. Cross-sectional imaging of the relevant recurrent laryngeal nerve is required, but considerable variability has...

Maternal angst

This paper confirms the anxiety that a mother experiences when their child undergoes surgery. The paper focuses on adenoidectomy and adenotonsillectomy for moderate to severe upper airway obstruction showing admirably how anxiety reduces following surgery. The authors recruited 66 mothers...

Surgery for hypopharyngeal obstruction causing OSA

Surgical treatments for OSA are evolving with improved diagnostic accuracy of the level(s) involved. Where the collapsing segment lies below the soft palate, a variety of surgical techniques to correct the affected segment(s) are emerging. This article concentrates on one...

Aerosols and polypi

Infection in the operative cavities after endoscopic sinus surgery for sinonasal polyposis leads to recurrence of symptoms and mucopurulent discharge. The usual therapies include systemic antibiotics sometimes with steroids. The authors hypothesised that the use of a topical antimicrobial (tobramycin...

Medicine in the Mountains

This is an easy-to-read paperback with interesting accompanying photographs. Its focus is one of the UK-based teams who have done considerable healthcare work in Nepal. Written by David Hawker, a British anaesthetist, we see the story unfold through his eyes....

Hearing aids or grommets for children with OME?

Otitis media with effusion is a highly prevalent condition in children and recurrence often occurs after surgical treatment with grommets. Repeated grommet insertion has its own problems of infection, perforation and scarring of the tympanic membranes, and continuity of providing...

Free flap reconstruction in stage three bisphosphonate-related osteonecrosis

There is no widely accepted gold standard for the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Early BRONJ is managed conservatively but there is controversy regarding the treatment of the later stages. Stage three is defined as exposed bone...

Endovascular management of cavernous and paraclinoid aneurysms

This review discusses management of aneurysms arising from the internal carotid artery from the entrance into the cavernous sinus until just before the take off of the posterior communicating artery. Whilst paraclinoid aneurysms do not tend to have ENT presentations,...

Eosinophilic or not eosinophilic: dupilumab seems to work

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammation with interleukin (IL)-4, IL-13, and IL-5. Tissue eosinophilia in nasal polyps dramatically increased over a 10-20-year period. Classification of the severity of eosinophil status is expected to lead to...

Epithelial risk factors

This review paper from Barcelona retrospectively assesses patients diagnosed with oral epithelial dysplasia between 1995-2014 and followed up until 2017. In total, 144 cases were noted, of which 42% progressed to an oral cancer by the time of review in...