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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...

Promising surgical technique for pulsatile tinnitus caused by sigmoid sinus dehiscence?

Pulsatile tinnitus (PT) can be caused by sigmoid sinus dehiscence (SSD). The authors report the results of 17 patients who underwent sandwich surgical technique for sigmoid sinus (SS) wall reconstruction for the treatment of pulsatile tinnitus caused by sigmoid sinus...

Traditional incision and drainage of a quinsy may be more efficacious than aspiration

Peritonsillar abscess drainage has always been one of the first procedures an ENT junior doctor performs. Traditionally incision and drainage (I&D) was the mainstay of treatment. In recent years, needle aspiration of the abscess has become much more commonplace, perhaps...

More than words: looking at all the evidence

Evidence based practice (EBP) is a three-pillared approach whereby information on the research evidence, factors relating to the patient and clinical experience are all considered to inform a care decision. Unfortunately, there is frequently very little research evidence to inform...

Everyone has the right to say no

Despite the introduction of the Mental Capacity Act in 2005, healthcare professionals remain uncomfortable with individuals who choose not to follow medical advice - who make informed decisions to decline a treatment or management plans. This paper highlights that speech...

Non-surgical and surgical management of arytenoids granuloma

Arytenoid granulomas are often a sequelae of laryngopharyngeal reflux (LPR). Unless there is suspicion of malignancy, they require a very balanced approach between conservative management and surgical intervention. The authors present a series of 62 patients with whom the primary...

Benign positional paroxysmal vertigo manoeuvres in children and adolescents: a systematic review

In this paper of Saniasiaya et al, the literature review is conducted in accordance to the PRISMA consensus, aiming to investigate the outcomes of canalith repositioning manoeuvres (CRM) to treat benign paroxysmal positional vertigo (BPPV) in a paediatric and young...

Sinonasal undifferentiated carcinoma – slowly getting there

The rarest of the rare, sinonasal tumours form only a small part of the total number of head and neck tumours and undifferentiated carcinoma (SNUC) is one of the rarest of this group. There is some data (and some expert...

Obstructive sleep apnoea: Does maxillomandibular advancement work?

This is a paper from the Netherlands reviewing 62 patients who underwent maxillomandibular advancement for moderate to severe obstructive sleep apnoea. The authors observed a 71% success rate with mean apnoea hypopnea index (AHI) reduction of 69%. There was no...

Prioritisation of surgery for pituitary tumours

This study is based on the findings of internationally renowned skull base surgeons who convened to recommend this stratification scheme. The study authors report that incidental diagnosis of pituitary tumours during routine imaging as well as early identification of visual...

Application of balloon dilatation in chronic eustachian tube dysfunction

Chronic eustachian tube dysfunction prevails in 1% of the adult population and can predispose to middle ear disease. There are subjective and objective features of this condition that can affect quality of life. The common methods to treat eustachian tube...

Single sided deafness and cochlear implants

Cochlear implants (CI) can restore hearing in the profoundly deaf ear. Risk/ benefit and cost considerations dictate strict criteria that must be met for patients to be eligible. People with single-sided deafness are not eligible to receive a cochlear implant...