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Surgical management of permanent facial paralysis

This article explores the management of flaccid facial palsy focusing on weakness less than one to two years’ duration. As a general rule, primary nerve repair produces the best outcome and should be performed where possible. For long-standing paralysis of...

The paediatric dilemma of one ear in and one ear out of NICE criteria

The auditory implant team in Manchester have implanted a cohort of children where audiological thresholds meet the NICE guidance for cochlear implantation (CI) in one ear only, and the other falls into moderate, severe or sloping loss. These children are...

Hearing loss and QOL

This article evaluates the impact of hearing loss and its rehabilitation on the quality of life (QoL) of adults. The authors suggest that the currently used scale, Aphab, is long, complicated and does not take into account minor changes. The...

How long after head and neck cancer diagnosis do patients need opioids?

With the advances in the management of head and neck cancer (HNC), patients tend to survive longer after their diagnosis. These people face the burden of chronic pain management which is strongly associated with HNC. A HNC team in Portland...

Allergen immunotherapy and allergic rhinitis – EAACI guideline 2017

Allergic rhinitis (AR) is a common chronic childhood disease with considerable social burden and impact on quality of life, frequently necessitating treatment with various combinations of antihistamines and corticosteroids. The allergen immunotherapy (AIT), sometimes known as desensitisation therapy, can modify...

Do ENT surgical patients need VTE prophylaxis?

In the UK, current NICE guidance for venous thromboembolism (VTE) prevention does not give specific advice about patients undergoing otolaryngology/head and neck surgery (OHNS). This systematic review provides up-to-date information based on available, although limited, evidence about the incidence of...

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...

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...

Microgravity: an extreme environment for otolith organs

Motion sickness in a car can be upsetting for all involved. Transferring this concept into a tiny cabin bound for space could have devastating consequences. Are the processes involved in ‘space motion sickness’ the same as motion sickness? How do...

Entrepreneurial aspirations for the otolaryngologist

Entrepreneurship is a process of identifying an idea and starting a business venture with this idea. It requires generation of a business model or plan that emphasises the value proposition for the customer. The model must identify the partners, resources,...

Is the lack of sunshine the reason behind allergic rhinitis?

Deficiency in Vitamin D, an in vogue immunomodulator, has been shown in emerging data to have a substantial pathogenetic role in allergic related diseases, particularly asthma. The concept of a shared upper and lower airway has allowed the natural extrapolation...

Embracing deafness and the silent world

Brian Kokoruwe shares his journey from growing up during civil war in Nigeria to becoming Director of Deaf UK Athletics and a published author. While I am active in the Deaf BSL community, involved in Deaf sports and the Government...