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Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture
Placement of voice prosthesis at the time of trachea-oesophageal puncture is well described using 20-French prostheses. There is debate about the optimal size of the prosthesis with work in the 1980s and 1990s supporting larger prostheses. The rationale was that...
Immunotherapy – could it be cheaper?
Immunotherapy is the only treatment for allergy to alter the disease course. Limited data exist on direct and indirect costs of subcutaneous (SCIT) and sublingual (SLIT) immunotherapy in America. This article assesses the cost effectiveness worldwide of the two immunotherapies....
Medialisation laryngoplasty can relieve pain related to voice use
Odynophonia, or pain associated with voice use, is a relatively uncommon manifestation of glottal insufficiency related to vocal fold motion impairment (VFMI). Its incidence is approximately 15% in patients with vocal fold paresis. Medialisation laryngoplasty (ML) was popularised by Isshiki...
Botulinum toxin and drooling – how much, how often and where?
This was an incredibly useful article covering all aspects of the use of botulinum toxin as a treatment modality in sialorrhoea. The article starts by outlining why treating sialorrhoea is important and describes the non-pharmacological and pharmacological options, highlighting that...
Early ENT involvement can improve long-term quality of life after temporal bone fractures
Sports injuries and road traffic accidents are common causes of head injuries, with 18-40% of skull base fractures involving the temporal bone. Often these patients have other more life threatening injuries so ENT intervention is delayed or absent. Facial palsy,...
Curettage adenoidectomy impairs eustachian tube function
Adenoidectomy is a common procedure undertaken for obstructive sleep apnoea and nasal obstruction. Curettage is the most common technique but is associated with complications (mucosal trauma, bleeding) that may cause eustachian tube dysfunction (ETD). This study analysed changes in middle...
Hyperbaric oxygen for sudden onset sensorineural hearing loss
Idiopathic sudden onset sensorineural hearing loss (SSNHL) is a relatively common presentation to the ENT emergency department, and can have profound effects on patients’ lives. This retrospective study looked at 15 patients who were treated with hyperbaric oxygen after failure...
Management of the neck in maxillary sinus carcinomas
Primary malignant tumours of the sinonasal tract account for less than 10% of head and neck cancers, of which the maxilla is the second most common subsite and squamous cell carcinoma (SCC) is the most prevalent histological type. Maxillary SCCs...
Beware of GPA as a cause of subglottic stenosis
Up to 92% of patients with granulomatosis with polyangiitis (GPA) have concurrent ENT manifestations of the disease. Whilst we are familiar with sinonasal and middle ear presentations of GPA, subglottic stenosis (SGS) is another important and potentially life threatening manifestation....
Paediatric coblation intracapsular tonsillectomy
The ENT-UK tonsillectomy audit in 2005 created understandable caution in the promotion of Coblation techniques. This prospective study on 100 consecutive paediatric patients looked at outcomes following ‘cold’ radiofrequency ablation (Coblation) intracapsular tonsillectomy. This series shows the technique to be...
Local dexamethasone infiltration in tonsillectomy
Intravenous dexamethasone is routinely given during tonsillectomy for its effects on postoperative pain and nausea. This Chinese randomised study divided 240 children undergoing tonsillectomy into three groups, receiving either no steroid, intravenous dexamethasone, or the same amount of dexamethasone infiltrated...
