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How do you solve a problem like Dysphagia?
When a patient is referred to a speech and language therapist for the management of swallowing difficulties, multiple options are available to address these issues. The choice is based on a detailed assessment of the patient’s swallowing physiology and function....
Cochlear implant electrode insertion technique
Atraumatic cochlear implant insertion techniques (so-called ‘soft surgery’) are now standard practice in most centres for all cases (no longer just for attempted hearing preservation cases). This has led to several studies examining cochlear trauma and electrode insertion force. In...
THRIVE: redefining airway management in endoscopic oesophageal surgery
Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) is no longer just a tool to help anaesthetists secure a difficult airway. Thanks to the work of authors like Yang and colleagues, it is being revolutionised to provide apnoeic oxygenation during endoscopic...
Myringoplasty in a bottle?
Management of large traumatic TM perforations can involve observation and water precautions or surgical repair. Closure rates for larger perforations can be 8-12 weeks and occurs for between 38-79%. Animal and human studies have shown that exogenous application of epidermal...
Outcome of TORS to tongue base and epiglottis in patients with OSA intolerant of conventional treatment
The use of transoral robotic surgery (TORS) in ENT is rather controversial, but the use of robotic surgery for obstructive sleep apneoa (OSA), makes it doubly so. Previous studies on TORS in OSA have been performed with other types 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...
Darn it! It’s going to take longer to get good at stapes surgery!
Traditionally, it has been said the learning curve for a particular operation lies between 20 and 30 cases. In stapedotomy, a surgeon is deemed successful and perhaps competent if closure of the air-bone gap (ABG) is reached to within 10dB...
Pharyngoplasty for palatal snoring
This prospective Belgian study looked at the benefits of barbed reposition pharyngoplasty in the management of patients with isolated unilevel palatal snoring. This technique involves using a barbed suture and repositioning the palatopharyngeal muscle in a more lateral and anterior...
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...
When should that child’s wet ear be operated on?
The team from Birmingham have provided a meta-analysis to answer the question of when to perform a type 1 tympanoplasty on chronic paediatric perforations (under 18 year olds). Forty-five studies were included which resulted in 2609 cases. Closure rate at...
Prophylactic swallowing exercises in head and neck cancer
Clinicians working in head and neck cancer will be familiar with the increased interest in prophylactic swallowing exercises to reduce the devastating impact of dysphagia experienced by patients undergoing radiation or chemo-radiation therapy. This study from Denmark is one of...
