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‘Pen’doscope - writing in a reduction in healthcare delivery costs
Optimal management of cleft lip and palate requires a multidisciplinary team approach to treatment, with the goal being maintenance of facial growth and improvement in speech and hearing, in addition to closure of the cleft. This can be especially challenging...
Patient factors associated with spontaneous CSF leak
This article highlights the role of obesity, sleep apnoea and raised intracranial pressure as linked pathologies in the aetiology of the spontaneous cerebrospinal fluid (sCSF) leak. The authors link sCSF leak with obesity and comment on sCSF leak incidence increasing...
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...
Horizontal canal PPV: is Gufoni manoeuvre better than barbecue manoeuvre?
Benign paroxysmal positional vertigo (BPPV) is the most common kind of vertigo that we come across in our out-patient clinic. Horizontal canal BPPV (HC-BPPV) accounts for 10–30% of total BPPV. Two techniques, namely Guffoni and barbecue roll manoeuvres, are generally...
The right to choose: stories from the rare dementias
People with primary progressive aphasia (PPA) experience an insidious onset and gradual decline in language on a background of lesser or no cognitive impairment, hence a language-led dementia. There are three different PPA variants that correspond with three different clinical...
Hemilaryngopharyngeal Spasm (HeLPS)
The authors report an unusual case of hemilaryngopharyngeal spasm (HeLPS) with glossopharyngeal neuralgia with otalgia in a middle-aged female patient. Her symptoms included left-sided sharp, electric sensation like pain radiating from her left ear to the left side of her...
Predictors of diabetes insipidus post-hypophysectomy
Transient diabetes insipidus (DI) after pituitary surgery is not uncommon and its diagnosis fairly obvious. Permanent DI is rare and often depends on the neurosurgeon’s experience. This retrospective study describes a large series of patients with majority undergoing endoscopic transsphenoidal...
Antibiotics in orthognathic surgery
This paper from the Netherlands looked at 137 patients over a one-year period, 18 of whom had Le Fort I procedures, 68 bilateral sagittal split surgery, and 51 bi-maxillary surgery. A further 54 surgical procedures were undertaken, including 15 having...
The telemedicine genie is out of the bottle
Delivering healthcare interventions remotely is not a new concept. The authors of this article provide a brief history dating back to the 1930s, when the International Radio Medical Centre was established to transmit medical advice to global seafarers. In the...
Let the maths do the talking for word-finding difficulties
Anomia (word-finding difficulties) can arise when a person has a stroke, dementia or other neurological disorder affecting the left (typically) hemisphere of the brain. There are lots of theories underlying the process of word retrieval, many of which have not...
Implications of tonsillectomy in very young children
This is a comprehensive study comprising 157 children who underwent tonsillectomy below the age of two years, mainly for sleep-disordered breathing (86.6%) and recurrent tonsillitis (7%). With relatively recent understanding of OSAS, the indications for tonsillectomy in children under two...
