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A soprano’s demise: a cautionary tale for the thyroid surgeon

Prior to the mid-19th century, thyroid surgery was considered excessively dangerous. The emergence of anaesthetic, antisepsis and improved instrumentation, however, increased its feasibility and frequency in Europe. The unhurried, judiciously antiseptic and haemostatic approach, advocated by Kocher, was popularised and...

How to train adults with single-sided deafness and cochlear implants

Cochlear implantation (CI) in patients with single-sided deafness (SSD) has been carried out in Perth, Australia from 2008. It poses challenges to clinicians and patients who are trying to tune in the poorer ear while still having a normally hearing...

Leadership in healthcare

There is often a great deal of confusion over the words ‘management’ and ‘leadership’. Sometimes they are used interchangeably. Sometimes they are used to represent opposite ends of a spectrum. Sometimes both are used as collective nouns, or to describe an activity.

Chronic cough hypersensitivity syndrome

We all have patients who give us a ‘heartsink’ feeling; for many of us, the coughing patient is exactly such a situation. In this overview, Bhaskar Ram and Sangeeta Maini outline their approach to diagnosis. Declan Costello, Editor. Introduction Chronic...

The death of Attila the Hun, a 70s film and Japanese cartoons

The 6th century Gothic monk, Jordanes, tells us that Attila the Hun, the notorious and allegedly merciless barbarian (who was a prime mover in the fall of the Roman Empire), died of a nosebleed on his wedding night in 453...

Shifting paradigms – how a visionary can change a specialty

The Tarabichi-Stammberger Ear and Sinus Institute came about because of a close working relationship and friendship between two senior figures in the specialty. Professor Muaaz Tarabichi tells us the story. My first meeting with Heinz Stammberger was in 1988 in...

Is there a limitation for excising parapharyngeal tumours transorally?

The parapharyngeal space is a complex anatomical space bounded medially by the oropharynx and laterally by the mandible. It is conceptualised as an inverted pyramid extending from base of skull above to the hyoid bone below. The space is divided...

Managing the thyroglossal duct cyst

Although the operation to remove thyroglossal cysts and their tracts is commonly performed, a full understanding of the possible anatomical locations of the tracts may be less appreciated. This article helps the reader understand the possible variations available which should...

Incidental findings in paranasal sinus Magnetic Resonance Imaging (MRI) studies

Incidental findings in the paranasal sinuses of mucosal thickening and polyps in MRI studies may cause concerns for clinicians and patients. The authors studied MRIs of 982 participants with a mean age of 58.5 years who randomly and independent of...

Childhood bony facial tumours

This review article covering maxillary and mandibular tumours is from an edition of the Clinics covering paediatric head and neck masses from frequently encountered congenital malformations to the rarities. There is a wide differential diagnosis for childhood mandibular or maxillary...

Thyroid nodules in children

Whilst 5% of nodules in adults may harbour malignancy it is reported in this review that about a quarter of nodules may do so in children. Malignancies in this group are almost always well-differentiated subtypes of papillary, follicular and medullary...

Malignant craniopharyngiomas

Craniopharyngiomas are successfully managed with surgery and / or adjuvant chemoradiotherapy. The transnasal endoscopic route has become increasingly utilised in the management of these challenging tumours. This paper reviews 23 cases from the literature of the rarely reported malignant transformation....