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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...

Non-surgical and surgical management of arytenoids granuloma

Arytenoid granulomas are often a sequelae of laryngopharyngeal reflux (LPR). Unless there is suspicion of malignancy, they require a very balanced approach between conservative management and surgical intervention. The authors present a series of 62 patients with whom the primary...

Non-absorbable synthetic material for middle fossa repair using a combined transmastoid/middle fossa approach

Repair of CSF leaks can be a challenging technical undertaking. In this article, the authors describe their use of a synthetic material to help with the successful repair of these leaks from the middle cranial fossa. Erosion of the middle...

Vocal cord paralysis: an update

The management of unilateral vocal cord paralysis has changed in the last few years: this has largely come about as a result of improvements in technology, meaning that medialisations are quicker and easier to perform than previously. This article will...

The benefits of early voice therapy for unilateral vocal cord paralysis

This retrospective review of voice outcomes following a diagnosis of unilateral vocal fold paralysis divided patients into three groups according to the time of initiation of voice therapy following the onset of paralysis. The ‘early’ group started voice therapy within...

Indication and timing of electrodiagnostic tests in facial palsy

This excellent review describes the benefits and limitations of electrodiagnostic testing for patients with facial paralysis. Tests such as Schirmer, stapedial reflex and electrogustometry have been largely replaced by neurophysiologic tests like nerve excitability test (NET), electroneuronography (ENoG), surface electromyography...

Philosophy and reality of entrepreneurship

Before you take the time to read this article, be informed that it is indeed hard to be an entrepreneur. It warrants passion, sacrifice, total commitment and willingness to spend day and night (even in your sleep) thinking and working...

In conversation with Prof Nobuhiko Isshiki

A 90th birthday is definitely a landmark that should be observed and celebrated. Elisabeth Sjögren interviews this man who has been such a huge influence in the world of laryngology. Nobuhiko and Keiko in the cosmos field. Congratulations on your...

Type 1 thyroplasty using a novel and inflatable implant from APrevent® VOIS

Unilateral vocal cord immobility severely impacts voice, swallowing, and airway functions. A novel approach offers adjustable medialisation for improved patient outcomes. Unilateral vocal cord immobility (UVCI) can cause significant disability to voice, swallowing, and airway functions. Patients with UVCI may...

Iatrogenic vocal fold paralysis – the time to recovery

Iatrogenic vocal fold paralysis can result from stretching, compression or complete transection of recurrent laryngeal or vagus nerves. These injuries are a significant source of concern for patients and clinicians alike. The question is how long should we wait for...

An update on laryngeal reinnervation

Laryngeal paralysis remains very difficult to treat, but reinnervation offers many attractions. Laryngeal paralysis presents a unique and varied problem that requires a patient centred approach and a range of treatment options depending on laryngeal and patient factors. There is...

Reduction thyroplasty

Introduction Male to female transgendered patients are referred to ENT for reduction thyroplasty – a procedure to reduce the external appearance of the thyroid cartilage of the larynx, and feminisation of the voice. Reduction thyroplasty, often erroneously called ‘tracheal shave’,...