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The effects of paediatric tracheostomy
Paediatric tracheostomy is usually an essential procedure to preserve life, or to allow a patient to function in the community. However, the effect of tracheostomy on the developing child - care requirements, lack of voice, impaired swallow, constant risk of...
Thyroidectomy patient survey regarding voice outcomes
One of the common adverse effects following thyroid surgery is a change in voice, which may be related to iatrogenic injury to the recurrent laryngeal nerve or superior laryngeal nerve during surgery or by direct cancer involvement. The burden of...
What to do if adenotonsillectomy does not cure sleep apnoea in children?
This article reviews the management of children with persistent obstructive sleep apnoea (OSA) following adenotonsillectomy (AT). Risk factors for patients to have persistent disease include obesity, being Afro-Caribbean and existing co-morbidities such as craniofacial and neuromuscular disorders. Initial assessment of...
Treatment of incus lysis with hydroxyapatite bone cement
Middle ear implants provide a suitable alternative for some patients with a certain degree of sensorineural or mixed hearing loss, not wanting a hearing aid. Vibrant SounBridge® (VSB) middle ear implant (MEI), of Med-El®firm, is one such implant. In this...
Association of quality of life with type of surgical treatment in patients with differentiated thyroid cancer
Standard treatment for differentiated thyroid cancer (DTC) is surgery, which includes either a total thyroidectomy or hemithyroidectomy. Surgery may then be followed by radioactive iodine treatment and, for some, treatment with thyroid hormone to suppress thyrotropin levels. All patients undergoing...
How can we improve outcomes for patients with acute vestibular neuritis?
Vestibular neuritis is a common disorder that can leave up to 50% of patients with persistent vertigo symptoms for months to years following the acute insult. Often their first contact with ENT or balance specialists is many months after the...
Stapedotomy in osteogenesis imperfecta
Osteogenesis imperfecta (OI) is a rare connective tissue disease caused by a defect in collagen structure. Hearing loss is a characteristic feature of OI. It typically presents with conductive hearing loss initially, followed by a superimposed sensorineural component later in...
X-ray vs. intraoperative testing for determining cochlear implant placement
Most cochlear implant centres confirm electrode position after surgery using X-rays to ensure optimal electrode placement. As well as transorbital view X-rays, this team check placement using impedance measures and neural response telemetry (NRT) performed intraoperatively. The former indicates whether...
Risks of tracheostomy in head and neck cancer
Tracheostomy is associated with several complications, with rates quoted as high as 8-45%, including: bleeding; displacement; obstruction; surgical emphysema; pneumothorax; fistulae and failure to decannulate. There are now many studies that confirm the increased length of stay and complications of...
Reliability of modified Dix-Hallpike test
Modifications of the Dix-Hallpike (DH) are sometimes necessary when the traditional DH is not feasible. The absence of any formal studies on modified DH was the idea behind this multicentre (three academic centres), prospective, randomised, single blinded and controlled clinical...
Management of frontal sinus fractures
Frontal sinus fractures are uncommon (associated with around 5-15% of facial fractures). The authors divide frontal sinus fractures into isolated anterior table fractures, fractures involving the frontal sinus outflow tract and posterior table fractures, discuss some of the recent relevant...
