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Elasticated retraction in head and neck surgery – a trainee’s perspective

The effectiveness of surgical technique and satisfactory outcome is greatly dependent on good surgical exposure. Retraction requires adequate traction and counter-traction of tissues in order to expose the tissue or organ under scrutiny for the surgeon. This is a universal...

Music and cochlear implants

Introduction The introduction of multichannel cochlear implants (CIs) in the early 1980s provided children and adults with severe and profound hearing losses with greatly improved speech perception skills. In this paper, however, I am going to focus on an area...

Time to professionalise medical leadership

For a profession proud of its adherence to an evidence base, medicine has been remarkably slow to acknowledge and to act on the evidence which underpins the value of good leadership to patients and the healthcare system. Mr Robert Francis...

A medical student’s perspective on the future of obstructive sleep apnoea management

Obstructive sleep apnoea remains an immensely challenging condition to treat. Many treatments have been used over the years, but no single management strategy has proven significantly better than the others. We hear about some technological innovations in the field of...

Pre-clinical development of magnetic delivery of therapy to middle and inner ears

Why are we developing this technology? A key problem in drug delivery is getting the therapy to the right place in the body, which is especially challenging for targets that are small, deep and are protected or surrounded by anatomical...

Communication Disorders: a combined discipline of audiology and speech and language pathology – the Israeli perspective

Liat Kishon-Rabin provides an excellent summary of audiology training in Israel, encapsulating the development of audiology services in the country. Readers will be intrigued by the systematic approach taken to its development, and its pairing with speech and language pathology....

Long-term outcomes of children and young people with cochlear implants

Introduction Profound childhood hearing loss has a huge impact on early communication skills, the acquisition of spoken language, and hence on educational attainments and employment prospects. Over the centuries, educators of the deaf attempted to overcome the challenge by using...

Enhancing care for adults with auditory neuropathy spectrum disorder

It’s time to improve and personalise care for adults with ANSD. Knowing the lesion site could open up treatment opportunities like cochlear implants or new cell therapies. Auditory neuropathy spectrum disorder (ANSD) comprises a group of hearing disorders characterised by...

Medicine in the Mountains

This is an easy-to-read paperback with interesting accompanying photographs. Its focus is one of the UK-based teams who have done considerable healthcare work in Nepal. Written by David Hawker, a British anaesthetist, we see the story unfold through his eyes....

Psychogenic vestibular disorders: understanding and management

‘Psychogenic vestibular disorders’, also known as ‘functional vertigo and dizziness’, are common causes of dizziness and balance difficulty. Although our understanding of their underlying pathophysiology remains incomplete, Drs Diego Kaski and Amy Edwards outline how early identification and positive diagnosis...

The risks of misjudging African American dialects as lesser!

Healthcare inequalities in multicultural societies, such as the UK, are becoming increasingly apparent. They arise via a complex interplay of factors, with socioeconomic deprivation, structural biases and specific cultural and biological risk factors all contributing to disparities. There is ample...

Should patients with dysphagia be allowed water freely?

Patients with dysphagia often experience dehydration as a consequence of “nil by mouth” or having to consume thickened fluids due to aspiration of thin fluids. However, not all incidents of aspiration develop into an infection. Factors that contribute to aspiration...