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Multiple surgeries for RRP – does a greater number of operations result in a worse voice outcome?

Recurrent respiratory papillomatosis (RRP) of the larynx remains a challenging condition to treat, with a number of affected patients requiring multiple operations to remove recurrent disease over the course of their lifetime. At the most severe end of the spectrum,...

Prolactinomas: when to operate

Prolactinomas are the most common functional pituitary adenomas, comprising 40% of all pituitary adenomas. There are consensus guidelines and several common management pathways. This article discusses the role of surgery for these patients. Following diagnosis, the goals of treatment are...

The association between pregnancy and otosclerosis could be due to psychosocial factors around parenthood rather than biological factors

The association between pregnancy and otosclerosis is controversial. If pregnancy physiologically increases the likelihood of otosclerosis progression, then one would expect that there would be a difference between male and female patients with regards to whether having children affects how...

Doing it for the people: how to do speech and language therapy

This review article distils 58 studies, collating information from people with aphasia, their families and clinical speech and language therapists summarising the seven habits of highly effective aphasia therapists. Habit 1: Effective therapists invest time in and prioritise relationships with...

Tell me like it is: advice for relatives of people with aphasia

More than a quarter of people who have a stroke present with aphasia immediately post-stroke (approx. 30%) and of these, around 60% experience chronic communication difficulties. Provision of information is seen as one of the top 10 best practice recommendations...

Intratympanic steroids - to give or not to give?

The treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) is controversial and different modes of steroids have been tried without any universal consensus. Various authors have reported combined oral and intratympanic steroid therapy in SSNHL, with consistent results in several...

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...

Foretelling: post-stroke recovery of dysphagia is predicted by cognition

Around two thirds of people in the acute phase of stroke recovery will experience dysphagia. Up to six months following a stroke this may be present in 13-18% of cases. The degree of cognitive impairment seems to be associated with...

Can ‘cone beam CT scan’ (CBCT) facilitate one-stop rhinology clinic?

Chronic rhinusinusitis can be diagnosed on the basis of its classical symptoms such as nasal obstruction, facial pains, postnasal drip and hyposmia, supported by endoscopic findings such as oedema of middle meatus, mucopus and polyps. However, CT scan findings are...

Recurrent seroma in cochlear implanted patients

Little is known about why some patients experience recurrent seromas over the implant package and in the absence of any cause, antibiotics are frequently prescribed as a precaution to protect the implant from infection. A tertiary referral centre selected five...

From a dysphagia clinical trial to a multidisciplinary head and neck clinical pathway – the road to implementation

This paper describes the barriers and facilitators to establishing a structured and coordinated multidisciplinary care pathway for patients with head and neck cancer at a medical centre in the USA. The initiative was set in motion by the roll out...

Parapharyngeal space tumours – is the transoral approach effective?

Several approaches are described to the parapharyngeal space to permit resection of tumours in this region, with the most commonly employed approach being the transcervical route. The transoral approach remains somewhat controversial as it is felt that this approach can...