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How well are we managing epistaxis cases?

Epistaxis constitutes 34.5% of all emergency admissions to otolaryngology departments nation-wide. Presently there are no detailed consensus guidelines for this commonest emergency, and there is tremendous variation of practice. Quite often, non-ENT trained doctors manage this emergency. This paper reviews...

A review of endoscopic sinus surgery outcomes

This review discusses the outcome measures that may be considered in the assessment of patients with chronic rhinosinusitis (CRS) as well as the outcomes of endoscopic sinus surgery (ESS) published so far. The authors also discuss the role of peri-operative...

Thyroidectomy - a pictorial walk through the surgical steps

We as ENT surgeons work closely with the endocrinologist to provide MDT care for patients with a variety of pathologic conditions of the thyroid gland, including benign, malignant and hormonal disease processes. Surgery plays a central role for a variety...

Steroids pre-FESS

This meta-analysis and systematic review from the Netherlands and the UK aims to answer the question of whether corticosteroids inhaled and / or taken orally are beneficial to patients with chronic rhinosinusitis undergoing functional endoscopic sinus surgery. Refreshingly 18 RCTs...

Which bone conduction implant (BCI) device to use?

Bone conduction implants (BCI) are alternatives when the use and benefit of conventional, prosthetic equipment is limited or contraindicated in patients who suffer from conductive, mixed and single-sided deafness. They are broadly divided into two main groups delivering vibration directly...

Stimulation for a good night’s sleep

This article was an interesting read. It is an update from the authors’ original paper printed in the NEJM in 2014 regarding the results of an implantable pulse generator (IPG) for stimulating the hypoglossal nerve in response to respiration. This...

Division of tongue tie helps breast feeding

The need for frenotomy in children with tongue tie is not universally accepted. It is however understood that among other problems, such as impaired speech, tongue tie impedes breast feeding possibly leading to early weaning. Therefore, with recent resurgence of...

Advancing the tongue in OSA surgery

This article further delineates the options for hypopharyngeal OSA and describes the technique of genioglossus advancement to improve the tension in the tongue base. The authors take the reader through the relevant anatomy appropriate to the procedure and describe the...

Risk factors for pharyngocutaneous fistula after laryngectomy

Pharyngocutaneous or salivary fistula is a feared complication following laryngectomy, causing significant morbidity, prolonged hospital inpatient stay / cost and mortality. Previous radiotherapy / chemoradiotherapy is a well recognised risk factor and leads many surgeons to recommend onlay pectoralis major...

Neonatal nasal stenosis - conservative approach

The authors retrospectively evaluated the efficacy of heated humidified high-flow nasal cannula (HFNC) in neonates with nasal stenosis for this study. Of the six infants included in the study, five had congenital pyriform aperture stenosis. Three of these five also...

Awake transnasal laryngeal and pharyngeal biopsy in the unsedated patient

In an attempt to improve the efficiency and flow of patients through a busy ENT clinic, technology now allows the ENT surgeon to consider biopsies in the outpatient setting on a more regular and controlled basis. This can avoid the...

The ear, nose and throat anaesthesia practice of Dr John Snow (1813-58)

News of the first successful public demonstration of general anaesthesia in Boston, Massachusetts in October 1846 reached Britain in mid-December of that year. James Robinson, a London dentist, gave the first anaesthetic in the United Kingdom when, on 19 December,...