Volume 4 Issue 1 - 2011

This issue of ‘The Otorhinolaryngologist’ has some excellent articles which I hope you enjoy reading. The Editorial team continues to increase in size and we are very pleased with the way that you have supported the journal which has been reflected in an increase in the number of articles submitted.

Welcome to this edition of the Otolaryngologist which is becoming an ever popular source of excellent reviews and clinical material.

Abstract

Sialorrhoea (drooling or excessive salivation) is defined as saliva extending beyond the margin of the lip. This is physiological in infants but usually stops by 15 to 18 months of age. It is common in children with cerebral palsy and other neurological impairment. Treatment of sialorrhoea is challenging and frequently requires a multi-disciplinary approach. Conservative measures like behaviour modification and oromotor exercises could be trialled in mild to moderate degrees of drooling. Parasympatholysis with Botulinum toxin injection into the salivary glands could be attempted although the dosage remains controversial. Various surgical procedures have been described and should be considered in severe cases of sialorrhoea.

Abstract Introduction: Treatment of voice disorders has evolved over the last 50 years into a multidisciplinary process. We examine the history, the evolution of modern examination equipment and techniques, and the current state of the Modern Voice Clinic. We suggest equipment that is essential and some that would be considered valuable adjuncts.

Discussion: We highlight the importance of the clinical history. The origins and evolution of diagnostic equipment and techniques are discussed. Equipment considered essential in the modern Voice Clinic setting is discussed in detail, highlighting the function and the pathologies that each piece can help diagnose. The need for a strong evidence base and ongoing prospective research is explained.

Conclusion: The set-up and constituents of the Modern Voice Clinic are an evolution in progress. Current clinical need requires a multidisciplinary team approach, specialist equipment and a strong evidence base, but the most important diagnostic tool will always remain the taking of a good clinical history.

Abstract

Peripheral nerve sheath tumours of the nose are rare. We present three patients, one with a neurofibroma, the second a schwannoma and the third a plexiform neurofibroma of the nose. They were successfully removed using an external rhinoplasty with good functional and aesthetic outcomes after a mean follow up of three years. The repercussion of these diagnoses is discussed with a review of the literature.

Abstract

Cross-sectional imaging is a cornerstone of management of patients with carcinoma of the head and neck and commonly Computerised Tomography (CT) and Magnetic Resonance Imaging (MRI) are used. Positron Emission Tomography (PET) is being increasingly used in the UK when combined with CT (hence PET/CT) to provide cross-sectional anatomical detail fused with images representative of tissue metabolic rate to provide information on both anatomy and function. We present an overview of the basic science behind PET/CT, typical applications in UK practice and limitations of its use in patients with carcinoma of the head & neck.

Abstract

Peripheral nerve sheath tumours of the nose are rare. We present three patients, one with a neurofibroma, the second a schwannoma and the third a plexiform neurofibroma of the nose. They were successfully removed using an external rhinoplasty with good functional and aesthetic outcomes after a mean follow up of three years. The repercussion of these diagnoses is discussed with a review of the literature.

This article is the third in a series aiming to simulate a viva scenario in the Intercollegiate FRCS Examination in Otolaryngology. The exam has evolved over the years and questions are now structured to ensure fairness across the board. All candidates will be asked the same opening questions and then discussion around the subject will continue in order to probe your depth of knowledge. If you are struggling with the introductory question for any reason there would usually be a recovery question to give you the chance get started. If you have answered questions well the discussion will move on to advanced questions which will be assessing whether you warrant more than a basic pass mark.

Introduction

With significant advances in cochlear implant (CI) design, surgical techniques and rehabilitation, the candidacy criteria have continued to evolve. However, the presence of a cochlear nerve abnormality presents a particularly difficult dilemma regarding candidacy for implantation.

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