Volume 6 Issue 1 - 2013

 

Welcome to the first issue of 2013, we have some very interesting articles including two articles on amyloidosis, which I am sure you will find to be a useful reminder of the management of this uncommon but important disease that we see in our clinics.

The Royal College of Surgeons is hoping to role out a program of mentorship, which will provide mentors for trainees as they pass through their training and into Consultant posts. The drive for this is, to a great extent, the number of Consultants, both surgeons and physicians who are being suspended pending investigation of their practice. While anything that can be done to support surgeons in the workplace and prevent unnecessary suspensions is to be welcomed, there is little indication as to how the scheme will work in practice.

Audio-vestibular assessment is important when assessing the dizzy patient. Baseline vestibular function may be established and used to determine if a peripheral, central or mixed pattern of vestibular dysfunction is present. A detailed history is vital, but in some cases this may be vague and audio-vestibular testing assists in formulating a diagnosis. Test results are then used for guiding the management of the dizzy patient.

Physiotherapists play a significant role in the management of the dizzy patient. More specifically their roles include screening patients for vestibular rehabilitation (VR) and assessing the multidimensional factors of disability associated with dizziness and balance disorders. Physiotherapists aim to capitalise on the information obtained during screening and assessment processes in order to formulate customised VR exercise programmes.

Juvenile nasopharyngeal angiofibroma (JNA) continues to provide clinical and surgical challenges consequent to its high vascularity, tendency to intracranial extension, and propensity to postsurgical recurrence. This review encompasses the current concepts with regard to its origin and progression, and discusses the principles of pre-surgical preparation and surgical excision.

Objective: To review the manifestations of amyloidosis relevant to otorhinolaryngology and head and neck surgery.
Method: A literature review was undertaken following a Medline search of articles pertaining to amyloidosis, otolaryngology and head and neck surgery.
Results: 42 articles were critically reviewed. Manifestations in the head and neck included amyloidosis of the larynx, thyroid, nose and paranasal sinuses, oropharynx and hypopharynx, and the salivary glands.

Cutaneous facial malignancy covers a diverse group of skin cancers with very different issues with respect to diagnosis, treatment and outcomes. The main skin cancers are discussed with respect to these factors. National guidelines on management of skin cancer are reviewed and summarised, and our own experience is described.

Introduction: Localised amyloidosis is a rare finding in the nasal mucosa. Our objective was to present a case of nasal amyloidosis, illustrate the complexity of subtype analysis, and examine the evidence for management options.

Paediatric microlaryngoscopy and bronchoscopy (MLB) is a commonly performed procedure in paediatric ENT departments. Thorough documentation of the pertinent intraoperative findings is essential to patient care, whilst a comprehensive clinical record is a critical facet of good clinical governance.

A 59 year old female patient presents with hoarseness and recurrent choking episodes for a period of 3 months. She is a heavy smoker but otherwise fit and well.

Introduction: The central focus of the ward round (WR) should be the patient. Given the nature of Ears, Nose and Throat (ENT) disorders, it was postulated that ENT patients would be particularly unsatisfied with the WR.

Vocal cord (VC) pathologies are commonly seen in ENT. Voice rest is commonly recommended after VC surgery with the aim of improving post-operative healing and voice quality. However there are few clinical studies on which to base practice and no standard protocol.

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