ENT

Five historical innovations that have shaped modern otolaryngological surgery (2024)

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Type of publication:
Journal article

Author(s):
*Patel R; Acharya R; *Shah S; Desai C; Raveshia D; *Panesar H; Patel N; Mcconaghie G; Cain DC; *Parmar D; Banerjee R; Singh R

Citation:
Journal of Perioperative Practice. 17504589241244996, 2024 Jun 03.

Abstract:
Throughout history, many innovations have contributed to the development of modern otolaryngological surgery, improving patient outcomes and expanding the range of treatment options available to patients. This article explores five key historical innovations that have shaped modern otolaryngological surgery: Operative Microscope, Hopkins Rigid Endoscope, Laryngeal Nerve monitoring, Cochlear implants and Laser surgery. The selection of innovations for inclusion in this article was meticulously determined through expert consensus and an extensive literature review. We will review the development, impact and significance of each innovation, highlighting their contributions to the field of otolaryngological surgery and their ongoing relevance in contemporary and perioperative practice.

Outcomes for Paediatric Patients Awaiting Bilateral Myringotomy and Ventilation Tube Insertion for Otitis Media with Effusion Listed Prior to the COVID-19 Pandemic (2022)

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Type of publication:Conference abstract

Author(s):*Lovett A.; Walters B.; Kumar Bhimrao S.

Citation:British Journal of Surgery. Conference: ASiT Surgical Conference 2022. Aberdeen United Kingdom. 109(Supplement 6) (pp vi38), 2022. Date of Publication: September 2022

Abstract:Aim: The decline in the incidence of otitis media with effusion (OME) during the COVID-19 pandemic has become apparent. This review investigates the outcomes for children with OME awaiting bilateral myringotomy and ventilation tube (BMT) who were referred prior to the COVID-19 pandemic. Method(s): All patients were reviewed in otolaryngology clinics between 1st February and 30th April 2021. Patients included were referred due to hearing, vestibular or developmental disorders prior to the first COVID-19 lockdown on 23rd March 2020. Analysis of routine consultation and audiological assessment was completed from records. Result(s): There were a total of 48 patients awaiting BMT. The average age was 6.8 years, with a male to female ratio of 1.38:1. Most initial referrals (54.2%) were due to hearing loss, followed by recurrent ear infections (33.3%). Forty-four patients were diagnosed with OME. Of those, only 9% remained awaiting BMT. All others were removed from the waiting list. One patient remained listed for an adenotonsillectomy, 30 were discharged, and nine required follow-up appointments. Conclusion(s): Our review demonstrates a significant reduction of BMT for OME following COVID-19. Further research on public health measures and changes in clinical practice during the 2020 lockdown would clarify the impact on OME.

Description of a novel technique for creation of a custom-made prosthesis to aid vocalisation following laryngectomy (2021)

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Type of publication:
Journal article

Author(s):
*Halliday, E; *Beswick, H; *Bunn, S; *Ahsan, S F

Citation:
European Annals of Otorhinolaryngology, Head and Neck Diseases; Dec 2021; vol. 138 (no. 6); p. 475-477

Abstract:
There are various options to restore phonation after laryngectomy; one option involves using tracheo-oesophageal voice by placing a speaking valve through the tracheo-oesophageal wall. Some patients struggle to obtain good fixation of an adhesive base plate to the skin; this can result in air leakage and poor voice. We describe a technique using a custom-made prosthesis to provide a better base plate for fixation of the heat and moisture exchange cassette. This technique involves making an impression of the anterior neck around the laryngectomy stoma to create an anatomically fitted prosthesis, which accurately fills the void around the stoma. The custom-made prosthesis provides a more individualised fit compared to a standard base plate, helping improve vocalisation and communication.

Impact of coronavirus disease 2019 on urgent referrals to secondary care otolaryngology: a prospective case series (2020)

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Type of publication:
Journal article

Author(s):
Osborne M.S.; Bentley E.; Farrow A.; Murphy J.; *Chan J.

Citation:
Journal of Laryngology and Otology; 2020 [epub ahead of print]

Abstract:
Objective. As the novel coronavirus disease 2019 changed patient presentation, this study aimed to prospectively identify these changes in a single ENT centre. Design. A seven-week prospective case series was conducted of urgently referred patients from primary care and accident and emergency department. Results. There was a total of 133 referrals. Referral rates fell by 93 per cent over seven weeks, from a mean of 5.4 to 0.4 per day. Reductions were seen in referrals from both primary care (89 per cent) and the accident and emergency department (93 per cent). Presentations of otitis externa and epistaxis fell by 83 per cent, and presentations of glandular fever, tonsillitis and peritonsillar abscess fell by 67 per cent. Conclusion. Coronavirus disease 2019 has greatly reduced the number of referrals into secondary care ENT. The cause for this reduction is likely to be due to patients' increased perceived risk of the virus presence in a medical setting. The impact of this reduction is yet to be ascertained, but will likely result in a substantial increase in emergency pressures once the lockdown is lifted and the general public's perception of the coronavirus disease 2019 risk reduces.

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Patulous Eustachian tube obliteration using endovascular coils: A novel technique (2018)

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Type of publication:
Journal article

Author(s):
*Jolly K.; *Darr A.; Chavda S.V.; Ahmed S.K.

Citation:
Journal of Laryngology and Otology; Jun 2018; vol. 132 (no. 6); p. 564-566

Abstract:
Background: Patulous Eustachian tube is a distressing condition characterised by chronic patency of the Eustachian tube and its failure to close. Patients typically present with symptoms of autophony and aural fullness. In patients requiring surgical intervention, a variety of different procedures have been demonstrated (both transtympanic and endonasal), with limited success. Evidence of the effectiveness of a number of surgical interventions is limited to small case series only.
Objective(s): This paper describes a novel treatment for patulous Eustachian tube using a 3 mm VortX Diamond endovascular coil. Case report: A transnasal endoscopic approach was adopted, with cannulation of the Eustachian tube orifice using a Relieva sinus guide suction tube from a balloon sinuplasty set. The coil was deployed 1.5 cm deep into the Eustachian tube. Post-operative imaging was used to confirm correct positioning. Regular follow up was arranged. The patient reported complete resolution of her symptoms.
Conclusion(s): The technique has so far proved highly effective and minimally invasive. It will be employed in more patients to fully establish its effectiveness in treating patulous Eustachian tube.

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Motor neuron disease in otolaryngology - A review (2017)

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Type of publication:
Journal article

Author(s):
*Fussey J.M.; *Skinner D.W.

Citation:
Otorhinolaryngologist; 2017; vol. 10 (no. 2); p. 79-81

Abstract:
Motor neuron disease is an incurable neurodegenerative disorder affecting both upper and lower motor neurons, resulting in progressive weakness and inevitable death due to respiratory failure. Up to 30% of patients present with bulbar symptoms and therefore may be seen first by an otolaryngologist. Furthermore, almost all patients experience bulbar symptoms in the late stages of the disease and may require the input of an otolaryngologist as part of their multidisciplinary management.

Introducing a realistic and reusable quinsy simulator (2016)

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Type of publication:
Journal article

Author(s):
*Giblett, N, *Hari, C

Citation:
The Journal of Laryngology and Otology, Feb 2016, vol. 130, no. 2, p. 201-203

Abstract:
An increasing number of inexperienced doctors are rotating through otolaryngology departments and providing care to ENT patients. Numerous acute ENT conditions require basic surgical or technical intervention; hence, effective and efficient simulation induction training has become paramount in providing a safe yet valuable educational environment for the junior clinician. Whilst simulation has developed over the years for numerous ENT skills, to date there has not been a realistic and easily reproducible model for teaching the skills to manage one of the most common ENT emergencies, a peritonsillar abscess or 'quinsy'. We have adapted the Laryngotech trainer, a well-established ENT simulation tool, to present a readily accessible, reusable and realistic simulation model. The model provides safe training for the drainage of quinsy.

Practical Otolaryngology for Junior Doctors (2015)

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Type of publication:
Book

Author(s):
Thomas Frederick Charles Saunders, Editors: Alistair Mitchell-Innes and *Duncan Bowyer

Citation:
Doctors Academy Publications; 1st edition
ISBN-13: 978-9380573076

Abstract:

This book is designed to guide the junior doctor through an Otolaryngology (ENT) rotation from the first referrals to the practical procedures carried out on a daily basis. ENT departments throughout the world will have different ways of managing particular conditions; however, this book will give the user a framework to deliver good quality clinical care and develop skills with confidence wherever one is working. All information is presented in an easy to digest format to give a handy reference guide on how to manage the hugely varied conditions that are dealt with by Otolaryngology. This makes the book an ideal companion to keep in an on-call bag or clinic room. The advice provided in this book is practical and very clear, with good explanations about simple procedures for settling difficult situations. Information is also provided about looking after patients on the ward following common ENT/Head and Neck operations. An ENT junior doctor should feel more confident quickly after checking through this book for advice, as well as knowing when to escalate a problem to a more knowledgeable senior doctor, if the patient is not improving.