Pub Date : 2018-02-01DOI: 10.1017/S0022215117002559
E. Chevretton, I. Pai, S. Haikel, A. Sandison, S. Connor, A. Siddiqui
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Pub Date : 2018-02-01DOI: 10.1017/S0022215117002468
S. Broomfield, P. Robinson, D. Hajioff
s presented at the South West ENT Academic Meeting 2017, Bath, UK Management of patients with unilateral facial nerve palsy in the acute setting at Royal United Hospital, Bath V Evans, A Henderson, S Gillett From the Royal United Hospital, Bath Introduction The inability to move facial muscles caused by unilateral lower motor neuron facial nerve palsy can have both a significant physical and psychological impact. Acute presentation may be to one of several different medical specialties. Objectives We aimed to: assess the quality of investigation and management of patients with acute lower motor neuron facial nerve palsy, compare with current national guidance, and determine whether ENT assessment changes the outcome. Methods A retrospective notes analysis was conducted of all patients presenting to the emergency department, medical assessment unit and medical ambulatory care with unilateral lower motor neuron facial nerve palsy during a six-month period (1 September 2016 to 1 March 2017). Parameters of measurement included: initial ENT assessment, clinical examination, further imaging, administration of steroids, antivirals and eye protection, and appropriate follow up. Results Of a total of 17 patients, only 5 were seen by ENT. Of those, 100 per cent underwent otoscopy and 80 per cent parotid examination, compared with 0 per cent and 8.33 per cent respectively for the remaining cohort. Of the total patients, 64.7 per cent underwent imaging (most commonly computed tomography of the head – 47.1 per cent). Eighty-two per cent of patients received steroids appropriately, within 72 hours in all cases. Thirty-five per cent of patients received acyclovir (all within 72 hours), but only one patient was examined with otoscopy (by ENT). One hundred per cent of those patients seen by ENT were given eye protection, compared with 58.3 per cent of the remaining patients. Eighty per cent of those seen by ENT were followed up in the outpatient department, compared with 25 per cent of the remainder.
在英国巴斯皇家联合医院对急性单侧面神经麻痹患者的管理V Evans, A Henderson, s Gillett介绍由单侧下运动神经元面神经麻痹引起的面部肌肉无法运动可能会对身体和心理产生重大影响。急性表现可能是几种不同的医学专科之一。我们的目的是:评估急性下运动神经元面神经麻痹患者的调查和管理质量，与目前的国家指南进行比较，并确定耳鼻喉科评估是否会改变结果。方法回顾性分析2016年9月1日至2017年3月1日6个月期间在急诊科、医学评估单元和门诊就诊的单侧下运动神经元面神经麻痹患者的资料。测量参数包括:初始耳鼻喉科评估、临床检查、进一步影像学检查、类固醇、抗病毒药物和眼睛保护的使用以及适当的随访。结果17例患者中，仅有5例在耳鼻喉科就诊。其中，100%的人接受了耳镜检查，80%的人接受了腮腺检查，而其余的人分别为0%和8.33%。在所有患者中，64.7%接受了影像学检查(最常见的是头部计算机断层扫描，占47.1%)。82%的患者在72小时内接受了适当的类固醇治疗。35%的患者接受了阿昔洛韦(全部在72小时内)，但只有一名患者接受了耳镜检查(耳鼻喉科)。在接受耳鼻喉科检查的患者中，100%的人都得到了护眼措施，而在其他患者中，这一比例为58.3%。在耳鼻喉科就诊的患者中，80%的人在门诊部接受了随访，而在其余患者中，这一比例为25%。
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Pub Date : 2018-01-18DOI: 10.1017/s002221511800004x
L. Flood
The costs remindme of the exchange rate and the declining value of Sterling, while the imminent breakwith our Continental cousins makes me grateful for my Irish passport. So, while the pound in your pocket has any value, you might consider your need for what is yet another handbook. The first edition appeared in 2010 and the years have seen an increase in price of only €5, which seems not unreasonable. The first edition was described as a pocket book, which could be accommodated in a long white laboratory coat, but it would certainly have resulted in a very asymmetric appearance of the wearer or a nasty scoliosis. This second edition is, we are told, award winning and ‘the GOLD standard amongst pocket guides for this specialty’. The immediate impression here is indeed of a book that is simply packed with text, but well presented. Sometimes structure can dominate and distract if overdone, but not here. The layout uses subtle bullet points, key text in highlighted boxes and clear headings. The result is a book one can actually read, rather than just dip into; the latter all too common a feature of handbooks. The second edition retains the paperback format and the cover is very similar. Indeed, the main change is that the image has been flipped through 180 degrees. Despite the many contributors, the multi-author chapters show a nice uniformity of style. There is new coverage of endocrine surgery and improved colour illustrations that are commendable for a ‘handbook’. I particularly liked the histology slides and the excellently rendered basic anatomy pictures. There are useful appendices added, including a series of anatomy diagrams and a fast reference to any content that covers emergencies, ideal for the novice reader. I was less convinced by the attempt to briefly describe a small series of procedures. Tracheostomy and cricothyrotomy worked fine, but I am not sure that rigid endoscopies or adenotonsillectomy benefitted much from this approach. The opening chapter gladdened my heart by simply explaining how to take a patient’s history and carry out a clinical examination, rather than just shouting out a list of abbreviations for laboratory tests, followed by ‘Stat’. Such might work for one handsome actor in the television show ‘ER’, but it is good to see that basic clinical skills are still encouraged by these authors. I was sure there was no reproduction of imaging whatsoever, but did find two scans eventually, in the thyroid section. This did not bother me at all. We have many an atlas to refer to, and personal supervised experience is the best learning tool for expertise in imaging interpretation. This book is very well updated (with tumour–node–metastasis staging systems labelled as 2017) and comprehensive, ranging from neurolaryngology to facioplastics. I was amused to note online reviews of the first edition criticising the coverage of aesthetic surgery as superficial, however good the rest of the content, with both of these reviews publishe
{"title":"HANDBOOK OF OTOLARYNGOLOGY; HEAD AND NECK SURGERY , 2nd edn D Goldenberg, B J Goldstein Thieme, 2018 ISBN 978 1 62623 407 9 pp 753 Price €89.99 £84.00","authors":"L. Flood","doi":"10.1017/s002221511800004x","DOIUrl":"https://doi.org/10.1017/s002221511800004x","url":null,"abstract":"The costs remindme of the exchange rate and the declining value of Sterling, while the imminent breakwith our Continental cousins makes me grateful for my Irish passport. So, while the pound in your pocket has any value, you might consider your need for what is yet another handbook. The first edition appeared in 2010 and the years have seen an increase in price of only €5, which seems not unreasonable. The first edition was described as a pocket book, which could be accommodated in a long white laboratory coat, but it would certainly have resulted in a very asymmetric appearance of the wearer or a nasty scoliosis. This second edition is, we are told, award winning and ‘the GOLD standard amongst pocket guides for this specialty’. The immediate impression here is indeed of a book that is simply packed with text, but well presented. Sometimes structure can dominate and distract if overdone, but not here. The layout uses subtle bullet points, key text in highlighted boxes and clear headings. The result is a book one can actually read, rather than just dip into; the latter all too common a feature of handbooks. The second edition retains the paperback format and the cover is very similar. Indeed, the main change is that the image has been flipped through 180 degrees. Despite the many contributors, the multi-author chapters show a nice uniformity of style. There is new coverage of endocrine surgery and improved colour illustrations that are commendable for a ‘handbook’. I particularly liked the histology slides and the excellently rendered basic anatomy pictures. There are useful appendices added, including a series of anatomy diagrams and a fast reference to any content that covers emergencies, ideal for the novice reader. I was less convinced by the attempt to briefly describe a small series of procedures. Tracheostomy and cricothyrotomy worked fine, but I am not sure that rigid endoscopies or adenotonsillectomy benefitted much from this approach. The opening chapter gladdened my heart by simply explaining how to take a patient’s history and carry out a clinical examination, rather than just shouting out a list of abbreviations for laboratory tests, followed by ‘Stat’. Such might work for one handsome actor in the television show ‘ER’, but it is good to see that basic clinical skills are still encouraged by these authors. I was sure there was no reproduction of imaging whatsoever, but did find two scans eventually, in the thyroid section. This did not bother me at all. We have many an atlas to refer to, and personal supervised experience is the best learning tool for expertise in imaging interpretation. This book is very well updated (with tumour–node–metastasis staging systems labelled as 2017) and comprehensive, ranging from neurolaryngology to facioplastics. I was amused to note online reviews of the first edition criticising the coverage of aesthetic surgery as superficial, however good the rest of the content, with both of these reviews publishe","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"26 1","pages":"463 - 463"},"PeriodicalIF":0.0,"publicationDate":"2018-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89604183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-13DOI: 10.1017/s0022215117002535
L. Flood
I expected to struggle through this book, but was encouraged by the publisher’s website, which did admit that this is ‘an incredibly complex topic’ and that ‘the literature that is available can be overwhelming and difficult to read as a quick reference’. Well, that struck a chord with this reviewer, but the promise was to provide practical content for daily clinical use. Further encouragement came from chapter titles, such as the opening ‘Functional Consequences of Hearing Loss; What’s Down Can Come Up!’ or the closing ‘Questions with no Answers in Pediatric Sensorineural Hearing Loss’. The latter title was so irresistible that my reading started on page 217. I was not disappointed. Despite a substantial multi-author contribution, there is a uniformity of style, with some very memorable tips and messages. In this last chapter, there is discussion of central auditory processing disorder and auditory neuropathy that is understandable and fascinating (not something easily achieved). This reviewer will long recall the playground being described as the ‘child’s cocktail party’ (you will have to read the book). Who appreciated the prevalence of noise-induced hearing loss in adolescents, or the relationship between hearing loss and global developmental delay? Hooked by now (and I admit pleasantly surprised), I went back to read from the start. Again, memorable phrases such as ‘we hear with our brain, not our ears’ summarise the message, but are so memorable for clinical use. A short but ‘punchy’ chapter is clever in addressing the limitations of newborn hearing screening. Audiometric evaluation is throughout pitched at a level that a simple surgeon can follow. A chapter on imaging has all the nice images of malformations we would expect, but, again, it is the text that is novel in addressing their clinical value. The content is then summarised in a nice overview chapter, containing a single algorithm on investigation of a new diagnosis, which alone justifies the textbook. The chapter on genetic hearing impairment is presented in a style that is comprehensive, informative and even readable (and that is quite a challenge to meet). ‘Infectious Etiology’ is sufficiently updated to include Zika virus, and, amongst no fewer than 208 references, several are from 2017. Management tends to concentrate more on amplification than cochlear or brainstem implants, which I had expected to dominate the book. This book is then really different. It is a paediatric audiology textbook that is targeted beyond paediatric audiologists. It is easy to read from beginning to end (unless you follow my example) and is not just a quick reference to dip into. It deals with a topic that is often overlooked in surgical training, but which frequently arises in those final examinations. It is far too good for trainees alone, and I would recommend this to the most senior expert clinician who has any contact with hearing-impaired children.
{"title":"PEDIATRIC SENSORINEURAL HEARING LOSS: CLINICAL DIAGNOSIS AND MANAGEMENT S Anne, J E C Lieu, M A Kenna Plural Publishing, 2017 ISBN 978 1 63550 011 0 pp 250 Price US$129.95","authors":"L. Flood","doi":"10.1017/s0022215117002535","DOIUrl":"https://doi.org/10.1017/s0022215117002535","url":null,"abstract":"I expected to struggle through this book, but was encouraged by the publisher’s website, which did admit that this is ‘an incredibly complex topic’ and that ‘the literature that is available can be overwhelming and difficult to read as a quick reference’. Well, that struck a chord with this reviewer, but the promise was to provide practical content for daily clinical use. Further encouragement came from chapter titles, such as the opening ‘Functional Consequences of Hearing Loss; What’s Down Can Come Up!’ or the closing ‘Questions with no Answers in Pediatric Sensorineural Hearing Loss’. The latter title was so irresistible that my reading started on page 217. I was not disappointed. Despite a substantial multi-author contribution, there is a uniformity of style, with some very memorable tips and messages. In this last chapter, there is discussion of central auditory processing disorder and auditory neuropathy that is understandable and fascinating (not something easily achieved). This reviewer will long recall the playground being described as the ‘child’s cocktail party’ (you will have to read the book). Who appreciated the prevalence of noise-induced hearing loss in adolescents, or the relationship between hearing loss and global developmental delay? Hooked by now (and I admit pleasantly surprised), I went back to read from the start. Again, memorable phrases such as ‘we hear with our brain, not our ears’ summarise the message, but are so memorable for clinical use. A short but ‘punchy’ chapter is clever in addressing the limitations of newborn hearing screening. Audiometric evaluation is throughout pitched at a level that a simple surgeon can follow. A chapter on imaging has all the nice images of malformations we would expect, but, again, it is the text that is novel in addressing their clinical value. The content is then summarised in a nice overview chapter, containing a single algorithm on investigation of a new diagnosis, which alone justifies the textbook. The chapter on genetic hearing impairment is presented in a style that is comprehensive, informative and even readable (and that is quite a challenge to meet). ‘Infectious Etiology’ is sufficiently updated to include Zika virus, and, amongst no fewer than 208 references, several are from 2017. Management tends to concentrate more on amplification than cochlear or brainstem implants, which I had expected to dominate the book. This book is then really different. It is a paediatric audiology textbook that is targeted beyond paediatric audiologists. It is easy to read from beginning to end (unless you follow my example) and is not just a quick reference to dip into. It deals with a topic that is often overlooked in surgical training, but which frequently arises in those final examinations. It is far too good for trainees alone, and I would recommend this to the most senior expert clinician who has any contact with hearing-impaired children.","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"25 1 1","pages":"375 - 376"},"PeriodicalIF":0.0,"publicationDate":"2017-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90422961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-11DOI: 10.1017/s0022215117002432
L. Flood
{"title":"OTOLARYNGOLOGY CASES: THE UNIVERSITY OF CINCINNATI CLINICAL PORTFOLIO, 2nd edn M L Pensak, C K Hart, Y J Patil Thieme, 2017 ISBN 978 1 62623 419 2 pp 420 Price £84.00 €89.99","authors":"L. Flood","doi":"10.1017/s0022215117002432","DOIUrl":"https://doi.org/10.1017/s0022215117002432","url":null,"abstract":"","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"8 6 1","pages":"188 - 188"},"PeriodicalIF":0.0,"publicationDate":"2017-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78356836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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