To compare the microbiological efficacy, turnaround time, cost, convenience, and patient and user tolerance of Tristel Trio Wipes, PeraSafe solution and Cidex OPA solution for the high-level disinfection of flexible nasendoscopes.

Flexible nasendoscopes were used in routine clinical encounters. They were then disinfected with one of the three disinfectant methods. Surveillance cultures were taken before and after each disinfection process. Data relating to each of the study parameters were recorded.

Positive bacterial cultures were discovered on nasendoscopes disinfected with PeraSafe and Cidex OPA. Tristel Trio Wipes have no capital outlay cost, the lowest running cost, the greatest convenience and the fastest turnaround time. PeraSafe had a faster turnaround time than Cidex OPA, and lower running costs.

Tristel Trio Wipes are equal to PeraSafe and Cidex OPA in terms of microbiological efficacy. Turnaround time and cost are dramatically reduced when using Tristel Trio Wipes compared to the other disinfectant methods.

To systematically search for studies reporting outcomes for adenoidectomy alone as a treatment for paediatric obstructive sleep apnoea and use the data to perform a meta-analysis.

Nine databases, including PubMed and Medline, were systematically searched through to 1 April 2016. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed.

A total of 1032 articles were screened and 126 full texts were reviewed. Three paediatric studies (47 patients) reported outcomes. Overall, apnoea–hypopnoea index values decreased from 18.1 ± 16.8 to 3.1 ± 5.5 events per hour (28 patients). Random-effects modelling demonstrated a mean difference of −14.43 events per hour (I2 = 23 per cent (low inconsistency)). The apnoea–hypopnoea index standardised mean difference was −1.14 (large magnitude of effect). The largest reduction in apnoea–hypopnoea index was observed in children aged less than 12 months (reduction of 56.6−94.9 per cent). Lowest oxygen saturation values improved from 80.0 ± 9.5 to 85.5 ± 6.0 per cent (13 children).

Adenoidectomy alone has improved obstructive sleep apnoea in children, especially in those aged less than 12 months; however, given the low number of studies, isolated adenoidectomy remains an area for additional research.

This study aimed to evaluate the activity of paediatric otolaryngology services required for children with Down's syndrome in a tertiary referral centre.

A review of the paediatric otolaryngology input for children with Down's syndrome was performed; data were obtained from the coding department for a two-year period and compared with other surgical specialties.

Between June 2011 and May 2013, 106 otolaryngology procedures were performed on children with Down's syndrome. This compared to 87 cardiac and 81 general paediatrics cases. The most common pathologies in children with Down's syndrome were obstructive sleep apnoea, otitis media, hearing loss and cardiac disease. The most common otolaryngology procedures performed were adenoidectomy, tonsillectomy, grommet insertion and bone-anchored hearing aid implant surgery.

ENT manifestations of Down's syndrome are common. Greater provisions need to be made to streamline the otolaryngology services for children and improve transition of care to adult services.

This study aimed to compare the diagnostic effectiveness of narrow band imaging and autofluorescence imaging for malignant laryngopharyngeal tumours.

Between May 2010 and October 2010, 50 consecutive patients with suspected laryngopharyngeal tumour underwent endoscopic laryngopharynx examination. The morphological characteristics of laryngopharyngeal lesions were analysed using high performance endoscopic systems equipped with narrow band imaging and autofluorescence imaging modes. The diagnostic effectiveness of white light image, narrow band imaging and autofluorescence imaging endoscopy for benign and malignant laryngopharyngeal lesions was evaluated.

Under narrow band imaging endoscopy, the superficial microvessels of squamous cell carcinomas appeared as dark brown spots or twisted cords. Under autofluorescence imaging endoscopy, malignant lesions appeared as bright purple. The sensitivity of malignant lesion diagnosis was not significantly different between narrow band imaging and autofluorescence imaging modes, but was better than for white light image endoscopy (χ2 = 12.676, p = 0.002). The diagnostic specificity was significantly better in narrow band imaging mode than in both autofluorescence imaging and white light imaging mode (χ2 = 8.333, p = 0.016).

Narrow band imaging endoscopy is the best option for the diagnosis and differential diagnosis of laryngopharyngeal tumours.

To compare stimulation parameters of peri-modiolar and anti-modiolar electrode arrays using two surgical approaches.

Impedance, stimulation thresholds, comfortably loud current levels, electrically evoked compound action potential thresholds and electrically evoked stapedial reflex thresholds were compared between 2 arrays implanted in the same child at 5 time points: surgery, activation/day 1, week 1, and months 1 and 3. The peri-modiolar array was implanted via cochleostomy in all children (n = 64), while the anti-modiolar array was inserted via a cochleostomy in 43 children and via the round window in 21 children.

The anti-modiolar array had significantly lower impedance, but required higher current levels to elicit thresholds, comfort, electrically evoked compound action potential thresholds and electrically evoked stapedial reflex thresholds than the peri-modiolar array across all time points, particularly in basal electrodes (p < 0.05). The prevalence of open electrodes was similar in anti-modiolar (n = 5) and peri-modiolar (n = 3) arrays.

Significant but clinically acceptable differences in stimulation parameters between peri-modiolar and anti-modiolar arrays persisted four months after surgery in children using bilateral cochlear implants. The surgical approach used to insert the anti-modiolar array had no overall effect on outcomes.

This study was conducted to explore the potential use of neuromuscular electrical stimulation as an adjunctive treatment for muscle tension dysphonia.

Voice data and ratings of fatigue and soreness were obtained for two experiments. Experiment one examined the vocal effects of neuromuscular electrical stimulation applied to the neck for 15 minutes. Experiment two examined the recovery effect of laryngeal neuromuscular electrical stimulation following a vocal loading task among normophonic women.

No significant differences in vocal function following 15 minutes of laryngeal neuromuscular electrical stimulation were found. Six of 11 participants receiving laryngeal neuromuscular electrical stimulation exhibited improved recovery following the vocal loading task.

A short session of laryngeal neuromuscular electrical stimulation may be beneficial in reducing muscle fatigue for some individuals. Further investigation is warranted to determine the applicability of laryngeal neuromuscular electrical stimulation in voice therapy.

Laboratory experiments indicate that changes in retinal image size result in adaptive recalibration or suppression of the vestibulo-ocular reflex. Myopia correction with spectacles or contact lenses also leads to retinal image size changes, and may bring about similar vestibulo-ocular reflex alterations.

A hypothesis-generating preliminary investigation was conducted. In this cross-sectional study, findings of electronystagmography including bithermal caloric testing were compared between 17 volunteer myopes using spectacles or contact lenses and 17 volunteer emmetropes (with no refractive error).

Bilateral hypoactive caloric responses were demonstrated in 6 of 11 spectacle users, in 1 of 6 contact lens users and in 1 of 17 emmetropes. Hypoactive caloric responses were significantly more likely in spectacle users than in emmetropes (p < 0.01; relative risk = 9.3).

A significant proportion of myopes using spectacles have vestibulo-ocular reflex suppression, as demonstrated by the caloric test. This has implications for the interpretation of electronystagmography and videonystagmography results, and highlights spectacle use as a possible cause of vestibular impairment. Further corroboration of these findings is warranted, with more precise and direct vestibulo-ocular reflex tests such as rotational tests and the head impulse test.

Sudden sensorineural hearing loss in divers may be caused by either inner-ear barotrauma or inner-ear decompression sickness. There is no consensus on the best treatment option. This study aimed to evaluate the therapeutic value of hyperbaric oxygen therapy for sudden sensorineural hearing loss in divers.

A literature review and three cases of divers with sudden sensorineural hearing loss treated with hyperbaric oxygen therapy are presented.

Hyperbaric oxygen therapy resulted in hearing improvement in 80 per cent of patients: 39 per cent had hearing improvement and 41 per cent had full recovery.

Hyperbaric oxygen therapy improved hearing in divers with sudden sensorineural hearing loss.

This study investigated long-term survival outcomes in surgically treated oropharyngeal cancer patients with known human papilloma virus status.

A case note review was performed of all patients undergoing primary surgery for oropharyngeal cancer in a single centre over a 10-year period. Human papilloma virus status was determined via dual modality testing. Associations between clinicopathological variables and survival were identified using a log-rank test.

Of the 107 cases in the study, 40 per cent (n = 41) were human papilloma virus positive. The positive and negative predictive values of p16 immunohistochemistry for human papilloma virus status were 57 per cent and 100 per cent, respectively. At a mean follow up of 59.5 months, 5-year overall and disease-specific survival estimates were 78 per cent and 69 per cent, respectively. Human papilloma virus status (p = 0.014), smoking status (p = 0.021) and tumour stage (p = 0.03) were significant prognostic indicators.

The long-term survival rates in surgically treated oropharyngeal cancer patients were comparable to other studies. Variables including human papilloma virus status and tumour stage were associated with survival in patients treated with primary surgery; however, nodal stage and presence of extracapsular spread were non-prognostic.

To ascertain determinants of an interest in a career in ENT surgery through a survey of medical students and junior doctors.

A survey was administered, comprising Likert scales, forced response and single option questions, and free text responses, at five different courses or events for those interested in a career in ENT.

The survey had an 87 per cent response rate; respondents consisted of 43 applicants for national selection, 15 foundation doctors and 23 medical students. The most important factors that encourage ENT as a career included: the variety of operative procedures, work–life balance, inherent interest in this clinical area and inspirational senior role models. Exposure to ENT in undergraduate or post-graduate training is critical in deciding to pursue this specialty.

It is important to promote those aspects of ENT surgery that attract people to it, and to argue for greater exposure to ENT during undergraduate and post-graduate training.

To inform on the incidence of high jugular bulb and dehiscent high jugular bulb, and the symptoms related to these vascular anomalies.

A retrospective analysis was performed of temporal bone computed tomography scans of 3285 patients who attended our clinic with various symptoms. The medical records of patients with high jugular bulb and dehiscent high jugular bulb were analysed, and the clinical findings reviewed. Patients with dehiscent high jugular bulb were evaluated for hearing loss with pure tone audiometry.

High jugular bulb was evident in 730 patients (22 per cent) (510 right-sided, 220 left-sided; p < 0.01). Twenty-six high jugular bulb patients had dehiscent high jugular bulb. Ten of these 26 patients had vertigo, 15 had tinnitus and 1 had hearing disturbance. Ten dehiscent high jugular bulb patients had undergone pure tone audiometry: seven patients had conductive hearing loss, two had sensorineural hearing loss and one had mixed hearing loss.

The incidences of high jugular bulb and dehiscent high jugular bulb were 22 per cent and 3.5 per cent, respectively. Tinnitus was the most common symptom of all patients. Dehiscent high jugular bulb was associated with various degrees of hearing loss, but not hearing disturbance.

This study aimed to compare two sampling methods for nasal nitric oxide in healthy individuals and allergic rhinitis patients, and to examine the within-subject reliability of nasal nitric oxide measurement.

The study included 23 allergic rhinitis patients without concomitant asthma and 10 healthy individuals. For all participants, nitric oxide levels were measured non-invasively from the lungs through the mouth (i.e. the oral fractional exhaled nitric oxide) and the nose. Nasal nitric oxide was measured by two different methods: (1) nasal aspiration via one nostril during breath holding and (2) single-breath quiet exhalation against resistance through a tight facemask (i.e. the nasal fractional exhaled nitric oxide).

Compared with healthy participants, allergic rhinitis patients had significantly higher average oral and nasal nitric oxide levels. All methods of nitric oxide measurement had excellent reliability.

Nasal nitric oxide measurement is a useful and reliable clinical tool for diagnosing allergic rhinitis in patients without asthma in an out-patient setting.

Epistaxis is the most common ENT emergency encountered in the Emergency Department. Most cases can be managed by simple anterior nasal packing. This is usually a safe and very effective option in an emergency situation, requiring minimal expertise and infrastructure. This paper describes a rare instance of a serious complication following anterior nasal packing in a case of nasopharyngeal angiofibroma.

A 27-year-old man diagnosed with nasopharyngeal angiofibroma presented to the Emergency Department with bilateral epistaxis. The patient was stabilised and anterior nasal packing was performed, which controlled the bleeding. Three hours later, the patient developed complete blindness in both eyes. Aggressive medical management was initiated immediately, but failed to restore the patient's vision.

Anterior nasal packing is a simple and minimally invasive procedure practised regularly in an Emergency Department setting. However, it can occasionally lead to serious complications such as blindness. Thus, obtaining informed consent is essential to avoid medico-legal consequences in high-risk cases.