Background: The COVID-19 pandemic led to the introduction of telephone consultations in order to provide specialist health care remotely. This study analyses the outcomes of ear, nose, and throat (ENT) telephone consultations. Methods: Retrospective analysis was undertaken of 400 ENT telephone consultations. Results: All 2-week-wait neck or face lump patients underwent imaging and 78% were successfully discharged. 80% of vertigo patients and 100% of 2-week-wait throat symptom patients were offered face-to-face consultations. All primary hyperparathyroidism patients were managed remotely, being discharged, or with telephone follow-up. The majority of routine referrals were managed without the need for face-to-face consultation. Conclusion: Vertigo patients and 2-week-wait throat symptom patients should be offered a face-to-face consultation in the first instance. For patients with neck or face lumps, initial referral for imaging may improve patient flow and facilitate safe discharge. It is appropriate to continue with telephone consultations for all other patient groups.
Objective: Accurate diagnosis of parotid neoplasia is a key to determine the most appropriate patient management choice, including the need for surgery. This review provides an update of the literature on current practice and outcomes of parotid tissue sampling techniques, with an emphasis on ultrasound-guided core biopsy (USCB) and comparison with fine needle aspiration cytology (FNAC). Methods: A literature review of EMBASE, Medline, PubMed and Google Scholar was conducted. Results: USCB has higher sensitivity, specificity and lower non-diagnostic rates than optimized FNAC. It also has a significantly higher sensitivity for the detection of malignancy. Significant complications post-USCB are uncommon, with only one reported case of tumour seeding and no cases of permanent facial nerve dysfunction. The technique is less operator-dependent than FNAC, with less reported variation in results between institutions. Conclusions: USCB can be considered as the optimum tool of choice for the diagnosis of parotid neoplasia. This would particularly be the case in centres utilizing FNAC with high non-diagnostic rates or reduced diagnostic accuracy when compared to USCB published data, or in centres establishing a new service. Advances in knowledge: An update of the role and outcomes of USCB in the diagnosis of parotid gland pathologies. Research shows that USCB preforms better than FNAC, in terms of sensitivity and specificity, particularly in the case of malignant neoplasia. Complications following USCB were found to be higher than that of FNAC; however, no long-term major complications following either method have been reported in the literature.
Background and Objectives: The United Kingdom (UK) national standard for the closure rate for myringoplasty is 89.5% (90.6% and 84.2% for primary and revision surgeries, respectively). The average hearing gains for primary and revision myringoplasty are 9.14 dB and 7.86 dB, respectively. This study compared the myringoplasty outcomes for a single surgeon over 5 years.Subjects and Methods: Data for 68 cases were analyzed retrospectively. The outcome measures were achievement of the tympanic membrane closure and the average hearing gain or loss.Results: The overall and primary closure rates were 97% and 98%, respectively and significantly higher than the UK national standard (p=0.0210 and p=0.0287, respectively). The revision closure rate was 93%; however, it was not significantly higher than the national standard (p=0.1872). The average hearing gain was 5.18 dB. The gains for primary and revision surgeries were 5.15 dB and 5.25 dB, respectively.Conclusions: We propose that these outcomes are a result of our surgical technique, including the simultaneous use of cortical mastoidectomy in ears with discharge.
Due to the widening access to medicine scheme, students with disabilities are entering medicine. Hearing-impaired students are an important subcategory of medical students, whose specific learning challenges with respect to medicine are poorly explored in the literature. We feel that this topic is particularly important and relevant given the current covid-19 pandemic, which has led to the widespread use of surgical masks, thereby posing a barrier to hearing, communication and education for hearing-impaired medical students. Therefore, the medical education of these students is of even more paramount importance as the pandemic continues. This personal view details the experiences of a current hearing-impaired medical student in the United Kingdom, with key learning points for medical educators who may require insight into hearing loss and how to tailor their teaching techniques accordingly.
This article was migrated. The article was marked as recommended. Background: The Covid-19 pandemic has resulted in significant change to ENT practice, as it a high-risk speciality in terms of SARS-Cov-2 virus transmission. The reduction in theatre time, loss of face to face outpatient appointments and redeployment has contributed to significant loss of training opportunities for current ENT trainees. Aim: This paper provides twelve easy and simple tips for current ENT trainees to follow. Methods: Relevant literature was reviewed and the first named author’s personal experiences were drawn upon. Results: The twelve tips are (1) Try run a telephone clinic, (2) Evaluate face to face patients independently and make a management plan, (3) Gain formative feedback, (4) Make the ward round a learning opportunity, (5) Organise formal consultant led teaching, (6) Learn from the interprofessional team, (7) Attend online courses and webinars, (8) Take pictures when performing flexible nasoendoscopy , (9) Organise simulation sessions, (10) Gain surgical knowledge and exposure outside of the theatre setting, (11) Undertake an audit or quality improvement project and (12) Look after yourself and make mental health a priority Conclusion: These twelve tips should help the ENT trainee to maximise their learning opportunities and improve their training.
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