The Wexham Criteria: defining severe epistaxis to select patients requiring sphenopalatine artery ligation.

This study aims to provide guidance regarding patient selection and timing of intervention with sphenopalatine artery (SPA) ligation by defining 'severe epistaxis'. An analysis of all patients undergoing SPA ligation (January 2002-2010) was performed. SPA ligation was deemed necessary if at least one of the four identified criteria was fulfilled.

Alternative injectable materials for vocal fold medialisation in unilateral vocal fold paralysis.

Background: Patients with unilateral vocal fold paralysis (UVFP) usually present with dysphonia, but can also be breathless and have problems with their swallowing. Speech and language therapy forms the initial mainstay of management in cases of UVFP, since up to 60% of cases will resolve spontaneously. If vocal fold paralysis persists surgery, in the form of injection medialisation, has been shown to be an effective intervention.

How clean is your scope? A completed audit cycle of the disinfection of nasendoscopes.

Introduction: Correct disinfection of nasendoscopes is essential to address both the potential iatrogenic transmission of infection and to avoid injury from the chemicals used.

Materials And Methods: Standards-based audit of the disinfection of nasendoscopes against the ENT UK guidelines.

Intervention: instructional poster and staff training session.

Lemierre's syndrome as a consequence of acute supraglottitis.

Lemierre's syndrome comprises internal jugular vein thrombosis following oropharyngeal sepsis and is a rare and serious condition. It is most commonly caused by the anaerobe Fusobacterium necrophorum and typically presents as metastatic sepsis to the lungs and joints. Thrombosis is demonstrated by computed tomography (CT) of the neck, and it is routinely treated with intravenous antibiotics and anti-coagulation.