Cavernous Sinus Thrombosis Associated With Contralateral Pansinusitis: A Case Report.

A healthy woman in her 60s presented acutely with right-sided periorbital edema, erythema, neck pain, and fever. Initial examination and investigations suggested right-sided orbital cellulitis with contralateral pansinusitis. Despite treatment with IV antibiotics, her symptoms worsened, and inflammatory markers continued to rise.

Learning needs of junior doctors in otolaryngology: a qualitative study.

Objectives: There is concern that junior doctors are not prepared for their post-graduate attachments in ENT. The aims of this study were to capture the learning priorities of those in the ENT first on-call role and facilitate further educational opportunities to address these needs.

Method: Semi-structured interviews were undertaken to explore the learning needs of junior doctors with seven junior and two senior ENT clinicians.

Mental health and life satisfaction among those advised to shield during the COVID-19 pandemic in the UK: a secondary analysis of the Understanding Society longitudinal study.

Introduction: During the COVID-19 pandemic in the UK, those considered most vulnerable to adverse outcomes from infection were designated "clinically extremely vulnerable" and advised to "shield." This involved prolonged confinement at home with strict limits on face-to-face contact, beyond national restrictions. Shielding ended in September 2021 and was considered likely to have harmed mental health and wellbeing.

The impact of COVID-19 on head and neck cancer patients: A review of speech valve complications and patient experience during the COVID-19 pandemic in the United Kingdom.

Purpose: Surgical voice restoration (SVR) is associated with improved patient quality of life following laryngectomy. This study aims to determine the impact of the COVID-19 pandemic on patients with SVR and analyse the complications in this cohort of patients.

Method: A retrospective review of all patients with SVR at a single tertiary ear, nose, and throat (ENT) unit in the UK for 12 months during the COVID-19 pandemic, with comparison to the preceding 12 months.

Sweet Shop Sialagogues: A Sour Solution to Sialolithiasis.

Historically, boiled sweets have been recommended by ear, nose, and throat surgeons for their sialagogue effect in patients with sialolithiasis. This study presents an in vivo analysis of boiled sweets and solutions to determine sialagogue superiority. Six high-street boiled sweets (lemon sherbets, rhubarb sweets, mint humbugs, Werther's Original® (August Storck, Germany), Fox's Glacier Fruits® (Fox's Confectionery, Braunstone, Leicester, United Kingdom), and Chupa Chups® lollipops (Perfetti Van Melle, Breda, Netherlands)) and two solutions (malt vinegar and lemon juice) were compared to two controls (no sweet and inert plastic) in two healthy participants.

Subglottic stenosis masquerading as asthma in a young adult: an overlooked and delayed diagnosis.

An otherwise fit young woman presented with a 10-year history of non-progressive wheeze and 'noisy breathing'. She had previously been diagnosed with teenage-onset asthma but had been unresponsive to inhaled corticosteroids and bronchodilators. A dysfunctional breathing disorder had been considered a possible diagnosis by several general practitioners, and there were no features to suggest systemic conditions.

Rationalising requests for preoperative sleep studies and postoperative HDU beds: a quality improvement project in paediatric ENT patients undergoing elective surgery.

Background: Sleep disordered breathing represents a spectrum of upper airway obstruction including snoring, increased respiratory effort and obstructive sleep apnoea. An increasing demand for paediatric preoperative sleep studies and postoperative high dependency unit (HDU) beds was having a significant impact on service delivery at this ear, nose and throat (ENT) unit.

Methods: Retrospective and prospective review of all paediatric sleep study requests over a 30-month period in a single tertiary ENT department.

Keeping it human: Pandemic era psychiatry teaching.

Background: Mental health is an important global issue, and doctors in training need a grounding in the principles of psychiatry. Undergraduate clinical placements in psychiatry can develop core knowledge and skills as well as challenging stigma towards mental illness. The onset of the coronavirus pandemic saw disruption to undergraduate clinical placements.

Attend anywhere clinic: A virtual outpatient clinic experience in otolaryngology during the COVID-19 pandemic.

Introduction: Numerous technological advances have been made during the COVID-19 pandemic. There has been a growing body of evidence highlighting the value of virtual consultations as an adjunct to physical appointments. This study presents the virtual clinic experiences of one ENT department in the UK.

Lessons learnt from the first 200 unselected consecutive cases of laparoscopic exploration of common bile duct stones at a district general hospital.

Background: The management of choledocholithiasis evolves with diagnostic imaging and therapeutic technology, facilitating a laparoscopic approach. We review our first 200 cases of laparoscopic exploration of the common bile duct, highlighting challenges and lessons learnt.

Methods: We retrospectively studied the first 200 cases of laparoscopic cholecystectomy with common bile duct exploration between 2006 and 2019.

Effectiveness of a multi-session combined near-peer and faculty-led surgical skills course on self-perceived ability to perform basic surgical skills.

Background: Newly qualified UK doctors report feeling unprepared to perform basic practical procedures. The Royal College of Surgeons of England (RCSEng) responded to this concern by developing a national surgical curriculum, however, a national survey of UK medical schools identified that surgical skills teaching is inconsistent throughout the UK.Peer assisted teaching sessions are delivered by senior students to junior peers and have been demonstrated to be effective in a number of settings.

Lateral nasal wall abscess following manipulation of fractured nasal bones.

Nasal fracture accounts for over 50% of facial fractures and is a frequent presentation to ear, nose and throat emergency clinics. Optimal management of nasal injuries with deformity is by manipulation under anaesthetic and should be offered when appropriate. A healthy 27-year-old woman presented with a lateral nasal wall mass with purulent discharge 1 month following manipulation.

The story of life: critical insights from evolutionary biology.

The notion that humans, in all their complexity, are merely an evolutionary accident, an insignificant speck in a boundless cosmos, is deeply unsatisfying for most nonscientists and fails to resonate with their life experience. What, then, can evolutionary biology ultimately tell us about the meaning of our lives? In conversation with Steve Paulson, executive producer and host of To the Best of Our Knowledge, paleoanthropologists Melanie Lee Chang and Ian Tattersall, and paleontologist Simon Conway Morris share their insights on these competing concepts and explain how meaning and purpose can be gleaned from the remarkable story of life itself.

Middle Ear Pressures in Wind Instrument Musicians.

Objectives: This study aimed to assess if playing wind instruments leads to a measurable increase in middle ear pressure during note generation and to provide evidence to clinicians to advise musicians undergoing middle ear surgery.

Study Design: An observational cohort study of 40 volunteers in 7 different wind instrument categories underwent tympanometry at rest and during note production.

Setting: Community.

Head and Neck Anatomy: Effect of Focussed Near-Peer Teaching on Anatomical Confidence in Undergraduate Medical Students.

Objectives: To assess the effect of near-peer head and neck anatomy teaching on undergraduates and to quantify the benefit from a focussed teaching course. Near-peer teaching involves colleagues within close seniority and age proximity teaching one another on a specified topic.

Design: Small group teaching sessions were delivered to medical students on 3 key areas of ENT anatomy.

Medical Students Teaching Medical Students Surgical Skills: The Benefits of Peer-Assisted Learning.

Objective: Teaching surgical skills is a labor intensive process, requiring a high tutor to student ratio for optimal success, and teaching for undergraduate students by consultant surgeons is not always feasible. A surgical skills course was developed, with the aim of assessing the effectiveness of undergraduate surgical peer-assisted learning.

Design: Five surgical skills courses were conducted looking at eight domains in surgery, led by foundation year doctors and senior medical students, with a tutor to student ratio of 1:4.

Meiofaunal deuterostomes from the basal Cambrian of Shaanxi (China).

Deuterostomes include the group we belong to (vertebrates) as well as an array of disparate forms that include echinoderms, hemichordates and more problematic groups such as vetulicolians and vetulocystids. The Cambrian fossil record is well-populated with representative examples, but possible intermediates are controversial and the nature of the original deuterostome remains idealized. Here we report millimetric fossils, Saccorhytus coronarius nov.

Investigating the impact of headaches on the quality of life of patients with glioblastoma multiforme: a qualitative study.

Objectives: Headaches and facial pain have been identified as the most prevalent form of pain among patients with glioblastoma multiforme, the most common malignant primary brain tumour. Despite this, minimal research has been undertaken investigating the direct and indirect impact these headaches have on their quality of life. Therefore, in this study, we aimed at gaining a personal insight into the importance and impact that these headaches have on the quality of life of patients with glioblastoma multiforme.

Sense of belonging to specific communities and depressive symptoms among Australian gay men.

Sense of belonging to the general and broader gay communities has been shown to be beneficial for gay men's mental health. This research investigated the interrelations between sense of belonging to three forms of gay community (the broader gay community, gay groups, and gay friends), sense of belonging to the general community, and depressive symptoms by examining a path model. A community sample of 177 gay men, aged 18 to 79 years, completed the Sense of Belonging Instrument-Psychological subscale, the Centre for Epidemiological Studies-Depression Scale, and the Sense of Belonging within Gay Communities Scale.

A primitive fish from the Cambrian of North America.

Knowledge of the early evolution of fish largely depends on soft-bodied material from the Lower (Series 2) Cambrian period of South China. Owing to the rarity of some of these forms and a general lack of comparative material from other deposits, interpretations of various features remain controversial, as do their wider relationships amongst post-Cambrian early un-skeletonized jawless vertebrates. Here we redescribe Metaspriggina on the basis of new material from the Burgess Shale and exceptionally preserved material collected near Marble Canyon, British Columbia, and three other Cambrian Burgess Shale-type deposits from Laurentia.

Tubicolous enteropneusts from the Cambrian period.

Hemichordates are a marine group that, apart from one monospecific pelagic larval form, are represented by the vermiform enteropneusts and minute colonial tube-dwelling pterobranchs. Together with echinoderms, they comprise the clade Ambulacraria. Despite their restricted diversity, hemichordates provide important insights into early deuterostome evolution, notably because of their pharyngeal gill slits.

Evidence for gill slits and a pharynx in Cambrian vetulicolians: implications for the early evolution of deuterostomes.

Background: Vetulicolians are a group of Cambrian metazoans whose distinctive bodyplan continues to present a major phylogenetic challenge. Thus, we see vetulicolians assigned to groups as disparate as deuterostomes and ecdysozoans. This divergence of opinions revolves around a strikingly arthropod-like body, but one that also bears complex lateral structures on its anterior section interpreted as pharyngeal openings.

Pikaia gracilens Walcott, a stem-group chordate from the Middle Cambrian of British Columbia.

The Middle Cambrian Pikaia gracilens (Walcott) has an iconic position as a Cambrian chordate, but until now no detailed description has been available. Here on the basis of the 114 available specimens we review its anatomy, confirm its place in the chordates and explore with varying degrees of confidence its relationships to both extant and extinct chordates and other deuterostomes. The body of Pikaia is fusiform, laterally compressed and possesses about 100 myomeres.