Sports-related neck trauma can cause significant injury to the laryngeal framework and endolaryngeal soft tissues, and most cases require surgical intervention. Clinical presentation may be subtle; a systematic approach along with a high index of suspicion is essential, as early diagnosis and treatment have been reported to improve airway and voice outcome.

Access to this document was granted through an Emerald subscription provided by emerald-srm:540409 [] For AuthorsIf you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -Previously published studies about trainee perceptions of clinical leadership, although small in number, have not assessed the opinions of senior registrars nor established their awareness of the relevant leadership frameworks. The paper aims to discuss these issues. Design/methodology/approach -Survey questions and interview questions were designed and a comparison of the relevant literature was performed. An online survey was sent via e-mail to a potential of 2,126 registrar trainees within the deanery and a series of semi-structured interviews (analysed via a content analysis) were conducted amongst voluntary subjects. Findings -The response rate for the questionnaire was 247/2,126 (11.6 per cent). Respondents recognised the importance of leadership (90.4 per cent), professionalism (99.6 per cent) and promoted team-working (89.8 per cent). In total, 94.3 per cent of respondents have had ideas for improvement in their workplace; however, only 27.9 per cent have had their ideas for change implemented. Of the 85.5 per cent of trainees who are not aware of the leadership frameworks, 89.1 per cent performed leadership activities either daily or sometimes. The priorities of registrars did appear to differ between the junior and senior grades. Originality/value -Registrar trainees have a desire to engage and a perceived ability to contribute to service improvement; however, a lack of encouragement, awareness and limited training opportunities serve to hamper the development of clinical leadership potential. This study presents itself as a pilot and will hopefully prompt a larger deanery study to gain a thorough assessment of all trainee perceptions, in order to improve the training programme and ultimately create a generation of consultants equipped to engage in clinical leadership throughout their lifelong career in the National Health Service.

We report on a case of unilateral tinnitus after a short course of low-dose amitriptyline for neuralgic foot pain. This has been described in the literature previously at much higher doses and is associated with prolonged administration; we present our case with a review of the current literature in-order to raise awareness of this possible complication of anti-depressant therapy. We also propose a novel hypothesis for the pharmacological basis of amitriptyline-induced tinnitus.

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