Necrotising Otitis Externa (NOE) has often posed some challenges in view of diagnosis and management by clinicians. One such challenge is the appropriate and timely use of imaging techniques, since its use is critical not only in diagnosis but also determining the extent and resolution of the disease. Hence, doctors in both primary and secondary health care need to be familiar with presenting symptoms, while specialists need to be appraised of advances in imagining techniques in management of NOE. Whilst there is a general consensus amongst clinicians on some aspects of management of NOE, there is very limited consensus on the use of imaging modalities. There is no single modality of imaging that can provide a complete picture of diagnosis, disease progression and resolution. There are some advantages and limitation of each methodology, which indicate that a multi-modal imaging technique at particular stages of the disease may provide better management outcomes. However, further research in this area is required, as there is not yet an established ‘gold standard’ for imaging in NOE. Keywords: Necrotising Otitis Externa; Malignant Otitis Externa; Skull base Osteomyelitis; Tc-99m bone scan; Ga-67 bone scan; Indium 111 labelled leukocyte scanning; SPECT
L aryngeal cancer is the most common form of head and neck cancer in the UK. The majority of cases are in people aged 60 years and over. Early diagnosis improves long-term outcomes and requires early recognition of significant symptoms and prompt referral. This article aims to provide an overview of the presenting features, investigation, management and follow-up of laryngeal cancer. The GP curriculum and laryngeal cancer Clinical module 3.15: Care of people with ENT, oral and facial problems states that GPs should:. Understand how to recognise rarer but potentially serious conditions, such as oral, head and neck cancer. Know the epidemiology of head and neck cancers, including the risk factors, and identify unhealthy behaviour
Spasmodic dysphonia (SD), also known as laryngeal dystonia, is a neurological voice disorder that causes involuntary spasms of the vocal cord muscles. This impacts speech to varying degrees and results in strained and strangled voice quality, as in adductor spasmodic dysphonia, or weak, quiet, and breathy, as in abductor spasmodic dysphonia. While there is currently no cure for SD, voice therapy and chemodenervation with botulinum toxin (btx) injections remain the mainstay of management. Surgery may be performed in some cases; however, btx injections are widely used to treat both adductor and abductor forms of SD. While btx injections may show vocal improvement in both types of SD, results can depend on several factors such as the general health of the patient, onset and severity of the condition, dosage, interval between injections, and expertise of the practitioner. While many studies have documented the efficacy of btx for improving vocal symptoms in individuals with SD, this review aims to discuss some of those studies from the last 10 years.
Necrotising Otitis Externa (NOE) has often posed some challenges in view of diagnosis and management by clinicians. One such challenge is the appropriate and timely use of imaging techniques since its use is critical not only in diagnosis but also in determining the extent and resolution of the disease. Hence, doctors in both primary and secondary health care need to be familiar with presenting symptoms while specialists need to be appraised of advances in imagining techniques in diagnosis and management of NOE. Whilst there is a general consensus amongst clinicians on some aspects of management of NOE, there is very limited consensus on the use of imaging modalities. There is no single modality of imaging that can provide a complete picture of diagnosis, disease progression and resolution. This review aims to highlight the strengths and weaknesses of various imaging techniques used in the diagnosis and management of NOE over the years and whether a multi-modal imaging technique at particular stages of the disease may provide better management outcomes.
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