We present an unusual case of Ludwig's angina secondary to a left tonsillar phlegmon in a previously fit and well 50‐year‐old woman. This tonsillar phlegmon spread along the peritonsillar/parapharyngeal plane to cause a diffuse cellulitis and collection in the submental, sublingual, and submandibular spaces despite empirical intravenous antibiotic therapy.

Objective A previous study in 2016 found that the quality of YouTube videos on epistaxis first-aid management was highly variable. This study aimed to reassess the accuracy and patient understandability of such YouTube videos. Method YouTube was searched using the phrase ‘How to stop a nosebleed’. The highest 50 ranking videos, based on relevance, were screened. Each video was assessed objectively using a standardised ‘advice score’, and subjectively using a video understandability and actionability checklist, the Patient Education Materials Assessment Tool for Audiovisual Materials (‘PEMAT-A/V’). Results The mean advice score was 4.1 out of 8. The mean (standard deviation) understandability and actionability scores were 76 per cent (17 per cent) and 89 per cent (18 per cent), respectively. There was a strong positive correlation between the actionability scores and the advice scores (ρ = 0.634; p < 0.001), and between the actionability scores and the understandability scores (ρ = 0.519; p = 0.002). Conclusion YouTube videos are providing increasingly relevant advice for patients seeking healthcare information. YouTube is proposed as a useful medium for teaching epistaxis management to patients and community practitioners.

Background Partly as a result of coronavirus disease 2019, YouTube has become a more frequent educational source for otolaryngology trainees. This study sought to assess the quality of flexible nasendoscopy and peritonsillar abscess drainage videos. Method YouTube was systematically searched using 13 terms related to flexible nasendoscopy and peritonsillar abscess drainage. Two independent reviewers assessed the quality of each video using the Laparoscopic Video Educational Guidelines. Results Twenty-seven videos were deemed suitable. The mean total Laparoscopic Video Educational Guidelines scores for videos on flexible nasendoscopy (18 videos) and peritonsillar abscess drainage (9 videos) were 10.3 (standard deviation = 3.1) and 11.7 (standard deviation = 4.6), respectively. Most of the videos were deemed of medium quality. The Laparoscopic Video Educational Guidelines score correlated positively with flexible nasendoscopy video length and how recently a peritonsillar abscess drainage video had been uploaded. Conclusion The limited high-quality videos on YouTube are difficult to identify from the search metrics available. Trainees and ENT induction programmes would benefit greatly from an online platform that contains a catalogue of high-quality surgical videos.

Background Acute nasal fracture is a common referral to ENT outpatient clinic. During the Covid-19 pandemic, NHS outpatient services were increasingly stretched and placed patients and staff at risk of Coronavirus. Virtual clinic appointments provided an effective method for reducing Covid-19 risk and improving the efficiency of outpatient services. We sought to implement a telephone triage system for the assessment of nasal fractures. Method A telephone triage pathway for nasal fracture was implemented in October 2021. Data on nasal fracture appointments and outcomes were retrospectively collected for 2 months prior to, and after, the introduction of the telephone triage pathway. All patients with suspected nasal fracture referred to ENT by the Emergency Department at Colchester Hospital were included. Results At baseline, 32 patients were referred for face-to-face (F2F) clinic, 20 (62%) attended and 12 (38%) did-not-attend (DNA). Of those who attended, 17 (85%) were managed conservatively and 3 (15%) had manipulation under anaesthetic (MUA). 24 patients were included in the telephone triage pathway, 13 (54%) attended and 11 (46%) DNA. Of those who attended, 11 (84%) were discharged and 2 (16%) were brought in for F2F assessment. One was managed conservatively and the other had a MUA (8%). The increase in DNA rate from the F2F pathway to the telephone triage pathway was not statistically significant. Conclusion Our data suggests that the telephone triage system for nasal fracture management results in fewer F2F appointments. This reduces COVID-19 transmission to the public and hospital staff but also improves utilisation of outpatient capacity.