These results are encouraging as they refute the fall in UK research output observed by other authors. In the face of growing challenges, it is important to maintain published output so that the fate that has befallen other specialties is not mirrored within UK otorhinolaryngology.

Dyskeratosis congenita is a rare condition; however, it is vital to recognise the increased risk of upper aerodigestive tract cancers in these patients. Management of such cancers can be particularly difficult in view of the need to avoid DNA-damaging therapies such as radiotherapy.

We are delighted that Lamyman and Lamyman enjoyed reading our article and thank them for highlighting the differences between peritonsillar and parapharyngeal abscesses. Our review specifically examined peritonsillar abscess after tonsillectomy.Parapharyngeal abscess complicating elective tonsillectomy has been reported previously in the literature. 1 We would agree that a parapharyngeal abscess should be considered in the differential diagnosis of a peritonsillar abscess. If a parapharyngeal abscess occurs as a complication of a peritonsillar abscess, then the clinical features may be impossible to distinguish. 2 In this circumstance we would agree that computed tomography (CT) is important and if there is evidence of a parapharyngeal collection it should, of course, be managed appropriately. However, CT screening of all patients with a peritonsillar abscess would be impractical. 3,4 None of the papers in our review reported the use of CT for diagnosis of a peritonsillar abscess. It is possible that there may have been misdiagnoses but all patients responded to conventional treatment for a peritonsillar abscess without complications and none were reported to have required transcervical incision and drainage. References 1. McEwan JA, Dhingra J, Rowe-Jones J, Bleach NR. Parapharyngeal abscesses: a rare complication of elective tonsillectomy.