We write this Editorial just after the Halloween festivities, so perhaps the title is timely. The importance of maintaining standards in undergraduate otolaryngology training is well recognised within our specialty.Reference Mirza, McClelland, Daniel and Jones1, Reference Löfgren, Alikoski, Hannula, Sorri and Alho2 Unfortunately, despite ENT complaints being common in both primary and secondary care settings, the amount of time allotted to ENT teaching in the undergraduate curriculum is frequently woefully brief. Thus, it is important to ensure that any assessment of undergraduate student ability is robust. Woods and colleagues assessed the utility of both short answer questions and an objective structured clinical examination in a cohort of medical students.Reference Woods, Subramaniam, Patterson, Hennessy and Timon3 They found that both assessments were valid and reliable, and enhanced the undergraduate course by driving learning across different domains of competency.
The increasing use of anticoagulant medications is a feature of modern medicine. Knowledge of the different anticoagulant medications is important in the safe management of both emergency and elective patients. In a previous article, Biggs and colleagues produced a useful treatment algorithm for anticoagulant and antiplatelet therapy in epistaxis patients.Reference Biggs, Baruah, Mainwaring, Harries and Salib4 New drugs are being introduced to the market with great frequency, and it is sometimes difficult to ascertain whether individual patients are on anticoagulants or not. The same group of authors have updated their original review with a guide to new anticoagulant medications for ENT surgeons.Reference Bajalan, Biggs, Mainwaring and Jayaram5 It is significant that most of the new antiplatelet drugs, such as apixaban and dabigatran, are irreversible in their actions.
An increasing amount of upper aerodigestive tract surgery is being undertaken endoscopically, particularly laser resection of laryngeal malignancy.Reference O'Hara, Markey and Homer6 Access in these cases is made more difficult (or impossible) by prominent incisor teeth, micrognathia or trismus. Damage to teeth may occur, and this is a frequent source of complaint and litigation. Butterworth and colleagues describe two cases in which elective dental extraction and replacement with an osseointegrated dental implant facilitated endoscopic surgery (performed for a pharyngeal pouch and glottic carcinoma).Reference Butterworth, Lancaster and Shah7 This method of osseointegrated treatment employed to overcome dental issues during transoral laryngeal surgery has not been previously described. It is interesting, however, that an account of dental extraction and re-implantation of the same teeth was described in The Journal of Laryngology & Otology in 1994, to address similar issues.Reference Wareing, Fisher, Manning, Gray and Lamb8
Finally, we would like to thank all of our colleagues at The Journal for their tireless work during 2015. We also thank our colleagues at Cambridge University Press for their support and partnership. Our Editorial Board continue to work hard in order to maintain a vigorous peer review system. We hope that our readers have enjoyed reading Journal articles over the past year and have also valued the increasing educational content of our website. We wish all our readers a successful 2016.
