The medially-invasive cholesteatoma: a case series

In this small case series, Casazza et al describe their management of seven cases of complex cholesteatoma presenting during a 16-year period. Patients were included if imaging confirmed restricted diffusion and an endophytic, medially-destructive disease involving the otic capsule, petrous...

Predictors of diabetes insipidus post-hypophysectomy

Transient diabetes insipidus (DI) after pituitary surgery is not uncommon and its diagnosis fairly obvious. Permanent DI is rare and often depends on the neurosurgeon’s experience. This retrospective study describes a large series of patients with majority undergoing endoscopic transsphenoidal...

Virtual reality surgical simulation for the temporal bone

This prospective study looked at 15 otorhinolaryngology residents in Belgium to see if using the VOXEL-MAN Tempo surgical simulator system improved their understanding of temporal bone radiological anatomy. As a secondary aim, they also assessed whether there was any improvement...

3D-printed temporal bone models - how good can they be?

In the era of increasingly difficult and expensive-to-come-by cadaveric temporal bones with which to practise drilling and learn the complex 3D anatomy of the temporal bone, decent alternatives would be welcome. McMillan et al report a prospective comparison study in...

PET-CT for malignant nasopharyngeal lesions

This retrospective Turkish review of 92 patients aimed to determine the ability of fluorine 18-fluorodeoxyglucose (FDG) maximum standardised uptake value (SUVmax) on positron emission tomography/computerised tomography (PET/CT) to differentiate benign processes and malignant nasopharyngeal lesions. The authors retrospectively reviewed the...

British Skull Base Society Clinical Consensus Document on Management of Head and Neck Paragangliomas (HNPGLs)

All forms of HNPGLs should be managed by a multidisciplinary team (MDT) of core members from skull base otolaryngology, head and neck surgery, clinical genetics, oncology, endocrinology, vascular surgery, radiology and pathology. Extended members include neurosurgery, endocrine surgery, nuclear medicine,...

Olfactory protective effect of omega-3 supplements during healing after endoscopic sellar and parasellar resection

This multicentre study, led by researchers from Stanford, demonstrates another use for omega-3 supplements. The study analysed cohorts equally divided between control arm and omega-3 supplementation. Post endoscopic sellar and parasellar resection, better olfactory function was observed at three and...

Do we need contrast MRI when screening for vestibular schwannoma?

Gadolinium contrast enhanced T1-weighted (gT1w) MRI images of the internal acoustic meati have long been considered the gold standard in the diagnosis of vestibular schwannoma (VS). However, the addition of contrast to the MRI examination increases the cost and time...

Gender inequality across medical specialties in the United States

The authors of this study collected and evaluated 4222 surveys of patient satisfaction ratings of male and female residents across subspecialties in the United States. Half of the evaluated residents were females, with first and second year residents being evaluated...

Preoperative prediction of pain outcomes in patients with trigeminal neuralgia

The authors of this retrospective study have developed a preoperative trigeminal neuralgia (TN) grading system for the preoperative prediction of long-term pain relief after microvascular decompression (MVD). Patients who had become refractory to or developed toxicity to carbamazepine or oxycarbamazepine...

Prolactinomas: when to operate

Prolactinomas are the most common functional pituitary adenomas, comprising 40% of all pituitary adenomas. There are consensus guidelines and several common management pathways. This article discusses the role of surgery for these patients. Following diagnosis, the goals of treatment are...

How to manage the concha bullosa in FESS

It is an interesting concept to assess how much impact the presence of a large concha bullosa (CB) has on both severity of chronic rhinosinusitis (CRS) and also postoperative outcomes after FESS. The authors accept that the paper has limitations...