Inpatient or outpatient thyroidectomy?

This systematic review and meta-analysis discusses the safety of hemithyroidectomy in an outpatient vis-à-vis an inpatient setting. Thyroidectomy has traditionally been performed as an inpatient procedure. Currently, an increasing number of surgeons are performing thyroidectomy in outpatient settings. The main...

Should we be utilising the pre-lacrimal approach for maxillary sinus inverted papilloma?

For some time now, gold standard management of the maxillary sinus inverted papilloma has been endoscopic medial maxillectomy (EMM). Recently the endoscopic prelacrimal recess approach (EPLRA) has been reported to provide good access whilst preserving the nasolacrimal duct and inferior...

Pharmacological treatment of glue ear in children

Otitis media with effusion (OME), also known as glue ear, is a common cause of hearing loss in children. Most cases resolve spontaneously within three months. Early and proper management of OME can help avoid hearing and speech impairment that...

Remote consultations: bringing ENT in to the 21st century

The ongoing peaks and troughs of the COVID-19 pandemic have imposed unprecedented challenges on day-to-day healthcare provision that we all took as given across the globe prior to spring 2020! The pandemic has, in many ways, made us push boundaries...

Cuff up or cuff down; to occlude or not to occlude? What effect does tracheostomy tube modification have on swallowing outcomes?

Dysphagia is commonly seen in patients with tracheostomy. The current global pandemic has increased interest in the impact of a tracheostomy on swallowing outcomes. This systematic review is therefore a timely addition to the literature and a useful read for...

Hearing outcomes after retrosigmoid resection of smaller vestibular schwannomas are better

The authors reviewed published literature reporting hearing outcomes in patients after retrosigmoid (RS) resection of vestibular schwannoma (VS). Aggregate hearing preservation of 31% and 35% under fixed and random models respectively was observed in the 2034 patients meeting eligibility criteria...

Extracapsular dissection versus parotidectomy

This is a literature review of 16 papers using the PRISMA protocol. In comparing the two techniques, not surprisingly, they found that extracapsular dissection was associated with a reduced incidence of facial nerve paralysis and Frey’s syndrome and a shorter...

Hierarchy of orthognathic surgical stability

This study was designed as “an overview” of secondary studies and analysed 15 articles. Two procedures were considered highly unstable: a bilateral sagittal split osteotomy for clockwise rotation of the mandible with bi-cortical screw rigid internal fixation, and posterior maxillary...

Outcomes of temporal bone-resurfacing for pulsatile tinnitus associated with vascular wall anomalies

This month’s Ed’s choice is an interesting systematic review into the management of pulsatile tinnitus. There are impressive results from resurfacing of symptomatic anatomical abnormalities of the temporal bone and I suspect that referrals for further imaging and otology clinic...

Bone grafting in orthognathic surgery

In this systematic review of 48 articles the authors reviewed the complication, stability, aesthetics and healing of Le Fort I, sagittal split, chin and zygomatic osteotomies. They concluded that there was strong evidence that bone grafting promotes healing of a...

Does Tranexamic acid reduce intraoperative bleeding during FESS?

Intraoperative bleeding during FESS can reduce visibility and obscure important landmarks. This can result in longer operative times, increase risks of complications and even lead to incomplete surgery. Tranexamic acid is a drug which prevents fibrinolysis and stabilises blood clots....

Cognition outcomes after cochlear implantation – is there an improvement?

Older adults with a severe to profound hearing loss are more at risk of cognitive decline than adults of a similar age with milder losses or normal hearing. This poses challenges, not only in the assessment process, but also for...

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