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Widen the ostium or keep it: that is the question

The original concept of wide endoscopic sphenoethmoidectomy for sinonasal polyposis has been a well-established principle since 1995. However, with the evolution of the understanding of sinonasal physiology, this might change. The authors present arguments based on the evolutionary and developmental...

A comparison between artificial and cadaveric temporal bones in terms of providing realistic setting and structural details

Increasing difficulties, costs and risks of infection have led to the use of artificial temporal bones for training in mastoid and middle ear surgery. Whether these provide a realistic learning environment (face value) and offer structural details to learn from...

Simulation and otologic surgery

Ensuring adequate exposure and developing surgical skills for trainees has been an ongoing challenge. In this article, the authors reviewed the role of simulation and its role in developing skills in otologic surgery for trainees. Virtual-reality (VR) simulation models have...

Random-pattern skin flaps: part 1 – advancement flaps

In the first of a short series covering random pattern skin flaps and their use in clinical practice (see Part 2 here, Part 3 here and Part 4 here), Christopher Thompson and Miles Bannister describe in some detail their techniques...

Surgical challenges in advanced or recurrent thyroid malignancy

The management of thyroid malignancy and extent of surgery is controversial, especially considering the limitations of preoperative diagnosis. Neil Tolley provides guidance and reminds us of our responsibility not to over-treat. In the UK, 16% of thyroidectomies are performed for...

Influence of smoking on vocal fold polyps

A vocal fold polyp is a benign lesion related to phonotrauma which induces upregulation of inflammatory processes and histological changes can occur in the epithelium and lamina propria. Whether smoking produces additional or enhanced changes is the subject of this...

Type 1 thyroplasty using a novel and inflatable implant from APrevent® VOIS

Unilateral vocal cord immobility severely impacts voice, swallowing, and airway functions. A novel approach offers adjustable medialisation for improved patient outcomes. Unilateral vocal cord immobility (UVCI) can cause significant disability to voice, swallowing, and airway functions. Patients with UVCI may...

Dacryocystorhinostomy revisited

In this technical variant, instead of seeking the lacrimal sac, the authors describe a retrograde technique. They first identify the nasolacrimal duct at the level of the most anterior insertion of the inferior turbinate in the lateral nasal wall. The...

Functional Endoscopic Sinus Surgery (FESS) - Part 1

In the first of a two-part series, Martyn Barnes and colleagues discuss indications for functional endoscopic sinus surgery (FESS), the surgical objectives and techniques, patient expectations and the risks of surgery. In part two, the authors will discuss how to...

Effect of peripheral and central vestibular dysfunction on sense of direction

Sense of direction (SOD) is the ability to orientate ourselves and to determine the locus of objects in our environment. The vestibular system plays a key role in spatial orientation by encoding angular acceleration in the absence of visual cues...

When ears go bad

Whilst rare, squamous cell carcinoma is the commonest primary malignancy of the temporal bone and is discussed in this review article. This tumour frequently presents with otalgia, ottorhoea and hearing loss; less commonly, with facial palsy or parotid mass. Investigations...

Visual distraction helps patients tolerate flexible laryngoscopy

With the arrival of flexible fibreoptic laryngoscope some 35 years ago, the examination of the laryngopharynx has become remarkably easier and saves immense time and costs since the days of mirror examination when this examination was not truly satisfactory in...