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Do anticoagulanis and facial plastic surgery mix?

Some surgeons think that antiplatelet and anticoagulant therapies (aspirin, warfarin sodium and clopidogrel bisulphate) increase perioperative bleeding and infections. However, the current evidence base provides conflicting data with respect to the risk of true complications. In this case-control study a...

Hearing rehabilitation for patients with chronic otitis media

Chronic otitis media (COM) commonly causes associated hearing loss. The authors performed a review of the literature, discussed challenges of restoring hearing in patients with COM and potential future work in reporting results both in terms of hearing outcomes and...

Preventing major postoperative haemorrhage following TORS

Transoral robotic surgery (TORS) has become an increasingly utilised treatment modality in the management of oropharyngeal squamous cell carcinoma (OPSCC). Postoperative haemorrhage, although uncommon, is a significant complication. To ameliorate this risk, transcervical ligation of branches of the external carotid...

Perioperative management of the head and neck cancer patient

The perioperative care of patients with head and neck cancer is complex and requires significant preoperative planning and patient education. The issues include analgesia, antibiotics, stoma and wound care, general and chest physiotherapy, thromboprophylaxis and nutrition. This article provides a...

Sellar surgery – when to prepare for repair

Endoscopic sellar surgery, especially for adenomas, is a relatively safe, straightforward surgery with (mostly) reproducible results and few complications. One of the commonest complications is the creation of a CSF leak with the subsequent need for repair (there is usually...

Pharyngocutaneous fistula after total laryngectomy

Pharyngocutaneous fistula (PCF) after total laryngectomy is a serious complication post-surgery, and can lead to prolonged hospitalisation, adding delays in postoperative chemoradiotherapy. This Turkish retrospective study looked at 166 patients who underwent total laryngectomy for laryngeal cancer, although it is...

The role of macrolide antibiotics in chronic rhinosinusitis

The use of long-term antibiotics in the treatment of chronic rhinosinusitis is a contentious issue, not only because of the increasing problem with antibiotic resistance but also because of the potential cardiac risks, including sudden death. In this article, Anders...

Call for action on hearing loss

The British and Irish Hearing Instrument Manufacturer’s Association (BIHIMA) and Alzheimer’s UK are encouraging people to book regular hearing tests and get hearing concerns checked earlier, as it could significantly lower their chances of developing dementia.

Factors affecting the occurrence of salivary fistula after total laryngectomy

It is generally believed that patients should be fed by nasogastric tube for 7-10 days after undergoing total laryngectomy or laryngopharyngectomy to avoid the occurrence of post-operative salivary fistula. This study challenges this belief and looks into various factors that...

Speculating on saliva during endoscopy

It has been noted that the presence of saliva in the pharynx and larynx during flexible endoscopic evaluation of swallowing (FEES) can be an indicator of increased risk of aspiration and consequent pneumonia, as well as weight loss and malnutrition....

Risks of tracheostomy in head and neck cancer

Tracheostomy is associated with several complications, with rates quoted as high as 8-45%, including: bleeding; displacement; obstruction; surgical emphysema; pneumothorax; fistulae and failure to decannulate. There are now many studies that confirm the increased length of stay and complications of...

Personal music systems are causing hearing loss

Sitting next to a teenager on a train with their iPod turned up loud enough for the entire carriage to hear is annoying, most will agree. Perhaps I might educate them about the risks of ‘music’ (if you can call...