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Vascularised tissue in salvage total laryngectomy

Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...

Reducing the risk of Frey’s syndrome after parotidectomy – which methods are best?

Gustatory sweating or Frey’s syndrome is a well-recognised complication of parotid surgery. The reported incidence is highly variable, from 4% to 96%, with around 30% of patients reporting symptoms. A number of intraoperative techniques can be used to reduce the...

Is it beneficial for children to undergo bilateral cochlear implantation before 12 months old?

Universal newborn hearing screening has allowed early diagnosis and, subsequently, early intervention in hearing loss. In 2020 the Food and Drug Administration candidacy criteria for cochlear implants (CI) expanded to include profound sensorineural hearing loss (HL) in children as young...

Hear me out – tiny steroid implants for fighting meningitis-induced deafness

Sensorineural hearing loss is the most common neurological complication of pneumococcal meningitis. Bacterial infiltration into the inner ear triggers inflammation, leading to cochlear fibrosis and sclerosis – damage that, in over a third of cases, affects both ears. Current Infectious...

You’re under arrest, you damned post-tonsillectomy bleed!

Tonsillectomy is a common, well-tolerated procedure most commonly performed in children for recurrent tonsilitis and sleep apnoea. Post-tonsillectomy bleeding (PTB) is a relatively uncommon complication that poses significant risks to patients and high rates of readmission and reintervention. Institutional guidance...

Comprehensive Management of Vestibular Schwannoma

This is the Holy Grail of texts for anyone involved in the management of vestibular schwannoma. Edited by Matthew Carlson from the Mayo Clinic in Rochester, Minnesota, the Associate Editors are from the same department, but the 156 contributors to...

The unknown primary again

In this retrospective study of 35 patients, the authors followed a systematic protocol for the detection and management of malignant cervical lymph nodes without an apparent primary lesion. Although their one, three and five year survival results are consistent with...

Management of metastatic neck disease

This article publishes the findings of a recent expert-led evidence based management symposium in the UK with recommendations according to the SIGN level of evidence and grading. The article neatly summarises the key points, and its clarity despite the complexity...

Sham controlled trial: BPPV

I was drawn to this study and it proved an enlightening read; it also is a good example of where recommendations of a Cochrane review for long-term evidence of benefit have been acted upon! The study looked at the efficiency...

Evaluating the nose

Objective evaluation of the nose before and after rhinoplasty is not standard. The authors adapted the MiRa scale after translation to French to be validated. For a better practical approach, the translation was conceptual rather than literal and followed five...

Till death do us part: the role of the speech and language therapists in palliative care

Increasingly, speech and language therapists are being involved in end-of-life and palliative care. This study reports on a three-phase project to explore this in the context of the Australian healthcare system. In phase one, the authors described a scoping review...

Better or barrier: what do healthcare professionals think about teletherapy?

Most healthcare professionals will have had to dabble in using some kind of telehealth platform over the last 18 months or so. And most of us will have had some reservations, or have colleagues who just weren’t sure about Zoom,...