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Darn it! It’s going to take longer to get good at stapes surgery!
Traditionally, it has been said the learning curve for a particular operation lies between 20 and 30 cases. In stapedotomy, a surgeon is deemed successful and perhaps competent if closure of the air-bone gap (ABG) is reached to within 10dB...
The middle way: treating idiopathic facial nerve palsy
Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...
Otolith dysfunction in congenitally deaf adults
This paper helps to further define the profile of ocular and cervical vestibular-evoked myogenic potentials (o and c VEMPs) in patients with congenital profound sensorineural hearing loss (PSHL). It highlights the prevalence of otolith (saccular and utricular) dysfunction that exists...
Voice outcomes following extended laser resections for laryngeal cancer
It is now widely accepted that the oncological and voice outcomes following transoral laser microsurgery for early T1a glottic cancers are equivalent to, if not superior to, traditional radiotherapy. Voice outcomes following more extensive resections have not been as frequently...
Surgical voice restoration after laryngopharyngectomy
Voice restoration is one of the key rehabilitative steps after laryngectomy or total laryngopharyngectomy (TLP). Patients who undergo TLP require reconstruction – increasingly commonly with microvascular free flaps. Despite their advantages in terms of fistula rates and swallowing outcomes, these...
Can laryngeal sensitivity testing predict aspiration and pneumonia in dysphagic patients?
The laryngeal adductor reflex (LAR) is characterised by brief vocal cord closure in response to laryngeal stimulation. It is important in swallowing physiology as it represents a mechanism for airway protection. The authors of this study examined whether the absence...
Impact of the updated cancer staging system on HPV-positive disease
The AJCC cancer staging manual was updated in 2017 (8th edition). It is used in the MDT setting for planning treatment and assessing prognosis for individual patients, and is also widely used internationally in clinical trials. Unlike previous iterations of...
Method of delivery: all topical nasal corticosteroids are not made equal
There is an increasing body of evidence that the role of surgery for chronic rhinosinusitis is to facilitate the delivery of topical medical treatment – most notably, topical corticosteroids. Two recent studies, one using flow dynamics and another one examining...
Help or hinder: how and why do SLTs make clinical decisions around swallowing?
Dysphagia is a relatively common consequence of stroke, with estimates between 50% and 60% of people presenting with swallowing dysfunction following stroke. It is associated with pneumonia, malnutrition and dehydration which in turn lead to increased length of hospital admission,...
Diagnostic performance of non-echo-planar diffusion weighted MRI in detection of suspected cholesteatoma
Even though a ‘second look’ remains a gold standard for detection of residual cholesteatoma after intact canal wall techniques, non-echo-planar diffusion weighted MRI is considered a reasonable alternative to avoid further surgery. However, to establish or exclude a cholesteatoma de...
Neurological complications associated with managing degenerative cervical myelopathy
Degenerative cervical myelopathy (DCM) is a common neuropathologic status due to degenerative changes to the cervical spine. There are multiple operative techniques available, including anterior cervical discectomy and fusion, anterior cervical corpectomy, laminoplasty, laminectomy and laminectomy with fusion. C5 palsy...
