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Parathyroid surgery in day care

Targeted parathyroid adenoma excision via preoperative ultrasound and radionuclide scanning techniques allow accurate localisation of the affected gland, allowing a minimally invasive surgical approach. The authors reviewed 144 cases undergoing surgery for primary hyperparathyroidism. Of these 67 were eligible for...

Paediatric lymphadenopathy – helpful decision making

The authors present a very helpful algorithm to manage cervical lymphadenopathy in children. The goal of managing children with inflamed lymph glands is to identify the rare malignant case and not over-investigate the vast majority of benign reactive swellings –...

International classification of BPPV

In the past few years, the Bárány Society has made great strides in defining and classifying vestibular disorders along the lines of the international classification of diseases. This article addresses the diagnostic criteria for BPPV, the commonest cause of vertigo....

Is benign intracranial hypertension underdiagnosed in patients with spontaneous CSF leaks?

In ENT practice we come across spontaneous CSF leaks. Patients present either as unilateral watery rhinorrhoea or otorrhoea, or sometimes as hearing loss with a watery middle ear effusion. Clinicians, after confirming the diagnosis of CSF leak with beta 2...

Risk factors in free flap failure

This is a retrospective analysis from China of 881 free flaps over nearly four years, 49 of which were ‘taken back’, 26 of which were lost, giving a 97% success rate. The commonest cause of flap failure was venous thrombosis....

Carotid artery involvement with head and neck metastases

This is a retrospective review of 27 patients radiologically diagnosed as having metastases involving the common or internal carotid arteries. All patients underwent a salvage neck dissection with surgical carotid peeling. Thirteen of the 27 achieved loco-regional control, five developed...

Clonidine based vs Remifentanil based hypotensive anaesthesia in FESS

A study investigating the use of clonidine preoperatively in FESS surgery. A double blinded trial of 47 patients in Barcelona randomised into receiving clonidine (20 minutes preoperatively) versus Remifentanil (continuous infusion). Propofol and fentanyl were used for induction and then...

Preoperative tumour embolisation

This review article analyses the role of preoperative endovascular tumour embolisation in the treatment of a variety of hypervascular head and neck lesions including juvenile nasal angiofibroma, glomus tumour, carotid body tumours, and meningioma. Although the concept of tumour embolisation...

Anatomy revision

This article is well-received as an article that goes into appropriate length and depth regarding the embryology and subsequent growth of the paediatric nose (internal and external), nasopharynx and all of the individual sinuses. It has excellent line diagrams of...

Microvascular free flap failures – looking beyond surgical technique

Microvascular free flaps are commonly used in reconstruction for head and neck defects. Failures of these flaps, however, are associated with a significant morbidity and mortality. Flap failures within the first 72 hours are commonly attributed to technical failure of...

Eagle syndrome and vascular complications

Eagle syndrome is characterised by an elongated styloid process, which is anatomically positioned between the external carotid artery laterally and the internal carotid artery and internal jugular vein medially. As a result, vessel impingement can be exacerbated by head movements,...