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Microvascular surgery - does size matter
Success rates for microvascular free tissue transfer performed for head and neck reconstruction are currently very high. As the recipient vessel diameter decreases, questions of reliability and ease of access are raised. This retrospective analysis looked at 89 flaps in...
One stage nasal reconstruction with local flaps
This is an excellent and authoritative review of an often difficult and controversial (as there are so many options or so few) clinical subject. Better education and earlier diagnosis of skin tumours allows defects with limited size and depth to...
Deglutition in pharyngolaryngectomy patients
Circular defects after total pharyngolaryngectomy present a reconstructive challenge. In this study, the authors compared the swallowing results after three reconstructive techniques: free forearm flap, free jejunal loop and folded pectoralis major flap. Forty-six patients were included and were evaluated...
Rib grafts for mandibular reconstruction
Reconstruction of the mandible following ablation requires good bone stock to allow optimal function and the placement of dental implants. In the developed world, vascularised bony flaps are accepted as the gold standard but these may not be widely available...
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...
Brown classification of a maxillary defect and prognosis
This is a retrospective study from Peking over the 10-year period, 2000-2010, for 137 patients with maxillary squamous cell carcinoma assessed. The overall survival rate was comparable with other studies at 64.8%. The most common Brown maxillary defect was 2b...
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...Random-pattern skin flaps: part 4 - transposition flaps
In the final part of our series on local skin flaps (see Part 1, Part 2 and Part 3) in ENT, the authors describe the usefulness of the transposition-type flap and highlight some examples. Rotational advancement flap Useful for defects...
Hearing Aids for Speech-Language Pathologists: a Guide to Modern Rehabilitative Audiology
This is a book of two parts. The first six chapters are not pitched at speech language pathologists (SLP), at least not for those in typical practice in the UK. This section of the book is appropriate to experienced audiologists...
Evidence based guidelines for ONS treatment in occipital neuralgia
Occipital neuralgia (ON) can flummox otolaryngologists especially when it follows mastoid surgery. The paroxysms of sharp, electrical pain originating from the occiput can extend along the posterior aspect of the scalp and even up to the mastoid. Although the aetiology...
Grading dysphagia as a toxicity in treating head and neck cancer
Common Terminology Criteria for Adverse Events (CTCAE) is a system used by clinicians to grade the toxicity of oncology treatments in a standardised manner. Dysphagia is perhaps the most common long-term toxicity of head and neck cancer treatment. Currently, a...
