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Modified subciliary approach to the orbital floor

Fractures involving the lateral midface and orbital floor are routinely treated by maxillofacial surgeons. The surgical management requires access to the facial skeleton to reposition and free the soft tissues. There are three main approaches to the orbital floor: infraorbital;...

Gardasil vaccination for laryngeal RRP – an update

This paper reports the results of a follow-up study investigating the possible role of adjuvant Gardasil vaccination in patients with recurrent laryngeal papillomatosis. The preceding study – also published in the Journal of Voice (2017) – reported the changes in...

Cerebrospinal fluid leaks after vestibular schwannoma surgery

This study analyses 30-day readmission data after vestibular schwannoma surgery using a multicentre longitudinal State of California dataset. The authors studied risk factors, and timing of readmission in 6820 patients over 15 years. Of these, 490 readmissions were reported for...

Management of patients with advanced otosclerosis

This paper discusses the management options of advanced otosclerosis. There are several definitions for advanced otosclerosis in the literature but, more recently, the diagnosis of advanced otoscletosis has been reserved for patients who have less than 30% aided speech discrimination...

Treating middle ear conditions in developing countries

This month’s journal issue discussed global health in otolaryngology with this paper focusing on the management of chronic middle ear disease in the developing world. Chronic suppurative otitis media (CSOM) is more common in developing countries. The reason for this...

Can smaller cancer centres deliver high quality care for patients with laryngeal cancer?

There is a continuing conflict between treating patients as close to their homes as possible and centralising specialised services, taking into consideration the critical mass and the multi-disciplinary expertise available. This is a report of outcomes in the treatment of...

Precautions to be taken in cosmetic facial surgery

In this comprehensive write-up on precautionary measures to be taken when doing cosmetic surgery on our patients, the authors begin by emphasising that facial plastic surgery is no longer limited to celebrities and the privileged. It has extended into everyday...

How effective and safe is audiologist-led screening of acoustic neuroma in patients with asymmetrical hearing loss and unilateral tinnitus?

About two out of 100 patients presenting with asymmetric hearing and unilateral tinnitus have acoustic neuroma. The traditional method in which these patients first attend a clinician and then undergo screening through an MRI, can be expensive and prolong the...

Tonsillectomy in or out?

Although tonsillectomy is the most common surgical act performed in ENT practice, there is still some concern about the safety of outpatient or day surgery scheduling, especially in adults. Although this has been common practice in many departments for some...

Superstructure-preserving stapes surgery in otosclerosis

Stapedectomy is a well-established procedure for otosclerosis but it has a small risk of a non-hearing ear, which can be devastating for patients. The development of a procedure which is safer and with a less steep learning curve for junior...

Inter-aural hearing preservation in cochlear implantation

Hearing preservation during cochlear implantation is becoming increasingly important, although results can be unpredictable. NICE are in the process of updating their guidance in the UK and it is possible that those with better hearing than the current candidates will...

Assessment and management of dysphagia in the elderly

This article covers dysphagia in older patients, which is an important topic due to an ageing population, and a relatively common symptom that we see in clinic. Dysphagia could be due to presbyphagia secondary to changes in head and neck...