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Clinical WG1. Establishing a standard for tinnitus: patient assessment and characterisation

Rilana Cima and Haúla Haider introduce an ambitious pan-European collaboration that seeks to establish guidelines for achieving best clinical practice for managing, assessing and treating patients with different tinnitus profiles. Tinnitus heterogeneity is the major reason for inconsistent results in...

Risks of tracheostomy in head and neck cancer

Tracheostomy is associated with several complications, with rates quoted as high as 8-45%, including: bleeding; displacement; obstruction; surgical emphysema; pneumothorax; fistulae and failure to decannulate. There are now many studies that confirm the increased length of stay and complications of...

Changing behaviour with a human factors approach

The Francis Report (2013) identified multiple problems relating to the safety culture of Stafford Hospital in the period 2005 – 2009, as well as serious failings in the supervisory and regulatory systems of the NHS. Particular criticism was directed at...

Righting the paralysed lip

Many surgical procedures that otolaryngologists perform put the facial nerve at risk of injury, a complication that the surgeon and patient fear alike. Unfortunately, injuries to the nerve can and do happen despite adequate precautions, and facial paralysis may be...

Small vestibular schwannomas (VS) – is waiting the right thing to do?

VS management can be surgical, by radiosurgery or watchful waiting. Middle fossa approach (MCF) can be implemented in small and some medium-size tumours, and has the potential to preserve hearing. The authors measured quality of life of VS patients who...

Access to and uptake of cochlear implants in the UK

Assessing demands on cochlear implant (CI) services is very important for both commissioners and clinicians in anticipating clinical need and funding requirements. Commercial CI’s were introduced in the late 1980s. Initial funding was from charitable sources. The first major advance...

Lateral skull base surgery using the endoscope

Endoscopic lateral skull base surgery could be performed via less invasive techniques due to wide panoramic visualisation of the operative field. With less invasive techniques, patients have been shown to require shorter recovery time and reduced postoperative pain. In this...

Random-pattern skin flaps: part 2 - rhomboid and bilobed flaps

In the second of our series on local skin flaps (see Part 1 here, Part 3 here and Part 4 here), the authors describe more techniques and examples of various skin flaps that trainees should find very interesting. Rhomboid flap...

Novel method for determining BCC margins

This correspondence describes a new technique for determining basal cell carcinoma (BCC) borders, to aid in obtaining clear peripheral resection margins. Whilst this can be straightforward in small well-defined nodular BCCs, some BCC subtypes are ill-defined or morphoeic, and resection...

Theory of mind and deaf children

Theory of mind relates to a person’s ability to understand the perspectives of others, to be aware that they may differ from one’s own perspectives and the ability to use this knowledge to navigate social situations. Dr Helen Chilton explores...

A novel scale for the assessment of tracheoesophageal voice quality – the SToPS

There is currently no assessment tool in widespread use that permits a valid and reliable perceptual assessment of voice quality following laryngectomy. Such a scale is needed to investigate the functional outcomes of surgical voice restoration and rehabilitation regimes. Existing...

To endo or to micro, that is the question: the musculoskeletal paradigm

Endoscopic ear surgery is a newer concept compared with the microscopic one. Both could lead to musculoskeletal pain due to the long static posture of surgeons during otologic procedures. The authors conducted a study on eight otolaryngologists, four attendings and...