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936 results found

Do bicycle helmets prevent facial injuries?

This is an analysis from Germany where they reviewed over 7000 bicycle accidents over a 16-year period that met their inclusion criteria. Over 1000 had a facial injury (bone or soft tissue) with helmets being worn in 11.8% of accidents....

What is the evidence for duration of antibiotic prophylaxis in head and neck free-flap cases?

The topic of this systematic review is one which is commonly heard in discussions between microbiologists and head and neck surgeons – what is the evidence for antibiotic prophylaxis in clean-contaminated free-flap cases, and crucially, how long should antibiotics be...

Does Tranexamic acid reduce intraoperative bleeding during FESS?

Intraoperative bleeding during FESS can reduce visibility and obscure important landmarks. This can result in longer operative times, increase risks of complications and even lead to incomplete surgery. Tranexamic acid is a drug which prevents fibrinolysis and stabilises blood clots....

The debate: endoscopic vs microscopic ear surgery – meta-analysis of outcomes

Although the endoscopic approach to ear surgery has become more common in clinical practice, the debate about its role versus the traditional microscopic approach continues in many ENT units. This meta-analysis from the Mount Sinai ENT department in New York...

Role of intratympanic corticosteroid for treatment of Bell’s palsy and Ramsay Hunt syndrome

Acute peripheral facial palsy occurs annually in 30 in 1,000,000 individuals in the general population. Bell’s palsy and Ramsay Hunt syndrome account for about 70% of cases of peripheral facial palsy. They are believed to be caused by viral reactivation...

Diagnosis of obstructive sleep apnoea hypopneoa syndrome (OSAHS) without sleep studies

Polysomnography is considered the ‘gold standard’ in the diagnosis of sleep apnoea but it is expensive and difficult to perform in children. Diagnosis based on subjective judgement is often inaccurate. An accurate diagnostic scale based on clinical parameters could obviate...

Should intratympanic steroids be the first line treatment for sudden sensorineural hearing loss?

This article looked at whether intratympanic steroids (ITS) provide more benefits over systemic steroid therapy (SST) as initial therapy in patients with idiopathic sudden sensorineural hearing loss (ISSHL). This meta-analysis study, based on published RCTs, concluded that ITS treatment exhibited...

Surgery or medicine: when should we stop trying to be conservative?

Although most otolaryngologists would agree that surgery improves the outcomes of patients with CRS when medical treatment has failed, both Cochrane reviews state that there is no proof of improved efficacy of surgery over medicine – however, that was after...

Factors determining success of adenotonsillectomy in paediatric obstructive sleep apnoea

Patient selection is important for any successful surgical procedure. Adenotonsillectomy for obstructive sleep apnoea secondary to adenotonsillar hypertrophy is no exception. This retrospective Taiwanese study attempts to find preoperative factors that have a positive influence for this commonly performed operation....

Pharyngocutaneous fistula after total laryngectomy

Pharyngocutaneous fistula (PCF) after total laryngectomy is a serious complication post-surgery, and can lead to prolonged hospitalisation, adding delays in postoperative chemoradiotherapy. This Turkish retrospective study looked at 166 patients who underwent total laryngectomy for laryngeal cancer, although it is...

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....

The double-half bilobed flap or traditional bilobed flap: which is better?

Reconstruction of the nasal tip following ablative surgery can be taxing. The nasal tip is a very visible area with largely immovable skin and reconstruction needs an appreciation of the various subunits to achieve best results. The traditional superiorly based...