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Malignant lesions and reconstruction of the pinna

External ear reconstruction can be challenging. Baskaran Ranganathan and Amr Abdelhamid describe how careful assessment, planning and surgery following the subunit principles and reconstructive ladder will ultimately lead to good aesthetic outcomes with restored form and function. The external ear,...

First UK Genio Nyxoah bilateral hypoglossal nerve stimulator implant for obstructive sleep apnoea

Obstructive sleep apnoea remains a very challenging condition to treat, but more options are becoming available. An estimated eight million adults in the UK suffer from obstructive sleep apnoea (OSA) and experience symptoms of troublesome snoring, daytime sleepiness and witnessed...

A brief overview on chronic facial pain in rhinology practice

Chronic facial pain is a common yet complex issue in rhinology, often neurologic in origin and frequently misattributed to sinus disease. Facial pain is a very common complaint in the rhinology clinic. In a community-based ENT practice where patient symptoms...

Simulation: human factors scenario training

It is said that surgical training has suffered as a result of a combination of factors – through the introduction of work time restrictions such as the European Working Time Directive (EWTD) [1], a limit on the number of years...

Maxillofacial and neck surgery in Iraq and Afghanistan

Introduction Over the past 150 years, military personnel wounded in action had a survival rate of approximately 80% [1]. During the current conflicts in Iraq and Afghanistan, those servicemen wounded in action have a 90.4% survival rate [2]. During the...

Coblation tongue channelling

After uvulopalatoplasty, the tendency is to focus on the tongue base as the next anatomical area to address in the management of snoring and sleep-disordered breathing. In this article, Glen Burgess describes the technique of tongue channelling, to reduce the...

Anaesthesia for sleep nasendoscopy and snoring / obstructive sleep apnoea surgery

Surgery for sleep disordered breathing inevitably requires surgeon and anaesthetist to share the airway. Here, Edward Bick gives us the anaesthetic viewpoint, reiterating that communication is the key. A specific note is made of the anaesthetic technique for sleep nasendoscopy,...

Singing after laryngectomy: Shout at Cancer

Thomas Moors is an ENT junior doctor with a background in music and singing. Combining these interests, he has set up a charity to help patients who have had a laryngectomy. He has achieved considerable public attention, and he tells...

Electronic nicotine delivery systems (e-cigarettes): what you need to know

As an aid to stopping smoking e-cigarettes may have a role, but they are heavily promoted by industry as a leisure pursuit and desirable fashion accessory. Sneh Biyani and Craig Derkay gives a thorough account of what we know about...

Adolescence, drug use and body image

Teenagers are notoriously conscious of how they are perceived by others. Dr Saraiva and colleagues explain how this can lead to problems with substance abuse for both boys and girls, and discuss the different substances they may encounter. Adolescence is...

Audiological evaluation and management of teenagers with tinnitus

There is a growing interest in investigating, understanding and managing tinnitus in children and adolescents, with several articles on the subject published in journals over the last year. Brian Fligor describes the approaches to consider when discussing tinnitus with teenagers....

Improving cochlear-implant performance in the short- and medium-term

Can bespoke cochlear implant programming strategies reduce the variability seen in patient performance with an implant? Bob Carlyon reviews the current situation and gives us a glimpse of the future. Although many cochlear implant (CI) patients understand speech well in...