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Roshna Rose Paul: interview between trainee and senior surgeon

Professor Paul has been heavily involved with training and educating multiple cohorts of ENT trainees over the years, since 2010. In this article, Mr Reid (a current ENT registrar from the West Midlands) picks her brains. Prof Roshna Rose Paul....

Non-absorbable synthetic material for middle fossa repair using a combined transmastoid/middle fossa approach

Repair of CSF leaks can be a challenging technical undertaking. In this article, the authors describe their use of a synthetic material to help with the successful repair of these leaks from the middle cranial fossa. Erosion of the middle...

ENT In this issue...Robotics in Head and Neck Surgery

Robotic surgery is here to stay. Within the specialty of otolaryngology, robotics has made headway across all of the subspecialties, although some advances may still be at the pre-clinical stage. The clinical applications are most acutely evident in the practice of head and neck cancer surgery, specifically transoral robotic surgery (TORS).

Cartilage conduction hearing aids: the third pathway for sound transmission and its application

Air-conduction and bone-conduction are familiar terms; now enter ‘cartilage conduction’. This new term offers a novel approach sound transmission. Hiroshi Hosoi explains the concept and proposes some future applications. The new sound pathway ‘cartilage conduction’ can provide various types of...

Voice change after total thyroidectomy with intact laryngeal nerves – a common but temporary problem

It has been reported that up to 87% of patients have a degree of voice dysfunction after thyroidectomy, even when the laryngeal nerves are preserved. Postoperative inflammation, laryngeal oedema due to vascular congestion, direct damage to the cricothyroid muscles and...

A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth

It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...

Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture

Placement of voice prosthesis at the time of trachea-oesophageal puncture is well described using 20-French prostheses. There is debate about the optimal size of the prosthesis with work in the 1980s and 1990s supporting larger prostheses. The rationale was that...

Can and should vestibular schwannoma surgery be carried out via the endoscopic transcanal approach?

The extent and scope of endoscopic ear surgery has rapidly progressed in recent years, and this paper, from one of the leading proponents of this technique, reports on the outcomes of a case series of patients who have had total...

Robotic insertion of electrode array in cochlear implantation

Cochlear implants (CIs) are commonly used for profound bilateral hearing loss. They have specific national guidance for their insertion, however patients with a substantial residual acoustic hearing are potential CI candidates. Preservation of this residual hearing can be sought with...

Otolaryngology - Head and Neck Surgery: Rapid Clinical and Board Review

This is a book written by a group of ENT surgeons from the Mayo Clinic, and a plastic surgeon from Colorado, and is aimed at US residents throughout their training, in particular in preparation for their board exams. As such,...

Papzimeos: a major advance in treating adult recurrent respiratory papillomatosis

Since the beginning of our specialty, generations of patients and surgeons have faced the challenging clinical problem of recurrent respiratory papillomatosis (RRP). Driven by a persistent and chronic infection with low-risk human papillomavirus (HPV) types 6 or 11, it is...

Role of ultrasonography-guided fine-needle aspiration in management of the neck after chemoradiotherapy

Primary chemoradiotherapy (CRT) is a well-established treatment for locally advanced head and neck squamous cell carcinoma (HNSCC). However, not every patient has a complete response to this treatment modality, necessitating eventual salvage neck dissection. Some patients with persistent adenopathy following...