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Radiosurgery for large vestibular schwannomas

The authors conducted a retrospective study of patients with large Koos grade 4 vestibular schwannomas undergoing gamma knife radiosurgery. A total of 68 patients with tumour size greater than 4 cm3 with baseline serviceable 60% hearing who received 12 Gray...

Stimulation for a good night’s sleep

This article was an interesting read. It is an update from the authors’ original paper printed in the NEJM in 2014 regarding the results of an implantable pulse generator (IPG) for stimulating the hypoglossal nerve in response to respiration. This...

Carotid artery involvement with head and neck metastases

This is a retrospective review of 27 patients radiologically diagnosed as having metastases involving the common or internal carotid arteries. All patients underwent a salvage neck dissection with surgical carotid peeling. Thirteen of the 27 achieved loco-regional control, five developed...

Concussion and isolated mandible fractures – are we asking the right questions?

Concussion and isolated mandible fractures – are we asking the right questions? The mandible is one of the most commonly fractured craniofacial bones. A significant force is required to bring this about. Hence the authors hypothesised that concussion after a...

Delayed facial palsy post vestibular schwannoma resection

This article presents findings of a retrospective evaluation of 489 patients who underwent vestibular schwannoma surgery and developed delayed facial palsy. The authors define delayed facial palsy as deterioration of at least two HB grades between postoperative days five and...

Can intraoperative electrically evoked auditory brainstem responses predict the outcome of cochlear implantation?

Electrophysiology during cochlear implant surgery remains an issue of debate among the various centres. In the present study, the latencies and quality of the eABR waveforms from 74 adult implanted patients were analysed. In addition, four children with severe cochlear...

Anatomy for extended sinus surgery

In the world of image guidance and pushing the boundaries of what can be achieved endoscopically the assessment and understanding of preoperative imaging is critical for success. This paper highlights the anatomical variations in the pterygopalatine and sellar regions. The...

One anastomosis or two

This is a cumulative meta-analysis from Hong Kong reviewing 27 articles and a total of 7,389 flaps. The authors, at the outset, acknowledge that the number of anastomoses is not the only factor of venous compromise and flap failure. Nonetheless...

Lymph node ratio is a significant predictor for loco-regional recurrence after neck dissection in patients with papillary thyroid cancer

Lymph node metastases are common in papillary thyroid cancer (PTC), yet the impact of nodal metastases on survival remains unclear. Lymph node density (LND) is the ratio between the number of positive lymph nodes excised and the total number of...

How best to manage single-sided deafness?

Nowadays there is a plethora of options for patients with single-sided deafness (SSD) including: Bluetooth contralateral routing of signal (CROS) aids; in-the-ear bone conduction hearing aids (TransEar); intra-oral bone conduction aids (SoundBite) and bone-anchored technologies (BAHA). Unilateral cochlear implantation is...

No soup for you…! Early identification of postoperative perforation increases the success of conservative management

Iatrogenic perforation of the hypopharynx or cervical oesophagus is a well-recognised life-threatening complication. Previous studies have demonstrated that conservative management with broad-spectrum antibiotics and withholding oral feeding may avoid morbidity associated with surgical repair. This study addresses when conservative management...

Identifying early flap failure

The holy grail of flap monitoring is an easy, reliable and predictive method to identify impending compromise. Does this paper provide it? Various methods have been used to improve our ability to monitor the viability of a flap and here...