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Risk factors for pharyngocutaneous fistula after laryngectomy
Pharyngocutaneous or salivary fistula is a feared complication following laryngectomy, causing significant morbidity, prolonged hospital inpatient stay / cost and mortality. Previous radiotherapy / chemoradiotherapy is a well recognised risk factor and leads many surgeons to recommend onlay pectoralis major...
Two for the price of one - multiple parotid neoplasms
With advancing years come many benefits, but one drawback is the acquisition of parotid (or thyroid) neoplasms. Conventional teaching is that most are benign and slowly enlarge, and not infrequently are found bilaterally as in Warthin’s. Pleomorphic adenomas are also...
Assessment of temporal bone skills on 3D-printed temporal bones – a useful training curriculum?
The authors contend it is now archaic to follow Halstead’s model of surgical training, namely ‘see one, do one and teach one’. Simulated training is now widely used in many surgical specialities. With every surgical trainee having an individual learning...
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...Ultrasonic bone aspirators for internal auditory meatus ‘drilling’ in retrosigmoid vestibular schwannoma resection
In this article, the authors describe the retrosigmoid approach to a vestibular schwannoma, using an ultrasonic bone aspirator as an alternative to the standard drill. Vestibular schwannomas (VS) are benign, usually slow-growing tumours of the vestibular nerve. Management of VS...
SPECT-CT imaging improves surgical efficiency in sentinel lymph node biopsy in melanoma
Sentinel lymph node biopsy is used in clinically lymph node negative, primary cutaneous melanoma. A combination of planer lymposcintigraphy using a radiolabelled colloid detected intra-op by gamma probe, and cutaneous injection of blue dye is used. However, with lymphoscintigraphy spillage...
Options for the endoscope and acquired cholesteatoma
This was a thought-provoking article examining the reasons why the authors believe that the endoscope is enabling an improved understanding of acquired cholesteatoma and its management. They describe in depth the ventilation pathways of the middle ear, and how they...The evolving role of OAEs in newborn hearing screening
An admission on emissions from James Hall! OAEs hold an established place in the screening of infants; Professor Hall introduces how OAEs established this position and the advances keeping the test relevant to today’s infant screening battery. Introduction Truthfully, when...
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...
Temporal bone drilling using artificial versus cadaveric specimens - does the specimen precipitate altered drilling techniques?
Hochman et al set an ambitious goal in their study analysing drilling strokes of eight otolaryngology residents (junior: PGY 1-3; senior: PGY 4-5) during temporal bone (TB) drilling practice using cadaveric and artificial specimens. Each trainee dissected one cadaveric and...
External auditory canal carcinoma
Although uncommon, primary malignant tumours of the external auditory canal (EAC) are associated with a poor prognosis as they often present late. In this study the authors evaluate the clinical and pathological factors associated with treatment and outcome of EAC...
