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Practical training courses for otolaryngology trainees

In this extended Trainee Matters, it’s a pleasure to present a trio of excellent articles with a theme of practical training courses for otolaryngology trainees. Miss Rachel Edmiston, Professor Nirmal Kumar and colleagues have written a valuable guide to setting...

The ACS-NSQIP study – predictive risk factors and outcomes in primary malignant parotid tumour surgery

Malignant parotid gland tumours occupy a good proportion of the ENT surgeon’s operative caseload. Large standardised datasets for malignant parotid tumour surgery are limited. This international multi-institutional study is based on the pooled American College of Surgeons National Surgical Quality...

3D endoscopy in pituitary adenoma surgery

Endoscopic approach for pituitary adenoma surgery is well recognised. There has been recent refinement of 3D endoscopy technology which improves on the depth of vision offered and more compact delivery. This may improve visualisation of the critical structures involved in...

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...

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...

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...

Endoscopic Approaches to the Parsanasal Sinuses and Skull Base

This is an excellent book to cover the endoscopic approaches to the paranasal sinuses and skull base with a step-by-step anatomic dissection guide. The editors are a group of eminent skull base otolaryngologists and neurosurgeons in Barcelona, Spain, and they...

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...

Challenging steps of virtual cortical mastoidectomy

This prospective study investigated which steps of cortical mastoidectomy were challenging for 10 medical students and 10 intermediate surgeons (surgical trainees) compared to 10 experienced expert surgeons. Each participant performed cortical mastoidectomy on eight different virtual temporal bone models. The...

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...