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Risk factors in free flap failure
This is a retrospective analysis from China of 881 free flaps over nearly four years, 49 of which were ‘taken back’, 26 of which were lost, giving a 97% success rate. The commonest cause of flap failure was venous thrombosis....
The double-half bilobed flap or traditional bilobed flap: which is better?
Reconstruction of the nasal tip following ablative surgery can be taxing. The nasal tip is a very visible area with largely immovable skin and reconstruction needs an appreciation of the various subunits to achieve best results. The traditional superiorly based...
Systematic review comparing transoral laser surgery versus open partial laryngeal surgery for advanced laryngeal cancer
The aim of this Italian systematic review was to establish outcomes (local control and survival) of conservative laryngeal surgery for advanced T stage laryngeal cancers. Articles published from 1980 onwards, had at least 10 patients that underwent partial laryngeal surgery...
Steroids pre-FESS
This meta-analysis and systematic review from the Netherlands and the UK aims to answer the question of whether corticosteroids inhaled and / or taken orally are beneficial to patients with chronic rhinosinusitis undergoing functional endoscopic sinus surgery. Refreshingly 18 RCTs...
Evidence based outcomes for canal wall up, canal wall down and subsequent canal wall reconstruction for primary cholesteatoma
There has been a long standing controversy over whether to treat primary cholesteatoma with open or closed technique. The general consensus is that limited disease can be treated with closed technique whereas the canal wall down approach helps reduce recidivism...
Changes in airway dimensions after orthognathic surgery
This is a systematic review of meta-analysis evaluating the effect of different types of orthognathic surgery on the cross sectional area and volume of the upper airway as assessed using CT or MRI. They found 28 articles of which only...
Risk factors for post laryngectomy fistula
This is a meta-analysis looking at the postoperative pharyngocutaneous fistula rates following total laryngectomy. The authors ended up with 34 studies with about 2500 patients. The most striking finding was that preoperative radiotherapy was a significant risk factor as well...
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...
Bone anchored implant stability predicted one week after implantation
Bone conduction (BC) devices can now be implanted as a single stage procedure with minimal soft tissue thinning to reduce the complications in the surrounding skin. The question of optimal loading time has to my mind not been answered. Here...
Head and neck cancer recurrence: a prospective analysis
The ‘cancer journey’ is synonymous for many individuals worldwide with frequent post-treatment hospital visits where the spectre of possible recurrence hangs over the consultation. This is a prospective analysis of 401 follow-up visits in Melbourne, Australia looking at follow-up in...
Applying ‘Sal classification’ to parotid cytology to replicate the success of the Thy classification system
The usefulness of the Thy classification in thyroid gland disease has led to attempts to generate a similar cytology classification for parotid lesions. However, the accuracy of fine-needle aspiration cytology in salivary gland disease is more variable because of the...
