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The microbiological environment of the paranasal sinuses
This article reviews the ecology of the sinuses and tries to make sense of the confusing literature on the subject. This covers the details of molecular studies, particularly those which attempt to differentiate normal sinuses from those in patients with...
International classification of BPPV
In the past few years, the Bárány Society has made great strides in defining and classifying vestibular disorders along the lines of the international classification of diseases. This article addresses the diagnostic criteria for BPPV, the commonest cause of vertigo....
The perils of poor postop blood pressure control
This retrospective case control study reviews 621 patients undergoing thyroid surgery over a 10-year period from 2002-2012 looking at postoperative haemorrhage rates. This potentially catastrophic complication warrants close analysis in order to best discern how it can be minimised. The...
SPECT scans not justified in growth of the mandibular condyle
This is a paper from Hong Kong of 200 patients between January 2011 and July 2013 who underwent SPECT bone scintigraphy for assessment of growth causing condylar hyperplasia and subsequent mandibular asymmetry. Thirty-four patients were found to have active growth...
Tricky post-laryngectomy swallows
Despite improvements in chemoradiation therapy and the adoption of organ preservation for some head and neck cancers, total laryngectomy remains the treatment often providing best survival chances for advanced laryngeal cancer. This article reviews the causes of dysphagia post-laryngectomy and...
Post-operative debridement following FESS
Postoperative treatment pathways for patients following functional endoscopic sinus surgery (FESS) vary widely with the topic of debridement of the nasal cavity a subject of conjecture. This article is the result of two independent reviewers using the consort guidance for...
New aminoglycosides with reduced ototoxicity risk
Aminoglycoside antibiotics are widely used for infections affecting patients of all ages and at different sites, however they carry a risk of ototoxicity, nephrotoxicity and rarely peripheral neuropathy. Preventing ototoxicity is crucial to the maintenance of auditory function and quality...
Clival chordoma recurrence
Chordomas are generally slow growing and are histologically considered low grade tumours. Their high recurrence rate even after postoperative radiation renders them difficult to treat. This is particularly true for clival chordomas whose deep anatomic location and proximity to vital...
Risk factors for post tonsillectomy bleeds
This paper reviews post-tonsillectomy bleeding in 692 patients and attempts to tease out risk factors. The overall bleed rate of 11.6% seems very high. The return to theatre rate was 2.6%. The paper identifies male patients and adult patients as...
Tracheostomy safety project
Tracheostomy care is evolving, with the majority of procedures now performed percutaneously to facilitate weaning from mechanical ventilation in the critically ill. Traditional surgical indications remain, but surgical tracheostomies are increasingly performed in more complex patients. This brings unique challenges...
Malignant craniopharyngiomas
Craniopharyngiomas are successfully managed with surgery and / or adjuvant chemoradiotherapy. The transnasal endoscopic route has become increasingly utilised in the management of these challenging tumours. This paper reviews 23 cases from the literature of the rarely reported malignant transformation....
