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Office-based otology procedures

This edition of the Otolaryngologic Clinics of North America covers office-based surgery in ENT. This article discusses procedures in otology that could be performed in the outpatient setting and covers innovations in office-based otologic procedures. The endoscope features prominently in...

Treatment of incus lysis with hydroxyapatite bone cement

Middle ear implants provide a suitable alternative for some patients with a certain degree of sensorineural or mixed hearing loss, not wanting a hearing aid. Vibrant SounBridge® (VSB) middle ear implant (MEI), of Med-El®firm, is one such implant. In this...

Lateral skull base surgery using the endoscope

Endoscopic lateral skull base surgery could be performed via less invasive techniques due to wide panoramic visualisation of the operative field. With less invasive techniques, patients have been shown to require shorter recovery time and reduced postoperative pain. In this...

Transmastoid facial nerve decompression for persistent traumatic facial nerve paralysis

Facial nerve paralysis (FNP) can occur following trauma, with a small number of these patients requiring facial nerve decompression (FND) to aid recovery. The authors shared their experience in decompressing the facial nerve for persistent severe FNP via a transmastoid...

Immunosuppresants and ototoxicity

There is a wide range of immunosuppressant drugs ranging from calcineurin inhibitors (e.g. cyclosporine), anti-folic agents (e.g. methotrexate) to anti-TNF and monoclonal antibodies, many of which could be ototoxic. The authors performed a systematic review assessing ototoxicity secondary to immunosuppressant...

How reliable is non-echoplanar diffusion-weighted MRI in picking up postoperative cholesteatoma in children?

Cholesteatoma occurs more often in children than in adults and is more aggressive, often resulting in ossicular erosion and marked conductive loss, amongst other more serious possibilities. Recurrence happens in all three methods used, namely canal wall up, canal wall...

Middle ear reconstruction in children: why, when and how

Every ear in every child is different. Rob Nash discusses the rationale behind reconstructive ear surgery in children and his philosophy on timing and techniques of reconstruction. It is rare for middle ear pathologies to be life threatening. Indeed, it...

Posterior TM perforations carry greater hearing loss: practical pointers for clinic

This single-centre prospective study of 100 adults with central pars tensa perforations examined how perforation size and quadrant relate to hearing loss. Using video-otoscopy to estimate perforation area and pure tone audiometry for thresholds, the authors found hearing loss in...

Medical and surgical management of performing vocalists

Dr Steven Zeitels is widely recognised as the foremost laryngologist of his generation. He has been at the forefront of innovation for 25 years, and has treated innumerable high-profile singers, most recently Sam Smith and Adele. Here, he gives us...

Present and future in myringoplasty

Tympanic membrane perforations are a common finding in ENT practice. Whilst watchful waiting or formal tympanoplasty are standard options – wouldn’t it be amazing if there was a low cost, safe, in-clinic option to immediately help patients (I hear you...

Reconstruction after parotid surgery

This is a retrospective study from Naples, Italy. The authors compare patients with benign parotid disease that were reconstructed with three different techniques. In total 224 patients between February 2002 and March 2009 were included; these patients had either formal...

Extracapsular dissection versus parotidectomy

This is a literature review of 16 papers using the PRISMA protocol. In comparing the two techniques, not surprisingly, they found that extracapsular dissection was associated with a reduced incidence of facial nerve paralysis and Frey’s syndrome and a shorter...