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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...

Anatomy for extended sinus surgery

In the world of image guidance and pushing the boundaries of what can be achieved endoscopically the assessment and understanding of preoperative imaging is critical for success. This paper highlights the anatomical variations in the pterygopalatine and sellar regions. The...

Do I need Google maps in here?

Image guidance surgery (IGS) has grown in popularity. This review article discusses its application in endoscopic sinus surgery (ESS). IGS technology has vastly improved with smaller, more mobile platforms that are easy to set up and use. IGS allows validation...

Endoscope assisted removal of jugular foramen schwannomas

This article, written by a renowned surgeon with extensive experience in removal of jugular foramen and skull base lesions, describes a new classification for jugular foramen schwannomas (JFS) and a template for selection of surgical approach for endoscope assisted removal....

Microvascular surgery - does size matter

Success rates for microvascular free tissue transfer performed for head and neck reconstruction are currently very high. As the recipient vessel diameter decreases, questions of reliability and ease of access are raised. This retrospective analysis looked at 89 flaps in...

Neurosarcoidosis: another aetiologic factor for deafness and labyrinthitis ossificans

Very few studies describe deafness secondary to neurosarcoidosis as the latter is a rare inflammatory disorder of the nervous system usually associated with facial nerve and optic nerve disorders. This interesting case report describes a rare case of cochlear ossification...

Back to basics: nasendoscopy beats CT, again!

There are few otolaryngologists (or patients) who have not been confronted with a computed tomography scan referring to a deviated septum. In a very similar way to the accidental findings of sinus mucosal thickening, the clinician is left in a...

Choosing Wisely!

This article focuses on the prickly topic of healthcare costs and specifically on reducing spending on neuroimaging for headaches. Epidemiological studies indicate that the prevalence of lifetime headaches is 93 to 99% and accounts for 1.5% of all primary care...

Use of tranexamic acid in ENT surgery

Postoperative bleeding in otolaryngologic procedures causes delayed discharge, requires re-admission and adds considerably to the cost of patient care. Whether the anti-fibrinolytic activity of tranexamic acid should be used routinely to prevent haemorrhagic complications after ENT operations is speculation but...

National analysis of outcome of head and neck cancer surger

Patient outcomes continue to become ever more visible in the NHS with ongoing drives to demonstrate transparency in our delivery of healthcare. This article reviews unit-level data publication using Hospital Episode Statistics data in all units undertaking head and neck...

Cost effectiveness and vestibular schwannoma surgery

This is the first cost effectiveness modelling study looking at the three main treatment options for small to medium sized vestibular schwannomas. This study uses the widely accepted cost per quality adjusted life year (QALY) outcome measure to evaluate three...

Assessing post-extubation dysphagia on the intensive care unit

The incidence of post-extubation dysphagia (PED) is reported to be about 12% in the general ICU population and around 18% in patients admitted to ICU as emergencies. PED was found to be an independent predictor of 28-day and 90-day mortality....