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1791 results found

Multiple free flaps for head and neck cancer

Most patients with advanced head and neck cancers now undergo microvascular free flap reconstruction. This is mainly as flaps facilitate complete tumour and margin removal by providing reliable wound coverage and better restoration of form and function. However despite this,...

Voice change after total thyroidectomy with intact laryngeal nerves – a common but temporary problem

It has been reported that up to 87% of patients have a degree of voice dysfunction after thyroidectomy, even when the laryngeal nerves are preserved. Postoperative inflammation, laryngeal oedema due to vascular congestion, direct damage to the cricothyroid muscles and...

Treating benign positional paroxysmal vertigo

Benign positional paroxysmal vertigo (BPPV) is one of the most common causes of dizziness. Its treatment is the repositioning of displaced otoliths by the canalith repositioning manoeuvre (CRM). Post manoeuvre restrictions are commonly given to the patient. Their benefit has...

Reconstruction with scapular tip following hemimaxillectomy and rehabilitation with dental implants

Post ablative defects in the maxilla can be extremely complex, involve all three dimensions and may result in significant morbidity. Rehabilitation may be difficult with either an obturator or surgical reconstruction with a free fibula, Iliac crest or scapula. This...

Is surgery in obese children with obstructive sleep apnoea effective?

The authors present the results of their literature review and meta-analysis of studies examining adenotonsillectomy, uvulopalatopharyngoplasty (UPPP), supraglottoplasty, tongue base surgery or a combination in obese children with obstructive sleep apnoea (OSA). The one study investigating effects of UPPP was...

Alternobaric vertigo: asymmetrical vestibular function due to asymmetrical middle ear pressures (Iron Man’s archenemy)

The Marvel Cinematic Universe could certainly be deemed an ‘extreme environment’ and yet very rarely do we see the Avenger’s popping to the clinic for a check-up. Hee-Young Kim has wondered how they cope with extreme pressure changes and discusses...

Managing high flow head and neck arteriovenous malformations (AVM)

Vascular malformations are lesions where the traditional network of capillaries linking arteries and veins are lacking. Patients usually present with bleeding, pain, disfigurement and tissue expansion and destruction. High flow lesions can be challenging to manage in the head and...

Monstrous craws and horrid butchery: a concise history of thyroid surgery

Prior to the foundation of our speciality, thyroid surgery had a dubious reputation and universally dismal outcomes. Jenny Walton casts a critical eye over this dark chapter. Diseases of the thyroid gland have been referenced in historic texts for well...

Post-operative tonsillectomy bleeding with a normal clinical exam

Tonsillectomy is amongst the most common surgical procedures performed across the western world. For patients who report bleeding post-tonsillectomy, but have no clinical findings on examination, the management can be unclear. The accepted current management in most centres would be...

Audiological symptoms in children with 18q deletion

18q deletion is a rare genetic condition that occurs in approximately one in 40,000 live births. Those born with this deletion often are born with a range of symptoms, including developmental delay, facial dysmorphism, autoimmune disorders and hearing loss. The...

A return to digital delay and lip reading

Hearing aid + accessory + smartphone app = a ‘synching’ feeling? Marshall Chasin explains why patients might be losing the rhythm. The historical literature (at least going back to some of the classic texts in the 1960s) is full of...

Anaesthesia for free-flap surgery

Adel Hutchinson is one of those calm and controlled anaesthetists for whom nothing seems too difficult. In this article, she describes the key perioperative factors for one of the highest complexity operations in ENT; free-flap surgery. It makes good reading...