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Endolymphatic sac surgery: controversial procedure for the treatment of Ménière’s disease

Landmark Paper: Thomsen J, Bretlau P, Tos M, Johnsen NJ. Ménière’s disease: endolymphatic sac decompression compared with sham (placebo) decompression. Ann N Y Acad Sci 1981;374:820-30. Of all of the chapters in the Landmark Papers book, the chapter that discussed...

Surgery or medicine: when should we stop trying to be conservative?

Although most otolaryngologists would agree that surgery improves the outcomes of patients with CRS when medical treatment has failed, both Cochrane reviews state that there is no proof of improved efficacy of surgery over medicine – however, that was after...

Surgery for class III malocclusions pharyngeal airway and sleep apnoea effects

Thirty-three patients from Brazil were assessed for obstructive sleep apnoea and hypopnoea syndrome pre- and six months postoperatively. The 33 patients were made up of nine having mandibular set back surgery, six maxillary advancement and 18 bi-maxillary surgery. They identified...

Predictors of postoperative improvement after endoscopic sinus surgery in patients with chronic rhinosinusitis

Improvement after endoscopic sinus surgery in patients with chronic rhinosinusitis varies considerably. If elaborate preoperative and intraoperative data could be used to predict the postoperative course, management and length of the follow-up could be adjusted to provide optimal care. Two...

Scott-Brown’s Essential Otorhinolaryngology, Head and Neck Surgery

The three-volume Scott-Brown’s Otorhinolaryngology Head and Neck Surgery is arguably the definitive encyclopaedia of ENT. Its comprehensive nature, however, limits its utility when preparing for examinations. The authors, in creating an “essential” version, have managed to produce an ideal textbook...

A lateralised middle turbinate post pituitary surgery and incidence of sinusitis

A common belief amongst pituitary surgeons is that lateralising the middle turbinate to access the sphenoid can result in an iatrogenic sinusitis. This paper attempts to find out whether this is in fact true. Thirty-eight patients fitted the inclusion criteria...

Otolaryngology Head and Neck Surgery: Clinical reference guide - Fourth Edition

This textbook, well known to North American residents, is now in its fourth edition. It has been extensively revised to include more up-to-date topics, such as robotic surgery, sleep medicine and paediatric otolaryngology. Authors Raza Pasha and Justin Golab aim...

The debate: endoscopic vs microscopic ear surgery – meta-analysis of outcomes

Although the endoscopic approach to ear surgery has become more common in clinical practice, the debate about its role versus the traditional microscopic approach continues in many ENT units. This meta-analysis from the Mount Sinai ENT department in New York...

Enhanced recovery following surgery for head and neck cancer – the current evidence

Enhanced recovery after surgery (ERAS) programmes are now well established in many surgical specialities as a means of reducing postoperative complications and length of stay in hospital. Whilst many head and neck teams have interventions used to aid postoperative recovery,...

REVISIONS acronym for preoperative imaging review in revision endoscopic sinus surgery

The authors have developed an acronym to aid evaluation of preoperative sinus CT imaging in revision endoscopic sinus surgery (RESS). To determine which pertinent aspects of anatomy to include, a systemic review of studies that investigated anatomic contributions to persistent...

Have we reached our limits in endoscopic skull base surgery?

As being an anterior skull base surgeon becomes the aspiration of many ENT trainees, Professor Nicolai gives his personal insights into the future for this exciting subspeciality. Having been directly involved in the evolution of transnasal endscopic surgery (TES) since...

Elasticated retraction in head and neck surgery – a trainee’s perspective

The effectiveness of surgical technique and satisfactory outcome is greatly dependent on good surgical exposure. Retraction requires adequate traction and counter-traction of tissues in order to expose the tissue or organ under scrutiny for the surgeon. This is a universal...