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Darn it! It’s going to take longer to get good at stapes surgery!
Traditionally, it has been said the learning curve for a particular operation lies between 20 and 30 cases. In stapedotomy, a surgeon is deemed successful and perhaps competent if closure of the air-bone gap (ABG) is reached to within 10dB...
Nasal steroids do not cause ocular problems
This excellent, high quality and detailed systematic review from Australia dispels the myth propagated recently by some poorly designed studies that intranasal corticosteroids cause intraocular problems. A 40 year review of the usual databases found 665 articles and 19 were...
Treating keloid scarring with pressure clips following excision: does it work?
Keloid scars can pose a difficult management problem. Whilst not harmful in themselves they can be cosmetically unappealing and lead to social embarrassment and resulting isolation, and following surgical excision they often reoccur. Mechanical pressure is an adjuvant to surgical...
Surgical voice restoration after laryngopharyngectomy
Voice restoration is one of the key rehabilitative steps after laryngectomy or total laryngopharyngectomy (TLP). Patients who undergo TLP require reconstruction – increasingly commonly with microvascular free flaps. Despite their advantages in terms of fistula rates and swallowing outcomes, these...
Patient reported outcomes improve if antibiotic choice is directed from endoscopic culture results in chronic rhinosinusitis
The use of antibiotics in chronic rhinosinusitis (CRS) has been established as part of the EPOS guidelines, as has the role of taking swabs for microbiology culture. There has not been much literature however on whether tailoring antibiotics in response...
Measuring the ‘impact’ of preoperative immunonutrition
Using preoperative nutritional supplements as part of ‘enhanced recovery’ in surgical patients is not a new concept. This interesting paper looks at the latest development in optimising patients undergoing head and neck oncological surgery. Immunonutrition (Nestle’s ‘Oral Impact’ in this...
Long-term results of incus vibroplasty in patients with moderate-to-severe sensorineural hearing loss
The Vibrant Soundbridge (VSB) middle ear implant is now a well-accepted and widely utilised treatment option for patients with sensorineural hearing loss unable to use standard hearing aids. However, as a relatively recent addition to the portfolio of implants available...
Bone anchored hearing devices in very young children
This paper presents results of BC devices in very young children and helps inform an honest discussion of risks / benefit with prospective parents. The authors of this article from Starship Children’s Hospital, Auckland, New Zealand have a series of...
Choosing our tools: assessing language in dementia
Language led dementia, also known as primary progressive aphasia (PPA), is an emerging area of practice in speech and language therapy. Given that the diagnosis centres around the key diagnostic feature of language, whereby language impairment is the most prominent...
Monitoring the mouth in ALS
Amyotrophic lateral sclerosis (ALS; or motor neurone disease) is characterised by gradual loss of function in the speech muscles resulting in a progressive deterioration in a person’s ability to communicate. The aim of this study was to investigate the use...
Sinonasal inverting papilloma: who is at risk of recurrence?
This study from a tertiary sinus surgery unit, describes some useful information in the follow-up of sinonasal inverted papilloma patients - in particular those likely to recur - and discusses the optimal staging systems to use to attempt to predict...
