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What’s the risk of regrowth with partial (intracapsular) tonsillectomy
Partial (intracapsular) tonsillectomy is enjoying somewhat of a revival offering the potential for less postoperative pain and bleeding whilst relieving the obstructive element. The authors look at 303 patients, 82 of whom had partial tonsillectomy using coblation. They measured pre...
Tracheostomy safety project
Tracheostomy care is evolving, with the majority of procedures now performed percutaneously to facilitate weaning from mechanical ventilation in the critically ill. Traditional surgical indications remain, but surgical tracheostomies are increasingly performed in more complex patients. This brings unique challenges...
Nasolabial flap to reconstruct periorbital defects
The authors present a series of 25, mainly geriatric patients that had ablative surgery with complex defects in the paranasal and orbital regions. The paranasal and periorbital regions are extremely important for facial aesthetics and quality of life. The authors...
Harvesting the flexor hallucis longus: what is the increased morbidity?
The free fibula flap is now widely used in clinical applications for microvascular reconstruction and occasionally, to add bulk, the flexor hallucis longus (FHL) muscle is harvested along with the fibula. The post-operative morbidity is usually described as mild and...
Consequences of tonsillectomy rationing?
This article examines Hospital Episode Statistics and Office for National Statistics data to investigate the change in rates of tonsillectomy and admissions for tonsillitis and its complications, over a 20-year period. Between 1991 and 2011, 44% fewer tonsillectomies were performed....
Sham controlled trial: BPPV
I was drawn to this study and it proved an enlightening read; it also is a good example of where recommendations of a Cochrane review for long-term evidence of benefit have been acted upon! The study looked at the efficiency...
Paediatric versus adult pituitary adenomas
This retrospective study compares paediatric with adult patients undergoing pituitary adenoma surgery over a period of 26 years at a single institution. All surgeries were performed via a sublabial approach using the operating microscope. An endoscope was used occasionally for...
The GP and the ear
General practitioners are the first members of the medical community to deal with ear problems. In this survey, 11 GPs examined 124 patients using a regular otoscope and a video-otoscope and reported their findings in a 10-item table. The same...
Helicobacter pylori infection delays mucociliary clearance in the nose
Chronic rhinosinusitis is not uncommonly a difficult condition to treat and therefore any possible association of this condition with factors outside the nose and sinuses is the subject of worthwhile research. Impairment of mucociliary clearance is paramount to upper respiratory...
Tramadol soaked nasal packs for post-septoplasty analgesia
Having had a septoplasty a number of years ago for the potential treatment of snoring, I was intrigued by this paper which compared the analgesic effect of tramadol-soaked and lignocaine-soaked nasal packs following septoplasty. In my practice, I have always...
Endoscopic transsphenoidal surgery versus dopamine agonist therapy for microprolactinomas
This study addresses the importance of the location of microprolactinomas in determining prognosis after surgery. Long-term dopamine agonist treatment is the current standard of treatment for microprolactinomas. However, patients often seek surgical removal. The authors of this study retrospectively analysed...
