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What is the evidence for duration of antibiotic prophylaxis in head and neck free-flap cases?
The topic of this systematic review is one which is commonly heard in discussions between microbiologists and head and neck surgeons – what is the evidence for antibiotic prophylaxis in clean-contaminated free-flap cases, and crucially, how long should antibiotics be...
Should patients with dysphagia be allowed water freely?
Patients with dysphagia often experience dehydration as a consequence of “nil by mouth” or having to consume thickened fluids due to aspiration of thin fluids. However, not all incidents of aspiration develop into an infection. Factors that contribute to aspiration...
A multidisciplinary approach to the management of frontal sinus fracture
Frontal sinus fractures account for about 5% of all facial trauma. Fractures of the posterior wall may result in cerebrospinal fluid (CSF) leak and meningitis, while obstruction of the outflow tract can cause sinusitis and mucocele formation. However, there are...
Outpatient closure of CSF leaks: a good idea or a step too far?
After day-case septoplasty, day case thyroidectomy, now day case CSF leak repair – has the pendulum moved too far? The authors put forward a convincing case for what, only 10 years ago, would have sounded like a provocation. They quote...
Laser for active mucosal chronic otitis media
Active mucosal chronic otitis media (COM) is a condition characterised by otorrhoea secondary to chronic inflammation of the middle ear and mastoid mucosa associated with granulations and a tympanic membrane perforation. Surgical intervention is often required, but concurrent mastoidectomy with...
Chronic rhinosinusitis – a pre-malignant condition?
Nasopharyngeal carcinoma (NPC) is a relatively uncommon diagnosis in the West but is prevalent in Southeast Asia. Several factors have been established to be associated with a higher risk of developing NPC, including salted fish consumption, smoking, alcohol, and Epstein...
Postop follow up of oral squamous cell carcinoma: a new protocol
Oral and oropharyngeal cancers together are the sixth most common malignancy in the world, with an increasing incidence of oral squamous cell carcinoma (OSCC). The recurrence rate of OSCC is reported to be approximately 10-26%. About two-thirds of all recurrent...
Combined endoscopic and transcutaneous approach for removal of parotid stones
The authors describe a small case series (n=8) of patients with obstructive symptoms from sialolithiasis of the parotid gland. A combined endoscopic and transcutaneous approach was used. The position of the stone in Stensen’s duct was identified by endoscopic transillumination....
Gardasil vaccination – an effective adjuvant therapy for RRP?
The clinical manifestations of recurrent respiratory papillomatosis (RRP) can vary hugely from individual to individual. Whilst some affected children will outgrow the disease, a subset of patients will experience frequent recurrences and require multiple surgical procedures over the course of...
Consider PCR testing in culture negative necrotising otitis externa
Necrotising otitis externa (NOE) often does not yield identification of a causative organism to treat although in 90% of cases it is a member of the pseudomonas species. The incidence of fungal NOE is not to be forgotten and this...
