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Percutaneous tracheostomy in anticoagulated patients

This Belgian study looked at the risks and complications of bedside percutaneous tracheostomy in patients who received anticoagulant therapy. The 231 tracheostomies included in the study were performed over an eight-year period by two otolaryngologists using bronchoscopic guidance. The mean...

Do parents sleep better after paediatric adenotonsillectomy?

Paediatric adenotonsillectomy for sleep disordered breathing (SDB) is amongst the commonest surgical procedures performed in ENT. In the outpatient clinic, parents routinely express their concern about their child’s breathing but the impact of sleep disordered breathing on the parent is...

Endoscopic stapes surgery

This retrospective Turkish study looked at the audiological and surgical outcomes of 40 patients who underwent endoscopic stapes surgery over a three-year period. To assess the learning curve, the patients were divided into two groups based on the date of...

What is the right balance to strike in the management of anaplastic thyroid cancer?

This is a pragmatic article on a difficult and much debated subject. Management of anaplastic thyroid cancer (ATC) can feel like making decisions between a rock and a hard place, and this article suggests one path to help navigate some...

Two reliable endoscopic myringoplasty techniques for anterior tympanic membrane perforations

Difficulties that arise in closing anterior perforations in the tympanic membrane are due to a narrow isthmus of the external auditory canal and an anterior wall bulge which obscures the most anterior part of the tympanic membrane. The conventional microscopic...

Preventing major postoperative haemorrhage following TORS

Transoral robotic surgery (TORS) has become an increasingly utilised treatment modality in the management of oropharyngeal squamous cell carcinoma (OPSCC). Postoperative haemorrhage, although uncommon, is a significant complication. To ameliorate this risk, transcervical ligation of branches of the external carotid...

Antibiotics in orthognathic surgery

This paper from the Netherlands looked at 137 patients over a one-year period, 18 of whom had Le Fort I procedures, 68 bilateral sagittal split surgery, and 51 bi-maxillary surgery. A further 54 surgical procedures were undertaken, including 15 having...

Canal wall up mastoid defects - can they be usefully reconstructed with hydroxyapatite cranioplastic cement?

Standard canal wall up (CWU) mastoid surgery leaves a mastoid defect of varying size, commonly covered by soft tissue. Rarely, this bony defect can cause discomfort, cosmetic issues or other problems. To mitigate these, the defect can be filled either...

Core biopsies are good enough for lymphomas

This paper, from the South of England, has reviewed ultrasound-guided core needle biopsies over a six-year period investigating the use of the detection of head and neck lymphomas. There were 367 samples included from 226 patients; 215 of the 226...

Ethanol ablation for benign cystic neck lesions

Benign cystic head and neck lesions have traditionally been managed conservatively or with surgical excision. Ethanol ablation (EA) has now established a role in the management of benign thyroid cysts, and its use has also been expanded to non-thyroid cysts....

Surgery safety checklists

The time-outs were based on pre-flight checklists adopted by airline pilots and were instituted in all accredited hospitals and ambulatory care centres in the United States in 2003. The guidelines originate from general surgery and are not specific for the...

Is there a limitation for excising parapharyngeal tumours transorally?

The parapharyngeal space is a complex anatomical space bounded medially by the oropharynx and laterally by the mandible. It is conceptualised as an inverted pyramid extending from base of skull above to the hyoid bone below. The space is divided...