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Imaging and embolisation of paragangliomas
Paragangliomas are rare tumours within the head and neck and any article which succinctly jogs the memory with respect to their existence and subsequent accurate diagnosis is welcome. This article concisely explains the imaging techniques used to diagnose these tumours...Ossicular reconstruction
Ossicular reconstruction often yields disappointing results, even for the most experienced and skilled of otologists. John Dornhoffer and David Walker explain that the most important determinant of outcome is the patient’s middle ear environment, and offer some valuable words of...
Preoperative CT checklist (using the ‘CLOSE’ mnemonic) improves identification of anatomical variants for endoscopic sinus surgery
Computed tomography (CT) scans of the paranasal sinuses act as roadmaps for endoscopic sinus surgery (ESS) and careful inspection preoperatively warns the operating surgeon of critical anatomical variants. This study aimed to investigate if implementation of a pre-ESS CT checklist...
Medialisation laryngoplasty can relieve pain related to voice use
Odynophonia, or pain associated with voice use, is a relatively uncommon manifestation of glottal insufficiency related to vocal fold motion impairment (VFMI). Its incidence is approximately 15% in patients with vocal fold paresis. Medialisation laryngoplasty (ML) was popularised by Isshiki...
Managing hearing preservation expectations of adult CI patients
This paper is a single-centre review of adult cochlear implants in patients with preserved low-frequency hearing, focusing on the outcomes at 10 months post-implantation, and the rates of electroacoustic stimulation actually used in this group of patients. The centre identified...
Multiple surgeries for RRP – does a greater number of operations result in a worse voice outcome?
Recurrent respiratory papillomatosis (RRP) of the larynx remains a challenging condition to treat, with a number of affected patients requiring multiple operations to remove recurrent disease over the course of their lifetime. At the most severe end of the spectrum,...
Head and neck high dependency unit - an alternative to ITU?
Close observation of the airway is a primary requirement for patients undergoing major head and neck surgery. It is also necessary for patients with upper airway infection and trauma. Wound care, drains, feeding and analgesia also require specific attention. Whilst...
Close monitoring of patients for delayed hyponatremia post-transsphenoidal surgery
he incidence of delayed hyponatremia is 16-28% and usually accounts for unplanned readmission of the patient within 30 days after transsphenoidal surgery. One of the surrogate measures of quality of care adopted by the government and regulatory agencies is 30-day...
Hyperbaric oxygen therapy and flap reconstruction: does it help?
This is a multicentresite retrospective review from four clinics in the USA on patients who received radical debridement and free flap reconstruction for osteoradionecrosis (ORN) between 1 Jan 1995 and 30 June 2011. Patients were stratified divided based on having...
Does minimally invasive surgery under local anaesthesia have a role in the management of chronic rhinusinusitis?
A formal FESS procedure usually done under local anaesthesia is considered as gold standard in the management of chronic rhinusinusitis. However, success is hampered by a significant recurrence rate of polyps requiring revision surgery, long waiting lists, reluctance of elderly...
Is endoscopic approach more precise in addressing failed ventilation system in chronic mucosal ear disease?
Chronic mucosal disease, as opposed to cholesteatoma, is more directly related to failure of the ventilation system involving three channels. Isthmus anticus and isthmus posticus are channels in front and behind the long process of the incus and there is...
