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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...
Seeking medical attention with tonsillectomy complications depends on who you are. Lessons from the USA
In the current UK model, NHS care is free at point of access so there are no perceived economic barriers to seeking attention with postoperative complications. This study from the US examines surgical and emergency room databases from across California,...
When should we decompress the facial nerve in Bell’s Palsy?
It has been over three decades since Fisch popularised facial nerve (FN) decompression for Bell’s Palsy. Studies further exploring this have been few since, partly due to the major complications that can occur following this type of surgery. The current...
CT and intraoperative nerve monitoring to identify non-recurrent laryngeal nerve during thyroid surgery
A non-recurrent laryngeal nerve (NRLN) is a rare (incidence 0.3% to 1.3%) anatomical variant that results in a higher rate of vocal cord palsy following thyroid surgery. This team from China examined the utility of preoperative CT and intraoperative nerve...
‘Dead ear’ after mastoid surgery
The primary aim of surgery in the management of cholesteatoma is eradication of the disease which can potentially result in serious complications such as intracranial extension, facial nerve weakness and further hearing loss. A profound hearing loss resulting postoperatively considerably...
Clinical value of 3 T magnetic resonance imaging after intratympanic gadolinium injection in cases of delayed endolymphatic hydrops
Recurrent vertigo can continue after severe unilateral or bilateral hearing loss. This is a condition similar to Ménière’s disease, the diagnosis of which can be difficult. In this study intratympanic injection of gadolinium-diethylenetriamine penta-acetic acid dimeglumine was done in 25...
The lateral neck cystic mass – diagnostic dilemma. Can HPV status help?
Solitary cystic masses in the lateral neck can present a significant diagnostic dilemma as they can be metastases from tumours of the oro or nasopharynx. This retrospective paper detailed all patients presenting to a university hospital in Germany, from September...
Are ENT surgeons better placed to perform cosmetic ear, nasal and facial procedures?
Cosmetic surgery is an essential component of plastic surgery training and is required in order to CCT. However, the training opportunities in plastic surgery in UK are limited. The current operative requirements for plastic surgery trainees are 100 procedures during...
Tonsillectomy in or out?
Although tonsillectomy is the most common surgical act performed in ENT practice, there is still some concern about the safety of outpatient or day surgery scheduling, especially in adults. Although this has been common practice in many departments for some...
Does Tranexamic acid reduce intraoperative bleeding during FESS?
Intraoperative bleeding during FESS can reduce visibility and obscure important landmarks. This can result in longer operative times, increase risks of complications and even lead to incomplete surgery. Tranexamic acid is a drug which prevents fibrinolysis and stabilises blood clots....
DISE as a rationalising tool for sleep apnoea surgery
This retrospective study on 85 adult obstructive sleep apnoea (OSA) patients provides further interesting information for sleep surgeons. These patients were all investigated with polysomnography (PSG) and drug induced sleep endoscopy (DISE). They all then underwent a simple uvulopalatoplasty with...
