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Canal wall down with obliteration of cavity for paediatric cholesteatoma
The authors present evidence that canal wall down (CWD) surgery with primary obliteration is an effective way to treat paediatric cholesteatoma. Fifty-eight ears were operated on and follow-up was for five years on average. Residual cholesteatoma rate was 9.9% with...
Management of necrotising otitis externa
Although uncommon, necrotising (previously malignant) otitis externa (nOE) can be very aggressive, particularly if not managed appropriately. In this study the authors perform a retrospective review of 25 patients admitted with nOE over a four year period at a tertiary...
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...
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...
Increasing tongue strength to reduce dysphagia: what is the potential benefit of a device driven exercise?
Weakness in tongue muscle strength and laryngeal elevation is known to have an adverse impact on swallowing function. Various swallowing exercises are often recommended to improve function of these important structures with the goal of preventing aspiration and improving swallow...
Neuromodulation in drug resistant epilepsy
Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...
The electromagnetic larynx
Current treatment options for a bilateral vocal cord palsy (tracheostomy, posterior cordotomy, arytenoidectomy) are suboptimal, with a focus primarily on a static means of airway restoration at the expense of voice production and potentially swallow safety. This paper reports on...
Semicircular canal dehiscence and cochlear implantation
Semicircular canal dehiscence (SCD) is thought to occur in 3% of the population, it is mostly asymptomatic, but patients may present with sound-induced vestibular symptoms, low-frequency conductive hearing loss, autophony, hyperacusis and aural fulness. With the increasing utilisation of cochlear...
Are quinsies worth draining?
Recent data is providing accumulating evidence that treatment failure in the management of peritonsillar abscesses (PTAs, aka ‘quinsies’) is similar when these are managed with medical treatment (MT) alone versus MT plus surgical drainage (M+ST). However, in the absence of...
Diagnostic features of acute invasive fungal sinusitis
Acute invasive fungal sinusitis (AIFS) is a rare but frequently lethal condition, commonly associated with a high morbidity among those that survive. It has gained recent media attention on account of its increased incidence following infection with (and treatment for)...
Parapharyngeal space tumours – is the transoral approach effective?
Several approaches are described to the parapharyngeal space to permit resection of tumours in this region, with the most commonly employed approach being the transcervical route. The transoral approach remains somewhat controversial as it is felt that this approach can...
