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Harvesting the flexor hallucis longus: what is the increased morbidity?

The free fibula flap is now widely used in clinical applications for microvascular reconstruction and occasionally, to add bulk, the flexor hallucis longus (FHL) muscle is harvested along with the fibula. The post-operative morbidity is usually described as mild and...

Vicarious (nasal) menstruation

Hippocrates himself is known to have said that when a woman’s menses are due, but instead of the usual vaginal menstrual flow, she has a haemorrhage from the nose, then this is a sure sign of pregnancy [1]. Artist’s impression...

Michelle – Chevalier Jackson’s choking doll: Simulation in paediatric airway management 100 years ago

Simulation has become an indispensable tool in modern paediatric airway management as it offers clinicians the opportunity to practise complex procedures in a safe, controlled environment [1], although challenges will always remain in replicating the true anatomical proportions and tactile...

Be who you needed when you were younger

Trainee audiologist, deaf England futsal player and deaf advocate Zara Musker discusses finding her own deaf identity: “It’s part of me but not all of me”. Am I an audiologist? A deaf England futsal player? An advocate for deaf individuals?...

What is Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE)?

THRIVE is a physiological mechanism for oxygenating and ventilating patients who are under general anaesthesia and who have diminished or absent respiratory effort [1]. Classical ventilation requires bulk flow of gases into and out of the lungs driven by chest...

Voices: In conversation with Nick Coleman

Nick Coleman is an author and journalist who has written for several national newspapers and music magazines. Following sudden unilateral deafness in 2007, he wrote The Train in the Night, which describes his experience of hearing loss, rehabilitation and what...

Music and cochlear implants

Introduction The introduction of multichannel cochlear implants (CIs) in the early 1980s provided children and adults with severe and profound hearing losses with greatly improved speech perception skills. In this paper, however, I am going to focus on an area...

Risk of second primary cancer among patients with head and neck cancers

Patients with head and neck squamous cell carcinoma (HNSCC) have an elevated risk of developing a second primary malignant neoplasm (SPMN). These are of increasing concern because the number of survivors of HNSCC has been growing owing to early detection...

Ultrasound-guided core biopsy of neck lumps as first-line investigative modality supersedes fine needle aspiration cytology in the diagnosis of neck lumps

Ultrasound-guided fine needle aspiration cytology (USFNAC) when applied as initial investigation often proves non-diagnostic, the incidence being as high as 50% in a recent audit. In this study, the authors applied ultrasound-guided core biopsy (USCB) to neck lumps over 1cm...

Retrieval of an aspirated voice prosthesis in the awake laryngectomised patient

In this article, the authors describe a simple and effective technique for extracting an aspirated voice prosthesis from within the tracheobronchial tree in the awake laryngectomised patient using the Ambu® aScopeTM 4 Broncho endoscope. Surgical voice restoration remains the dominant...

Mucormycosis: In conversation with Dr Deepak Haldipur and Dr Aditya Moorthy

COVID-19 has ravaged the world in the past 18 months. The second wave in many countries was deadlier than the first. Mucormycosis, infamously labelled ‘the black fungus’ has affected some countries, such as India, in epidemic proportions within this COVID...

Thoughts on war: von Clausewitz revisited

We few, we happy few, we band of brothers; For he to-day that sheds his blood with me Shall be my brother; be he ne’er so vile, This day shall gentle his condition: And gentlemen in England now a-bed Shall...