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In conversation with Professor Patrick Gullane: My life in Otolaryngology-Head & Neck Surgery

Fellowship RCSEng 2009. Patrick, as you have recently ‘stepped down’ as Chairman and Chief of ORL-HNS at Toronto General Hospital, what next? Firstly, so often I have been asked why I selected this career path, from a quote by Johnny...

Predicting postoperative respiratory complications following paediatric adenotonsillectomy

This systematic review aimed to compare the presence of clinical features versus the polysomnography results in predicting major postoperative respiratory complications in children undergoing adenotonsillectomy for OSA. The study was prepared according to the PRISMA checklist. Overall 22 studies met...

Role of ultrasonography-guided fine-needle aspiration in management of the neck after chemoradiotherapy

Primary chemoradiotherapy (CRT) is a well-established treatment for locally advanced head and neck squamous cell carcinoma (HNSCC). However, not every patient has a complete response to this treatment modality, necessitating eventual salvage neck dissection. Some patients with persistent adenopathy following...

The sentinel lymph nodes revisited

The concept of sentinel lymph node sampling has been around for some time. However, its acceptability in routine head and neck practice has yet to be established. This article presents the authors’ experience in 10 patients with Merkel cell carcinoma...

Core or fine needle assessment in lymphadenopathy and salivary gland tumours

This paper from the Republic of Korea analyses 278 patients retrospectively, 112 of which underwent fine need aspiration and 166 core needle biopsies. Eleven patients had indeterminate fine needle aspiration cytology, six of whom had an additional core biopsy. The...

Stepwise approach to manage palatal myoclonus successfully

Palatal myoclonic tinnitus (PMT) is a rare condition caused by rhythmic voluntary or involuntary movements of the soft palate, mainly the tensor veli palatini and levator veli palatine muscles. Patients usually present with a ‘clicky’ noise in the ear. Oral...

Can we avoid FESS in patients with true isolated odontogenic sinusitis?

This is a useful study looking at how best to manage patients with odontogenic sinusitis and if FESS can be safely avoided. The authors treated patients by removing the odontogenic cause of the rhinosinusitis by extracting the offending tooth and...

The incidence of coagulopathies in children presenting with post-tonsillectomy haemorrhage

Tonsillectomy is often the first haemostatic challenge for a child. Postoperative haemorrhage may therefore represent the first presentation of a child’s underlying bleeding disorder. This study aimed to quantify the rate of occult coagulopathy in patients who had experienced a...

Congenitally anosmic patients do have fewer olfactory foramina

It has been previously established that patients with Kallman’s syndrome (very much associated with anosmia) have a similar number of cribriform plate foramina when compared to controls. As non-invasive CT assessment of the cribriform plate is now possible in cadavers,...

When should that child’s wet ear be operated on?

The team from Birmingham have provided a meta-analysis to answer the question of when to perform a type 1 tympanoplasty on chronic paediatric perforations (under 18 year olds). Forty-five studies were included which resulted in 2609 cases. Closure rate at...

INTEGRATE: Uniting collaborative research in ENT

Exposure to clinical research as a trainee is often sporadic and unstructured, despite it featuring in both the GMC’s Good Medical Practice and the ISCP’s syllabus for all surgical specialities, including otolaryngology [1,2]. The majority of trainees undertake small-scale research...

Don’t smoke after a septoplasty!

This is a retrospective review of 281 patients, all of whom underwent elective septoplasty. Simply put, those who smoked displayed a much higher postoperative septal perforation rate than those who did not. So, some cautionary advice for patients undergoing this...