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Darn it! It’s going to take longer to get good at stapes surgery!
Traditionally, it has been said the learning curve for a particular operation lies between 20 and 30 cases. In stapedotomy, a surgeon is deemed successful and perhaps competent if closure of the air-bone gap (ABG) is reached to within 10dB...
Nasal steroids do not cause ocular problems
This excellent, high quality and detailed systematic review from Australia dispels the myth propagated recently by some poorly designed studies that intranasal corticosteroids cause intraocular problems. A 40 year review of the usual databases found 665 articles and 19 were...
Salivary gland blues…
Intravenous methylene blue is a well-described method to assist in intraoperative localisation of parathyroid glands. The technique does come with challenges as anybody will know who has had to run adjacent to a theatre-bound trolley to ensure that the infusion...
Adenotonsillectomy can improve ADHD and nocturnal enuresis
The link between chronic adenotonsillar hypertrophy (CAH) and behavioural disturbance is well recognised. Several studies have found that CAH has been associated with attention deficit hyperactivity disorder (ADHD) and treatment of CAH may diminish symptoms of ADHD in a subset...
The middle way: treating idiopathic facial nerve palsy
Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...
BPPV duration as a predictor for therapy
Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibuar disorders encountered in the neurotology clinic. The majority of cases of BPPV are due to vestibuar lithiasis in the posterior semicircular canal, but there are reports of cases...
Changes in swallowing function after thyroidectomy
Evaluation of functional impact following thyroidectomy tends to be focused on voice quality. The aim of this study was to document early (seven days postoperatively) and late changes (60 days postop) in swallowing function after thyroidectomy. A preoperative naso-endoscopic evaluation...
Sialendoscopy assisted excision of parotid stones
This is a retrospective paper from China that looks to assess the efficacy and safety of sialendoscopy with a combined transoral or transcutaneous approach for the removal of parotid stones. Sialolithiasis is known to be a cause for obstructive parotid...
Treating keloid scarring with pressure clips following excision: does it work?
Keloid scars can pose a difficult management problem. Whilst not harmful in themselves they can be cosmetically unappealing and lead to social embarrassment and resulting isolation, and following surgical excision they often reoccur. Mechanical pressure is an adjuvant to surgical...
Voice outcomes following extended laser resections for laryngeal cancer
It is now widely accepted that the oncological and voice outcomes following transoral laser microsurgery for early T1a glottic cancers are equivalent to, if not superior to, traditional radiotherapy. Voice outcomes following more extensive resections have not been as frequently...
Surgical voice restoration after laryngopharyngectomy
Voice restoration is one of the key rehabilitative steps after laryngectomy or total laryngopharyngectomy (TLP). Patients who undergo TLP require reconstruction – increasingly commonly with microvascular free flaps. Despite their advantages in terms of fistula rates and swallowing outcomes, these...
