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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...
DIY Epley manoeuvre
This is an interesting paper that looks at getting patients to do their own particle repositioning manoeuvre (PRM) after having it done by a clinician (‘Epley’ to you and me although there are some slight differences) once a week for...
Zinc and rhinosinusitis
Patients with chronic rhinosinusitis (CRS) in general, and those with nasal polyps (CRSwNP) in particular, have been shown to have down-regulation of tight junction genes. Zinc, on the other hand, is well-known for its role in immune regulation and deficiency...
The relevance of rhinoplasty and septorhinoplasty from the commissioners
The rising costs of running the National Health Service and its overburdened resources has led to the constant monitoring of the low clinical value treatments. The operations of rhinoplasty and septorhinoplasty inevitably fall into this group and are subject to...
Systemic steroid therapy for reduction of macrophage migration inhibition factor in the control of nasal polyposis
It is believed that macrophage migration inhibitory factor mediates inflammation by stimulating the release of other pro-inflammatory cytokines. The use of systemic steroids in control of nasal polyposis is an established treatment. In this study the authors have aimed at...
Can we predict risk of adverse events preoperatively in patients undergoing head and neck cancer surgery?
Ed’s Choice reviews a paper aiming to create a reliable index to predict postoperative outcomes in head and neck cancer patients. This interesting study identifies variables that may assist in risk assessing prospective surgical candidates. There have been a few...What’s new in hearing aid technology? Requisites for successful implementation of eHealth in hearing health care
Like Eeyore in AA Milne’s Winnie the Pooh stories it appears we all will soon have a personal cloud, but unlike Eeyore this will be something to celebrate! The future of hearing aid technology is in the cloud argues Uwe...ENT in this issue...Multidisciplinary Teams
Joanne Rimmer, MBBS, MA(Hons) Cantab, FRCS(ORL-HNS), FRACS, Consultant Otolaryngologist / Rhinologist, Monash Health; Honorary Senior Lecturer, Department of Surgery, Monash University, Melbourne, Australia. E: rimmer.joanne@gmail.com The multidisciplinary team (MDT) has long been regarded as the gold standard in cancer care,...
Bile acids and pharyngeal malignancy
Laryngopharyngeal reflux is a commonly described condition. There is strong evidence linking gastro-oesophageal reflux with oesophageal carcinomas. Gastric refluxate consists of gastric acid, pepsin and bile acids. The roles of pepsin and acidic conditions in the development of laryngopharyngeal carcinoma...
Unilateral vocal cord mobility impairment and laryngopulmonary physiology
The concept of iatrogenic recurrent laryngeal nerve injury following thyroid surgery is often considered with respect to voice change but its potential impact on airway physiology has thus far not been evaluated. A cross-sectional observational study reviewed 21 patients with...
What’s the risk of regrowth with partial (intracapsular) tonsillectomy
Partial (intracapsular) tonsillectomy is enjoying somewhat of a revival offering the potential for less postoperative pain and bleeding whilst relieving the obstructive element. The authors look at 303 patients, 82 of whom had partial tonsillectomy using coblation. They measured pre...
