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Is there a ‘best’ ventilation tube?
Studies on grommet materials and sizes are not exactly new but this was a well-designed randomized study in Sweden with some useful findings. The extrusion rate and complications associated with four different ventilation tubes (grommets) were assessed prospectively in 400...
What is the evidence for duration of antibiotic prophylaxis in head and neck free-flap cases?
The topic of this systematic review is one which is commonly heard in discussions between microbiologists and head and neck surgeons – what is the evidence for antibiotic prophylaxis in clean-contaminated free-flap cases, and crucially, how long should antibiotics be...
Facial reconstruction with polyethylene implants
Planning reconstructive surgery for complex craniofacial defects challenges even the most experienced of surgeons. In most cases surgery is undertaken to improve anatomical functioning. However the anatomical structure of these regions is also critical to facial aesthetics and patient satisfaction...
Measuring the ‘impact’ of preoperative immunonutrition
Using preoperative nutritional supplements as part of ‘enhanced recovery’ in surgical patients is not a new concept. This interesting paper looks at the latest development in optimising patients undergoing head and neck oncological surgery. Immunonutrition (Nestle’s ‘Oral Impact’ in this...
Combined endoscopic and transcutaneous approach for removal of parotid stones
The authors describe a small case series (n=8) of patients with obstructive symptoms from sialolithiasis of the parotid gland. A combined endoscopic and transcutaneous approach was used. The position of the stone in Stensen’s duct was identified by endoscopic transillumination....
Gardasil vaccination – an effective adjuvant therapy for RRP?
The clinical manifestations of recurrent respiratory papillomatosis (RRP) can vary hugely from individual to individual. Whilst some affected children will outgrow the disease, a subset of patients will experience frequent recurrences and require multiple surgical procedures over the course of...
Experience of the Sophono transcutaneous bone conduction system
This article is a frank discussion of the authors’ experience implanting these devices. The principle of the device is surgical implantation of a bilobed magnet within a bony well in the cranium (similar position to BAHA). The implant is a...
Consider PCR testing in culture negative necrotising otitis externa
Necrotising otitis externa (NOE) often does not yield identification of a causative organism to treat although in 90% of cases it is a member of the pseudomonas species. The incidence of fungal NOE is not to be forgotten and this...Random-pattern skin flaps: part 2 - rhomboid and bilobed flaps
In the second of our series on local skin flaps (see Part 1 here, Part 3 here and Part 4 here), the authors describe more techniques and examples of various skin flaps that trainees should find very interesting. Rhomboid flap...
Scott-Brown’s Essential Otorhinolaryngology, Head and Neck Surgery
The three-volume Scott-Brown’s Otorhinolaryngology Head and Neck Surgery is arguably the definitive encyclopaedia of ENT. Its comprehensive nature, however, limits its utility when preparing for examinations. The authors, in creating an “essential” version, have managed to produce an ideal textbook...
Coupler microvascular anastomoses: how good?
This paper is written by a group of reconstructive surgeons and a school of computing. The study used computational fluid dynamics to model blood flow through idealised sutured and coupled vessels, to investigate if differing anastomotic techniques affect intravascular blood...
