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A move away from bony free flaps in reconstruction
Techniques for facial reconstruction have come on in leaps and bounds since the world wars. The use of titanium implants is more recent and the technology for manipulating the metal and how we use it is rapidly developing. Here the...
Surgical anatomy for central auditory device implantation
This cadaveric study by researchers in the USA and Japan examined the cerebellopontine angles with the aid of the surgical microscope and 45o endoscope via the retrosigmoid and translabyrinthine approach. Using fibre dissection technique, the ascending auditory pathways between the...
The Impact of sleep endoscopy for paediatric obstructive sleep-disordered breathing
Paediatric obstructive sleep apnoea (OSA) is not always resolved or improved with adenotonsillectomy. Persistent or complex cases of paediatric OSA may be due to sites of obstruction in the airway other than the tonsils and adenoids. Investigation of paediatric obstructive...
Cheek reconstruction following melanoma excision
Malignant melanoma occurs most commonly on the cheek and thus is usually diagnosed early, and rarely needs large reconstructions for advanced disease. This is a retrospective study looking at 26 patients that had undergone treatment for cheek melanomas between 1996...
What about the older adults?
The authors of this paper propose that significant changes in the delivery of services, including speech and language therapy management of swallowing difficulties, may be required. Among the most common causes of dysphagia in older adults are stroke, progressive neurological...
What is the right balance to strike in the management of anaplastic thyroid cancer?
This is a pragmatic article on a difficult and much debated subject. Management of anaplastic thyroid cancer (ATC) can feel like making decisions between a rock and a hard place, and this article suggests one path to help navigate some...
Indication and timing of electrodiagnostic tests in facial palsy
This excellent review describes the benefits and limitations of electrodiagnostic testing for patients with facial paralysis. Tests such as Schirmer, stapedial reflex and electrogustometry have been largely replaced by neurophysiologic tests like nerve excitability test (NET), electroneuronography (ENoG), surface electromyography...
The never-ending vertigo
The authors comment on the Barany Society guidelines for bilateral vestibulopathy (BV). This is one of the murky entities of vestibulogy. By definition, patients will eventually lose vestibular function and don’t experience any vertigo. However, some patients still get recurrent...
Vestibular schwannoma surgery and inner ear injuries
Iatrogenic inner ear injury during vestibular schwannoma (VS) surgery ranges between 20% and 30% in the literature. However, there is no up-to-date quantification of such injuries, hence this study. The authors conducted a US-multicentre database search looking for patients who...
