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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...

Auditory processing in children with unilateral hearing loss

It is a common assumption that unilateral hearing loss (UHL) in children is of little consequence because appropriate development of speech and language can still occur with one normal hearing ear. Recent studies, however, suggest that there are significant differences...

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...

A new era in the treatment of recalcitrant nasal polyps?

Chronic rhinosinusitis with nasal polyps (CRSwNP) can be difficult to treat effectively in patients with aggressive or recalcitrant disease. Omalizumab (Xolair) is a monoclonal anti-IgE antibody with proven benefits for patients with moderate/severe asthma and CRSwNP, but this study looks...

Painful temporomandibular joints

This paper is a meta-analysis of randomised controlled trials comparing arthrocentesis with conservative management in painful and restricted mouth opening temporomandibular joint symptoms. Temporomandibular joint dysfunction comprises a spectrum of disorders commonly involving facial pain and loss of oral function...

Helmets make a difference in bicycle injuries

This is a meta-analysis of maxillofacial injuries arising from riding a bicycle. The incidence of maxillofacial fractures in cycling accidents varies from 3-20% and, whilst the effectiveness of helmets in preventing traumatic brain injuries is well known, their protective effect...

Tympanometry with cochlear implants

Multifrequency and multicomponent tympanometry enables evaluation of minute changes in the middle ear system as well as changes in resonant frequency. Change in resonant frequency would indicate a change in the natural characteristics of the middle ear, such as mass...

Posterior nasal neurectomy – long-term data shows tailing off of benefits but still improvement after three years

It is well understood that allergic rhinitis has a very detrimental effect on quality of life for afflicted patients. This study looks at patients with allergic rhinitis but no other associated sinonasal or respiratory diagnoses. Patients with a history of...

Composing with Meniere’s disease: a personal reflection

Is a fluctuating hearing loss and composing music incompatible? Professor Andrew Hugill discusses his personal experience of Meniere’s disease and the work that has developed as a result of the condition. As I write this article, I am in the...

Global recognition for the work of Professor Mahmood Bhutta

Professor Mahmood Bhutta, Chair of ENT Surgery and Professor of Sustainable Healthcare at Brighton and Sussex Medical School, University of Sussex, is the recipient of both a prestigious international award and a grant for his pioneering work on ear disease around the world.