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Preoperative CT checklist (using the ‘CLOSE’ mnemonic) improves identification of anatomical variants for endoscopic sinus surgery

Computed tomography (CT) scans of the paranasal sinuses act as roadmaps for endoscopic sinus surgery (ESS) and careful inspection preoperatively warns the operating surgeon of critical anatomical variants. This study aimed to investigate if implementation of a pre-ESS CT checklist...

How should I excise sinonasal tumours, open or endoscopic? En bloc or piecemeal?

Sinonasal tumours often present late because initial symptoms mimic benign disease. They tend to produce more unilateral nasal symptoms, and patients with advance disease often describe paraesthesia and other cranial neuropathies. They only account for approximately 3% of upper aerodigestive...

What are the best minimal surgical techniques used for concha bullosa?

This prospective endoscopic and radiologic evaluation studied 42 patients who underwent concha bullosa surgery, amounting to a total of 55 conchae surgeries. The patients were allocated consecutively to either of the two groups. The presurgical and one year postsurgical endoscopic...

Comparing patient and surgeon concerns in sinus surgery

This prospective observational study had a total of 180 patients undergoing endoscopic sinus surgery for chronic rhinosinusitis with or without polyposis. Data was analysed using descriptive statistics and analysis of variance. Subjects felt the greatest level of concern regarding potential...

A novel way to reduce postoperative nausea and vomiting

This is an interesting RCT which evaluates the prophylactic effect of bilateral endoscopic injection of local anaesthetic in the sphenopalatine ganglion (SPG) on postoperative nausea and vomiting (PONV). It has a robust design, and is sufficiently powered and blinded, with...

Balloons – more complicated than first thought?

This study describes the complications seen after balloon sinuplasty (BSP) - a commonly performed procedure (particularly in the USA where it is often performed as an office procedure) versus traditional functional endoscopic sinus surgery (FESS). The data source was a...

Double layer graft in endoscopic tympanoplasty

This Turkish retrospective study looked at the success rates following endoscopic tympanoplasty using the double layer graft technique. This involves using a tragal cartilage and perichondrium composite graft and a separate perichondrial graft for closure of the perforation. The crescent...

Is endoscopic approach more precise in addressing failed ventilation system in chronic mucosal ear disease?

Chronic mucosal disease, as opposed to cholesteatoma, is more directly related to failure of the ventilation system involving three channels. Isthmus anticus and isthmus posticus are channels in front and behind the long process of the incus and there is...

QoL post-endoscopic hypophysectomy

This prospective study conducted over four years surveyed more than 300 patients after endoscopic pituitary adenoma resection. The authors used the Anterior Skull Base Questionnaire-35 and the Sinonasal Outcome Test-22, and the scores were analysed for quality of life (QoL)...

Should we be utilising the pre-lacrimal approach for maxillary sinus inverted papilloma?

For some time now, gold standard management of the maxillary sinus inverted papilloma has been endoscopic medial maxillectomy (EMM). Recently the endoscopic prelacrimal recess approach (EPLRA) has been reported to provide good access whilst preserving the nasolacrimal duct and inferior...

Practical training courses for otolaryngology trainees

In this extended Trainee Matters, it’s a pleasure to present a trio of excellent articles with a theme of practical training courses for otolaryngology trainees. Miss Rachel Edmiston, Professor Nirmal Kumar and colleagues have written a valuable guide to setting...

Frederik Dikkers: championing change in laryngology

Prof Dikkers shares the details of his journey into ENT surgery, his dedication to treating laryngeal papillomatosis, and his pioneering advancements in button battery safety. Recurrent respiratory papillomatosis (RRP) is one of the most frustrating conditions managed by laryngologists. There...