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Non-autologous graft material in paediatric tympanoplasty – is it as good as temporalis fascia and is it cost-effective?

This retrospective case review looks at the experience of a single unit using a variety of autologous (temporalis fascia, n=292) and non-autologous graft material, n=241 (alloderm (human dermis), biodesign (porcine submucosa, $170-$255) and tutoplast (human pericardium, $350). The average patient...

Transmastoid facial nerve decompression for persistent traumatic facial nerve paralysis

Facial nerve paralysis (FNP) can occur following trauma, with a small number of these patients requiring facial nerve decompression (FND) to aid recovery. The authors shared their experience in decompressing the facial nerve for persistent severe FNP via a transmastoid...

Method of delivery: all topical nasal corticosteroids are not made equal

There is an increasing body of evidence that the role of surgery for chronic rhinosinusitis is to facilitate the delivery of topical medical treatment – most notably, topical corticosteroids. Two recent studies, one using flow dynamics and another one examining...

Using SNOT-22 to predict revision sinus cases

A simple way of predicting which patients will require revision endoscopic surgery does not yet exist. This study, which is a prospective, longitudinal cohort study, part of the UK national audit, aims to predict this by using a relatively simple,...

X-ray vs. intraoperative testing for determining cochlear implant placement

Most cochlear implant centres confirm electrode position after surgery using X-rays to ensure optimal electrode placement. As well as transorbital view X-rays, this team check placement using impedance measures and neural response telemetry (NRT) performed intraoperatively. The former indicates whether...

CT and intraoperative nerve monitoring to identify non-recurrent laryngeal nerve during thyroid surgery

A non-recurrent laryngeal nerve (NRLN) is a rare (incidence 0.3% to 1.3%) anatomical variant that results in a higher rate of vocal cord palsy following thyroid surgery. This team from China examined the utility of preoperative CT and intraoperative nerve...

Otolaryngology Head and Neck Surgery: Clinical reference guide - Fourth Edition

This textbook, well known to North American residents, is now in its fourth edition. It has been extensively revised to include more up-to-date topics, such as robotic surgery, sleep medicine and paediatric otolaryngology. Authors Raza Pasha and Justin Golab aim...

Managing high flow head and neck arteriovenous malformations (AVM)

Vascular malformations are lesions where the traditional network of capillaries linking arteries and veins are lacking. Patients usually present with bleeding, pain, disfigurement and tissue expansion and destruction. High flow lesions can be challenging to manage in the head and...

More than words: looking at all the evidence

Evidence based practice (EBP) is a three-pillared approach whereby information on the research evidence, factors relating to the patient and clinical experience are all considered to inform a care decision. Unfortunately, there is frequently very little research evidence to inform...