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Robot controlled mastoid surgery!

This is a fascinating piece of work by a Korean team developing a human-robot collaborative control. Their model uses image guidance surgery to locate the drill tip’s position. Important structures can be highlighted – in this case the facial nerve....

Risk factors for post laryngectomy fistula

This is a meta-analysis looking at the postoperative pharyngocutaneous fistula rates following total laryngectomy. The authors ended up with 34 studies with about 2500 patients. The most striking finding was that preoperative radiotherapy was a significant risk factor as well...

Should all patients with BPPV have an MRI?

This paper describes an interesting series of 500 patients over a 10-year period with posterior canal BPPV, who had been investigated with MRI. The female to male ratio was 1.6:1 with a mean age of 56. There was a right...

Merocel vs Cutanplast Anal packing

This study compared two different nasal dressings after septoplasty. Seventy-six patients acted as their own controls by having one nostril packed with Merocel and one nostril somewhat improbably with Cutanplast Anal (gelatin sponge). It seems that the gelatin sponge was...

What’s the risk of regrowth with partial (intracapsular) tonsillectomy

Partial (intracapsular) tonsillectomy is enjoying somewhat of a revival offering the potential for less postoperative pain and bleeding whilst relieving the obstructive element. The authors look at 303 patients, 82 of whom had partial tonsillectomy using coblation. They measured pre...

A new septoplasty technique

This article describes a novel septoplasty technique to correct a cartilaginous deflection. Although it took a while to understand it as the operative photographs were not very helpful it is an interesting concept. The author excises an inferior strip and...

Risk factors for post tonsillectomy bleeds

This paper reviews post-tonsillectomy bleeding in 692 patients and attempts to tease out risk factors. The overall bleed rate of 11.6% seems very high. The return to theatre rate was 2.6%. The paper identifies male patients and adult patients as...

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...

Laryngeal cleft in a 66-year-old man!

This is a fascinating case report of a 66-year-old man who presented with a carcinoma of the piriform sinus. During chemoradiotherapy, he developed dyspnoea, dysphagia and aspiration pneumonia. His chemoradiotherapy was stopped and he underwent a pharygnolaryngectomy. When the surgical...

Your voice and your personality

Variations of vocal effort are a normal adaptation to difficult communication situations. However, persistence of these abnormal strategies can lead to various functional dysphonias. In this experiment, the authors tested 41 females aged 18-52. The subjects were asked to instruct...