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The hidden enemy of microtia reconstruction: cholesteatoma

Although ear reconstruction for concha-type microtia is generally successful, its frequent association with congenital aural stenosis introduces a hidden risk of cholesteatoma due to disruption of epithelial migration. This negatively affects hearing and reconstructive outcomes. This single-centre retrospective case series...

Botulinum toxin in ENT

This comprehensive review neatly summarises non-cosmetic uses of botulinum toxin within otorhinolaryngology, it is perhaps easy to forget the medical use of botulinum toxin has now been approved for the last thirty years. Its overall safety profile places it as...

Resection margins in head and neck surgery

Although an increasing proportion of head and neck malignancies are treated with non-surgical modalities, when surgery is undertaken an incomplete clearance results in significantly worse prognosis. However, the intraoperative assessment of an adequate margin is difficult. The personal practice of...

Classification and assessment of midfacial fractures; no more Le Fort facial fractures

There is some evidence that severe or complex midfacial or orbital fractures have declined over the last decade. Interestingly there is also evidence of an increase in road traffic accidents but a decrease in facial injuries. This is possibly attributed...

Transnasal oesphagoscopy

In this useful and practical article, the authors describe their use of transnasal oesophagoscopy, including the range of clinical scenarios in which it is used. What is TNO? Transnasal oesphagoscopy (TNO) is a technique that can be used in the...

Mastoid fistula closure

This article describes a clear and useful technique for the repair of a troublesome mastoid fistula. The clear instructions make this easy to apply in daily practice. Mastoid fistula is a rare condition whereby an abnormal connection develops between a...

What Plug?

For decades, audiologists have encouraged people to wear hearing protection when they attend concerts. Traditionally, the most accessible options have been foam plugs, which have limited appeal due to their poor sound quality. Disposable foam plugs absorb high frequency sounds...

Another use for Tisseel – plugging of the round window

After insertion of a cochlear implant electrode through the round window, there are several methods of sealing the perilymph leak and in my experience fascia (with varying amounts of attached muscle) seems to be most commonly used. Stephen O’Leary’s group...

Running a post-COVID smell clinic

Over the past year, much of our effort as a speciality has been directed towards crisis management and keeping services afloat. Our practice has changed in untold ways, but unprecedented numbers of patients with smell disorders will increasingly require our...

Transoral endoscopic thyroidectomy / parathyroidectomy – a new approach

Historically, scarless surgery has been popular in certain cultures. But is it gaining traction around the world? A UK team tell us more. Background Alternative, remote access approaches to thyroidectomy and parathyroidectomy are increasing in popularity, the newest of these...

A new criterion for diagnosing chronic tonsillitis?

It is essential to establish the diagnosis of recurrent tonsillitis in patients undergoing tonsillectomy. This is based mainly on history which itself can be inaccurate and is supported by clinical findings which are not truly specific. There seems to be...

Endoscopic excision of cholesteatoma

In this article Vikranth Visvanathan describes an exciting development on the use of endoscopic technology in complex otological practice. Transcanal endoscopic ear surgery (TEES) is rapidly evolving as a recognised method of addressing middle ear and mastoid pathology. Since its...