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CAD/CAM assisted mandibular reconstruction or freestyle?
The gold standard for the reconstruction of the mandible is a free bone flap and the fibula is commonly used. The fibula is a straight bone and presents considerations and difficulties in the formation of a U-shaped neo-mandible. Computer aided...
An overview of microsurgical reconstruction of the head and neck worldwide
Microsurgical reconstruction is an integral part of the treatment following ablation for malignancy or trauma. Currently there are no clear treatment guidelines following tumour resection. This was recognised a few years ago and in 2008 various collaborative groups were founded...
Margin control using optical techniques in head and neck surgery
Emerging optical techniques such as high-resolution microendoscopy (HRME) are currently being examined for their reliability in discriminating benign from neoplastic epithelium. These techniques may offer the potential to detect the margin of an upper aerodigestive tract tumour in a non-invasive...
Free flap reconstruction in stage three bisphosphonate-related osteonecrosis
There is no widely accepted gold standard for the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Early BRONJ is managed conservatively but there is controversy regarding the treatment of the later stages. Stage three is defined as exposed bone...
Peripheral nerve reconstruction using cell-enhanced acellular nerve grafts
Autologous nerve grafts are the current gold standard for peripheral nerve reconstruction. This systematic review analyses the role of cell-enhanced acellular nerve (ANA) grafts on the regeneration of peripheral nerve injuries. Several studies have been published to examine alternatives to...
An eye-opening resection technique
It is widely accepted that the gold standard treatment of inverted papilloma of the maxillary sinus (IPMS) is endoscopic excision via medical maxillectomy or mega antrostomy, and these approaches can be augmented by a Caldwell-Luc or canine fossa trephination if...
Radiological diagnosis of mastoiditis in patients screened for acoustic neuroma
Magnetic resonance imaging is the ‘gold standard’ for screening patients suspected to have acoustic neuroma. Various abnormalities are picked up through this investigation, one of which, not uncommonly reported, is mastoiditis. This requires referral to otolaryngology and further evaluation. In...
Rib grafts for mandibular reconstruction
Reconstruction of the mandible following ablation requires good bone stock to allow optimal function and the placement of dental implants. In the developed world, vascularised bony flaps are accepted as the gold standard but these may not be widely available...
Salivary pepsin – a simple test for LPR?
A diagnosis of laryngopharyngeal reflux (LPR) can be made on the basis of characteristic symptoms and nasendoscopy findings. Objective tests exist for this condition; for example, 24-hour dual-channel pH-metry which is considered to be the gold standard. Such tests are,...
A cost reducing protocol for magnetic resonance imaging in patients suspected to have acoustic neuroma
Magnetic resonance imaging is the ‘gold standard’ for screening patients suspected to have an acoustic neuroma. However, inappropriate referrals for imaging are not helpful, especially with the growing need to reduce costs. In this study the authors compared two audit...
Does minimally invasive surgery under local anaesthesia have a role in the management of chronic rhinusinusitis?
A formal FESS procedure usually done under local anaesthesia is considered as gold standard in the management of chronic rhinusinusitis. However, success is hampered by a significant recurrence rate of polyps requiring revision surgery, long waiting lists, reluctance of elderly...
