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Radiology and sinus disease: “the ever-evolving landscape”
Computed tomography (CT) remains the imaging modality of choice in assessment of patients with symptoms of chronic rhinosinusitis resistant to conservative treatment. In the last 10 years, CT technology has seen significant advances with the development and integration of multi-detector...
Parathyroid pearls
This article serves to deliver some pearls of wisdom in parathyroid surgery for the ‘low volume parathyroid surgeon’. They have been divided into those relating to the preoperative diagnosis, imaging and localisation techniques and surgical difficulties. Recognised sources of error...
Salivary gland blues…
Intravenous methylene blue is a well-described method to assist in intraoperative localisation of parathyroid glands. The technique does come with challenges as anybody will know who has had to run adjacent to a theatre-bound trolley to ensure that the infusion...
CSF leak – endoscopic or open repair?
Cerebrospinal fluid (CSF) rhinorrhoea is well known to the ENT surgeon. It commonly occurs secondary to a predisposing event such as accidental or iatrogenic trauma. When it occurs spontaneously, it can be associated with benign intracranial hypertension. The commonest CSF...
Which cross-over frequency is best for electro-acoustic stimulation?
Advances in technology and improved soft surgical techniques have led to individuals with better hearing thresholds, especially at the low frequencies, becoming candidates for cochlear implants (CI). Surgeons are more confident that residual hearing can be preserved thus making those...
Cough no more?
The challenge of the ‘unexplained chronic cough’ that just will not go away is a challenge that frustrates many of us. Often patients have seen respiratory, upper GI and eventually they see you as the last resort! Is behavioural therapy...
Improving the temporal contour in reconstruction
A feature of the temporalis flap is the sunken contour left behind. This group from Japan present a variation for filling defects for which we would traditionally use a temporalis muscle containing. The laterally based peri-cranial flap they present uses...
A move away from bony free flaps in reconstruction
Techniques for facial reconstruction have come on in leaps and bounds since the world wars. The use of titanium implants is more recent and the technology for manipulating the metal and how we use it is rapidly developing. Here the...
A modification of the crescentic flap for nasal skin reconstruction
Non-melanoma skin cancers are the most frequent skin tumours and in over 25% of cases affect the nose. Following excision, the reconstruction may be challenging. Reconstruction aims to preserve the anatomical units, nasal functions and also an aesthetic final outcome....
Preserving hearing in NF2 patients
Neurofibromatosis type 2 (NF2) is known to result in bilateral hearing loss, even when there is no significant tumour growth. The cause is postulated to be multifactorial: stretching and compression of the cochlear nerve by the tumour, impairment of labyrinthine...
Voice issues in transgender individuals
Recently, former decathlete and TV personality, Bruce Jenner, admitted that he is transgender, thereby becoming the most famous and vocal advocate for transgender issues. Transgender refers to female to male or male to female identification. In either case, voice modification...
