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Tranexamic acid and blood loss in bimaxillary surgery

This is a randomised double-blind placebo-controlled trial from Thailand to clarify the most effective dose of Tranexamic acid in reducing blood loss during a bimaxillary osteotomy. They confirmed that the dose of 10mg per kg is the most efficacious and...

Keep the condyle if you can

This is a study of 41 patients who underwent benign tumour resection and reconstruction over a four year period. Patients fell into three groups; condyle preserved, condyle sacrificed, condyle frozen in combination with a DCIA free flap. Following this, they...

Power tools dance off

The use of the harmonic scalpel is popular with some head and neck surgeons. This study looked at selective neck dissections for 40 patients with oral cavity carcinoma. They were randomised into harmonic scalpel (HS) use and monopolar electrocautery. The...

Tissue engineered flaps

This article provides a thorough summary of the current techniques available in head and neck reconstruction. It details the challenge of restoration of form and function posed by the shape of the craniofacial skeleton and soft tissue. The introduction on...

Safe distances in the infratemporal fossa

This analysis from China involved 50 enhanced CT datasets to reconstruct the skull, internal carotid artery and the internal jugular vein. The anatomical routes of these vessels were related to the styloid process, height of the pterygoid plates, distance from...

Maxillary osteotomy stability

This systematic review assesses inferior repositioning of the maxilla six months after surgery. Two articles were identified with a total of 22 patients. The repositioning was of a mean of 3.2 to 4.5mm anteriorly and 0.1 to 1.8mm posteriorly. Six...

Bad splits

This is a meta-analysis of reported risk factors of a ‘bad split’ in a sagittal split mandibular osteotomy. They identified 30 observational articles and therefore acknowledged it is based on low quality studies. It is compounded by the definition of...

Carnoy’s and the KOT

This is a retrospective review of 105 patients with keratocystic odontogenic tumours treated over a 23-year period with a mean follow up of 86 months. The recurrence rate was 11.4%. Permanent neuro-sensory deficit of the inferior alveolar nerve 16%. Younger...

What can the anterior cranial fossa fracture pattern tell us?

This assessment involves 81 patients treated between two regional major trauma centres in the UK. Fifty sustained a predominantly anterior directed force and 31 a lateral impact. They found that anterior impacts reduce the incidence of fracture propagated beyond the...

Oesophageal atresia and trachea-oesophageal fistula: a perspective on dysphagia management from Turkey

Children born with oesophageal atresia with or without trachea-oesophageal fistula usually receive early surgical repair to create tension-free anastomosis that facilitates oral feeding. However, many children are at risk of problems related to subsequent dysphagia. This includes respiratory, nutritional, motility...

Should we be doing earlier MRIs in sudden sensorineural hearing loss?

There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....

An alternative device for obstructive sleep apnoea

Continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnoea (OSA), primarily due to the vast amount of short-term evidence in the medical literature it has accrued. The enduring obstacle to CPAP from becoming a treatment option...