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Microvascular surgery - does size matter
Success rates for microvascular free tissue transfer performed for head and neck reconstruction are currently very high. As the recipient vessel diameter decreases, questions of reliability and ease of access are raised. This retrospective analysis looked at 89 flaps in...
Adjuvant intratympanic steroid therapy in sudden sensorineural hearing loss
Sudden sensorineural hearing loss (SNHL) means abrupt hearing loss by 30dB affecting three consecutive frequencies within 72 hours. This is treated by high tapering doses of systemic steroids, the role of which is controversial and fraught with possible complications in...
Peritonsillar abscess - an indication for tonsillectomy?
Extension of infection beyond the tonsil results in a peritonsillar abscess and is a frequent emergency presentation in otolaryngology. In many places one episode of peritonsillar abscess is not considered an indication for emergency or interval tonsillectomy and future episodes...
Hearing aids or grommets for children with OME?
Otitis media with effusion is a highly prevalent condition in children and recurrence often occurs after surgical treatment with grommets. Repeated grommet insertion has its own problems of infection, perforation and scarring of the tympanic membranes, and continuity of providing...
Semi dynamic reconstruction of the lower lip
The main goal of reconstructive surgery for facial paralysis is the restoration of smiling and function of eye closure. The deformity of the lower lip in paralysis is ptosis of the corner of the mouth, eversion of the vermillion and...
A new flap for the perinasal region
Perinasal defects are most commonly caused by tumour extirpation or trauma. There are a number of methods to reconstruct the defect, and the method chosen depends on the size of the defect and other patient considerations. When the defect is...
Vestibular migraine – the story so far and the work still to do
This interesting discussion paper begins with an overview of the background to the development of vestibular migraine as a separate diagnostic category. It discusses in some depth the diagnostic uncertainties in the context of an entity without a biomarker and...
Surgery for drooling
This paper looks at the surgical options for sialorrhoea once the first two options of behavioural and physiotherapy interventions and pharmacotherapy have been exhausted. The social impact of sialorrhoea on patients and their families is significant and often lifelong therefore...
When ears go bad
Whilst rare, squamous cell carcinoma is the commonest primary malignancy of the temporal bone and is discussed in this review article. This tumour frequently presents with otalgia, ottorhoea and hearing loss; less commonly, with facial palsy or parotid mass. Investigations...
Clonidine based vs Remifentanil based hypotensive anaesthesia in FESS
A study investigating the use of clonidine preoperatively in FESS surgery. A double blinded trial of 47 patients in Barcelona randomised into receiving clonidine (20 minutes preoperatively) versus Remifentanil (continuous infusion). Propofol and fentanyl were used for induction and then...
Total lower lip reconstruction: a review
Total or near total defects of the lower lip may result from trauma, cancer ablation or congenital causes. Defects usually involve the full thickness and include skin, muscle and mucosa. There are a number of techniques for the one stage...
