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Linking tooth extraction and snoring
One of the more contemporaneous theories about OSA is that extraction of teeth or other orthodontic treatment during the development of the facial skeleton leads to alteration of bony growth and therefore alteration of the final result. There is evidence...
When should that child’s wet ear be operated on?
The team from Birmingham have provided a meta-analysis to answer the question of when to perform a type 1 tympanoplasty on chronic paediatric perforations (under 18 year olds). Forty-five studies were included which resulted in 2609 cases. Closure rate at...
Scalp reconstruction a new algorithm
Reconstruction of the scalp after acquired defects remains a common challenge for the reconstructive surgeon, especially in light of a history of radiation to the area. Wound healing by secondary intention or with a wound vacuum assisted closure are viable...
Grading dysphagia as a toxicity in treating head and neck cancer
Common Terminology Criteria for Adverse Events (CTCAE) is a system used by clinicians to grade the toxicity of oncology treatments in a standardised manner. Dysphagia is perhaps the most common long-term toxicity of head and neck cancer treatment. Currently, a...
When should we decompress the facial nerve in Bell’s Palsy?
It has been over three decades since Fisch popularised facial nerve (FN) decompression for Bell’s Palsy. Studies further exploring this have been few since, partly due to the major complications that can occur following this type of surgery. The current...
Vascularised tissue in salvage total laryngectomy
Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...
Are ENT surgeons better placed to perform cosmetic ear, nasal and facial procedures?
Cosmetic surgery is an essential component of plastic surgery training and is required in order to CCT. However, the training opportunities in plastic surgery in UK are limited. The current operative requirements for plastic surgery trainees are 100 procedures during...
Is there a role for facial nerve decompression in Ramsay Hunt syndrome?
This is an interesting paper. The authors recommend a transmastoid facial decompression for patients with complete facial nerve paralysis with House Brackman HB 5/6 who do not show any sign of recovery after two weeks of treatment following a diagnosis...
Does Tranexamic acid reduce intraoperative bleeding during FESS?
Intraoperative bleeding during FESS can reduce visibility and obscure important landmarks. This can result in longer operative times, increase risks of complications and even lead to incomplete surgery. Tranexamic acid is a drug which prevents fibrinolysis and stabilises blood clots....
DISE as a rationalising tool for sleep apnoea surgery
This retrospective study on 85 adult obstructive sleep apnoea (OSA) patients provides further interesting information for sleep surgeons. These patients were all investigated with polysomnography (PSG) and drug induced sleep endoscopy (DISE). They all then underwent a simple uvulopalatoplasty with...
Socially appropriate part 1: assessing people with TBI
Social communication disorders are one of the most common and yet most under-addressed sequelae of a traumatic brain injury (TBI). Yet speech and language therapists report a lack of assessment tools and a lack of time to fully assess these...
