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Microbiome changes after endoscopic sinus surgery: all is not what it seems

As we keep fighting a losing battle with bacteria and antibiotics, it becomes clear that it is not about killing bacteria, not even diminishing the bacterial load, but rather about shifting the different types of bacteria that colonise and live...

Early cochlear implant activation and its effects on the cochlea

In this article, Alhabib et al consider the changes to electrode impedance with early device activation (day one) compared to conventional activation (day 30). Activation at day 30 is a cautious approach, which has been popular for many years. However,...

Robotic Head and Neck Surgery: An Anatomical and Surgical Atlas

I was excited to receive and review this book. Unfortunately I was disappointed to discover the strange paperback spirally bound exterior, which the publisher’s website states makes it robust. It looks anything but robust and, as an intended textbook to...

Skull Base Surgery: Strategies

This book sets out to highlight the decision-making process in this most complex and technically demanding area of surgical practice. Its aim, as described in the foreword, is to show the “decision making process of choosing and executing a surgical...

Adenoidal hypertrophy in children with allergic rhinitis

Nasal congestion in children with allergic rhinitis can be confounded by adenoidal hypertrophy. This retrospective Turkish study examines this association in more detail. The sample studied was 566 children (age 2-18) that were diagnosed (based on ARIA guidelines) and treated...

Outpatient closure of CSF leaks: a good idea or a step too far?

After day-case septoplasty, day case thyroidectomy, now day case CSF leak repair – has the pendulum moved too far? The authors put forward a convincing case for what, only 10 years ago, would have sounded like a provocation. They quote...

Approach to the orbital floor: which is better?

During skeletal surgery sufficient exposure is key – often a direct approach through the overlying tissues is the easiest route. In the face, however, as the scar would be readily visible, approaches are designed to hide this. Surgical access to...

Voice change after total thyroidectomy with intact laryngeal nerves – a common but temporary problem

It has been reported that up to 87% of patients have a degree of voice dysfunction after thyroidectomy, even when the laryngeal nerves are preserved. Postoperative inflammation, laryngeal oedema due to vascular congestion, direct damage to the cricothyroid muscles and...

Persistent dysphonia due to cricothyroid muscle dystonia – should we be requesting laryngeal EMGs for non-resolving ‘functional’ dysphonia?

This article is an interesting report of a case of persistent voice problems affecting a 43-year-old physician that significantly compromised her ability to converse and communicate at work. Specifically, she had a fluctuating voice quality that would ‘choke off’, combined...