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The mark of the head and neck surgeon

Like Zorro, the head and neck surgeon leaves their mark. No more so than during parotid surgery. Various modifications have been put forward modifying the classic Blair incision. This latest modification camouflages the pre-tragal scar by running it on to...

How should I excise sinonasal tumours, open or endoscopic? En bloc or piecemeal?

Sinonasal tumours often present late because initial symptoms mimic benign disease. They tend to produce more unilateral nasal symptoms, and patients with advance disease often describe paraesthesia and other cranial neuropathies. They only account for approximately 3% of upper aerodigestive...

Bone bridge conduction device for patients with bilateral microtia-atresia

Management of microtia-atresia requires a multidisciplinary approach. Children normally require bone conduction hearing aid devices very early in life to improve and facilitate speech and language development. At a later stage, when the cranial bones have strengthened and become thicker,...

Vestibular schwannoma surgery and inner ear injuries

Iatrogenic inner ear injury during vestibular schwannoma (VS) surgery ranges between 20% and 30% in the literature. However, there is no up-to-date quantification of such injuries, hence this study. The authors conducted a US-multicentre database search looking for patients who...

Imaging in hyperparathyroidism

Following their caudal migration at eight weeks of development, the parathyroid glands normally locate posterolaterally to the upper pole of the thyroid gland at the level of the cricoid cartilage (superior parathyroid glands arising from the fourth branchial pouch and...

Superior semicircular canal dehiscence: transmastoid obliteration

Sometimes patients with dizziness turn out to have slightly more unusual causes of their problem. Thomas Milner and Georgios Kontorinis describe their technique for managing patients who have a diagnosis of superior canal dehiscence as an identified cause of their...

Two for one forearm flaps

There are many and varied free flaps available for reconstructions. Here is a variant on the workhorse radial free forearm flap. The modification involves a longer, narrower flap that can be rotated back on itself to increase the flap width...

Sleep apnoea in children with craniofacial syndromes

Whilst snoring and obstructive sleep apnoea are relatively common diagnoses in paediatric ENT, children with craniofacial syndromes take the problem to the next level. Robert Nash and Michelle Wyatt describe the Great Ormond Street multidisciplinary approach to treating this complex...

Otolaryngology Head and Neck Surgery: Clinical reference guide - Fourth Edition

This textbook, well known to North American residents, is now in its fourth edition. It has been extensively revised to include more up-to-date topics, such as robotic surgery, sleep medicine and paediatric otolaryngology. Authors Raza Pasha and Justin Golab aim...

Vestibular paroxysmia, diagnostic controversy clarified?

Historically, the cause of vestibular paroxysmia (VP) had been attributed to neurovascular compression of the eighth cranial despite the observation that such compression is very common in asymptomatic subjects. This paper, part of International Classification of Vestibular Disorders (ICVD) by...

The role of imaging in differentiating rare temporal bone neoplasms

This paper provides a useful tool to assist in determining the diagnosis of benign neoplasms of the temporal bone using readily available imaging modalities. Specifically, this group have looked at chondrosarcoma, an expansile hypermetabolic mass lesion usually found in the...

Identifying CN IX and X using endotracheal tube electrodes

This clinical study describes the possible usefulness of endotracheal tube electrodes in monitoring vocal cord function during cerebellopontine angle surgery in 20 patients. Lower cranial nerves, especially IX and X are at risk of injury during skull base surgery although...