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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...

Local dexamethasone infiltration in tonsillectomy

Intravenous dexamethasone is routinely given during tonsillectomy for its effects on postoperative pain and nausea. This Chinese randomised study divided 240 children undergoing tonsillectomy into three groups, receiving either no steroid, intravenous dexamethasone, or the same amount of dexamethasone infiltrated...

Current management of facial fractures in the preadolescent

This article reviews the trends in management of preadolescent facial fractures – a challenging population due to the need to consider growth, dynamic changes in dentition, and evolving fracture patterns. In summary, conservative management is preferred in all fractures in...

Is it time for cone-beam CTs to replace the traditional orthopantomogram in the primary diagnosis of temporomandibular joint disorders?

Cone-beam CT requires a lower dose of radiation compared to the multidetector CT and provides much more detailed information in 3D about the bony structures of the temporomandibular joint (TMJ) when compared to the traditional orthopantomogram (OPG). In this article...

Treating middle ear conditions in developing countries

This month’s journal issue discussed global health in otolaryngology with this paper focusing on the management of chronic middle ear disease in the developing world. Chronic suppurative otitis media (CSOM) is more common in developing countries. The reason for this...

Tonsillectomy in or out?

Although tonsillectomy is the most common surgical act performed in ENT practice, there is still some concern about the safety of outpatient or day surgery scheduling, especially in adults. Although this has been common practice in many departments for some...

3D-printed temporal bone models - how good can they be?

In the era of increasingly difficult and expensive-to-come-by cadaveric temporal bones with which to practise drilling and learn the complex 3D anatomy of the temporal bone, decent alternatives would be welcome. McMillan et al report a prospective comparison study in...

How best can we manage Samter’s Triad/AERD?

The classic ‘Samter’s Triad’ of asthma, chronic rhinosinusitis with nasal polyposis (CRSwNP), and aspirin sensitivity is now referred to as aspirin-exacerbated respiratory disease (AERD) or non-steroidal anti-inflammatory-exacerbated respiratory disease. We often come across in our rhinology setting, patients with recalcitrant...

The push towards scarless parotid surgery

When dealing with benign parotid pathology, high expectations are placed on the operating surgeon to preserve key neurovascular structures, especially the animating facial nerve, through meticulous dissection. With time, there has been a greater emphasis on improving cosmesis in parotid...

The future of rhinology: What will come first, a radical change in rhinological management or the decimation of the world?

In this article, Simon Gane looks forward to what the future holds, on the presumption he survives. Setting aside the questions of the UK even existing, the NHS still working, or the fact we’ll be commuting to our jobs in...

The hidden enemy of microtia reconstruction: cholesteatoma

Although ear reconstruction for concha-type microtia is generally successful, its frequent association with congenital aural stenosis introduces a hidden risk of cholesteatoma due to disruption of epithelial migration. This negatively affects hearing and reconstructive outcomes. This single-centre retrospective case series...

Armageddon and surgical outcomes

In the excitement of the festive season I am sure many of you will have omitted to commemorate the 60th anniversary of a highly significant world event. According to a small apocalyptic cult led by a Chicago housewife named Dorothy...