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How rare is vocal fold paralysis after spinal and epidural anaesthesia – should we be more concerned?

The authors present an unusual case of right vocal fold paralysis. Their patient was a 38-year-old woman who experienced new onset dysphonia following neuraxial anaesthesia (NA) for a caesarean section. Flexible nasendoscopy showed a right VFP with fixation in the...

The future of inner ear drug delivery

The techniques for delivering drugs to the inner ear system are evolving. Jeffrey Harris considers the myths, the facts and the potential for drug delivery innovations and how they can improve tomorrow’s hearing outcomes. The inner ear’s delicate membranous structure,...

Radiology and paediatric neck lumps

This is a comprehensive article examining the modalities available for children presenting with suspected congenital neck lumps. Each modality is explained in turn, with pros and cons highlighted, but also in the context of the emergency patient and the elective....

A comparison of same day with staged bilateral cartilage graft tympanoplasty for tubotympanic CSOM

This randomised, controlled study compares the tympanoplasty outcomes in two groups of patients: one undergoing bilateral tympanoplasty on the same day (18 patients, 36 ears) and the other having the same procedure done on different days, with a gap of...

The double-half bilobed flap or traditional bilobed flap: which is better?

Reconstruction of the nasal tip following ablative surgery can be taxing. The nasal tip is a very visible area with largely immovable skin and reconstruction needs an appreciation of the various subunits to achieve best results. The traditional superiorly based...

When to treat a fractured mandible?

This is a prospective study from Brisbane of 215 patients with a total of 359 fractures of the mandible. Nine outcome variables were analysed with a further 19 included to adjust for potential confounding. Treatment delay was found not to...

Inpatient or outpatient thyroidectomy?

This systematic review and meta-analysis discusses the safety of hemithyroidectomy in an outpatient vis-à-vis an inpatient setting. Thyroidectomy has traditionally been performed as an inpatient procedure. Currently, an increasing number of surgeons are performing thyroidectomy in outpatient settings. The main...

Wisdom teeth and mandibular osteotomies

This is a systemic review and meta-analysis from Italy and Brazil where they try to clarify the role of wisdom teeth and complications in a sagittal split mandibular osteotomy. Whilst, like many other papers, they outline the quality of evidence...

How to manage the cheek in gender affirming surgery

This publication discusses cheek augmentation surgery related to gender-affirming facial surgery. The publication describes the difference between the common male cheek anatomy and the desired ideal feminine appearance and how to achieve it. In the author’s experience, gender-affirming surgery patients...

Day case orthognathic surgery

This paper analyses whether patient safety is maintained when orthognathic surgery is performed as an outpatient. This Swedish paper reviewed 165 patients, 107 of whom were to have what was termed outpatient care, and of which 101 (94%) were able...

Eosinophilic complications during dupilumab therapy

Dupilumab is a humanised monoclonal antibody that targets type 2 inflammation by blocking IL-4 and IL-13 signalling. Reported adverse events from its use include injection site erythema, conjunctivitis, arthralgia and hypereosinophilia. The potential for more severe eosinophilic-related complications such as...

Is there a ‘best’ ventilation tube?

Studies on grommet materials and sizes are not exactly new but this was a well-designed randomized study in Sweden with some useful findings. The extrusion rate and complications associated with four different ventilation tubes (grommets) were assessed prospectively in 400...