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An overview of human factors in ENT and anaesthesia
James Bates and Chris Frerk are both passionate about how human factors science can improve safety in healthcare and have co-authored this article describing how communication, ergonomics and other non-technical skills are making operating theatres safer. There is no doubt...The changing landscape of thyroid and parathyroid surgery
How has clinical practice in the management of thyroid and parathyroid disease has evolved in recent years? I perform very few head & neck operations where the patient tells me just one week following surgery that they ‘feel much better’....
Stepwise approach to manage palatal myoclonus successfully
Palatal myoclonic tinnitus (PMT) is a rare condition caused by rhythmic voluntary or involuntary movements of the soft palate, mainly the tensor veli palatini and levator veli palatine muscles. Patients usually present with a ‘clicky’ noise in the ear. Oral...Wound moisture sensing in traumatic wounds
Wounds can be small and unpleasant, or may be large and life-threatening. The skin is a physical and an immunological barrier to infection, and any defect in the integrity of the skin may enable bacterial or fungal invasion. The successful...The role of the maxillo-facial surgeon in the management of skull base malignancy
Whilst ablative surgery remains the principal treatment option for head and neck malignancy, the skull base is the last frontier. The complex anatomy, supreme functionality of the brain, and varied pathology provokes many a detailed discussion in the multidisciplinary team...
Bilateral transposition lip flaps of central upper lip defects
This case series brilliantly explains a novel technique to repair central upper lip deformities at a Moh’s reconstruction referral practice. Most of the current treatment operations advocate a secondary surgery in order to fully restore the philtral columns and the...
Submental island flap to reconstruct the lower lip
The lips are necessary for oral competence, cosmesis, speech and feeding. Non-melanoma cancers can affect the lips, and the lower lips are about 80% more likely to be affected. A large number of these cancers are squamous cell carcinomas. Treatment...
A move away from bony free flaps in reconstruction
Techniques for facial reconstruction have come on in leaps and bounds since the world wars. The use of titanium implants is more recent and the technology for manipulating the metal and how we use it is rapidly developing. Here the...
Free flap reconstruction in stage three bisphosphonate-related osteonecrosis
There is no widely accepted gold standard for the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Early BRONJ is managed conservatively but there is controversy regarding the treatment of the later stages. Stage three is defined as exposed bone...
Nasolabial flap to reconstruct periorbital defects
The authors present a series of 25, mainly geriatric patients that had ablative surgery with complex defects in the paranasal and orbital regions. The paranasal and periorbital regions are extremely important for facial aesthetics and quality of life. The authors...
Delirium post-op
This is a retrospective study from Japan analysing 102 patients who underwent oral cancer resection and free flap reconstruction. Postoperative delirium occurred in a third of these patients. An increased risk was identified in those with high preoperative albumin, postoperative...
