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Do adhesions actually cause nasal blockage?

All of us who perform nasal surgery are familiar with the disappointing presence of nasal adhesions (NA) or synechiae in our postop patients. These can often lead to patients deriving less perceived benefit from their surgery than that which they...

How well are we managing epistaxis cases?

Epistaxis constitutes 34.5% of all emergency admissions to otolaryngology departments nation-wide. Presently there are no detailed consensus guidelines for this commonest emergency, and there is tremendous variation of practice. Quite often, non-ENT trained doctors manage this emergency. This paper reviews...

Does endoscopic tympanoplasty give better results than a conventional approach?

This is a retrospective review looking at two groups of patients who had undergone middle ear surgery for chronic otitis media (perforation, retraction pocket/cholesteatoma) either open or endoscopic. Four hundred and five patients underwent open ear surgery and 501 endoscopic,...

Hearing preservation in cochlear implantation – an American cocktail

There has been an increase in hearing preservation cochlear implant (HPCI) surgery over the last decade. Both steroid and L-N-acetylcysteine (NAC) were used and investigated respectively in the past in HPCI surgery. Authors investigated the role of perioperative NAC and...

Comprehensive Techniques in CSF leak repair and skull base reconstruction

This book certainly does what it says on the tin, and covers its subject very comprehensively. Normally a topic covered by a single chapter in a rhinology or skull base surgery textbook, this book offers 17 chapters on all aspects...

The relevance of rhinoplasty and septorhinoplasty from the commissioners

The rising costs of running the National Health Service and its overburdened resources has led to the constant monitoring of the low clinical value treatments. The operations of rhinoplasty and septorhinoplasty inevitably fall into this group and are subject to...

Augmented reality – a quick overview of potential technology

Is that the optic nerve? Where is the carotid? Both questions you would prefer to know the answer to upfront. This article discusses if augmented reality can help us with surgical navigation around the skull base. Although endoscopic skull base...

Intraoperative MRI use during pituitary tumour resection

This article provides an overview of intraoperative MRI (iMRI) use in transphenoidal surgery (TSS) for pituitary tumours. Traditionally imaging of the surgical field during surgery involves intraoperative fluoroscopic imaging or neuronavigation which help to avoid injury to critical structures but...

Salivary gland blues…

Intravenous methylene blue is a well-described method to assist in intraoperative localisation of parathyroid glands. The technique does come with challenges as anybody will know who has had to run adjacent to a theatre-bound trolley to ensure that the infusion...

Otosclerosis - to scan or not to scan?

In an era of insidiously reducing thresholds for investigating patients, Maxwell and colleagues pose an important question: is high-resolution computed tomography (HRCT) prior to stapes surgery for otosclerosis worthwhile? Their practice typically considers HRCT for cases of suspected otosclerosis presenting...

How satisfying can a rhinoplasty be?

Rhinoplasty has seen an exponential rise in its uptake over the last few decades globally, offering patients a way to surgically correct the external appearance of the nose with the aim to improve cosmesis. Whilst the success of the procedure...

Secondary Rhinoplasty by the Global Masters

This well-written, beautifully illustrated two-volume book, along with its accompanying ebook version and videos, provides a comprehensive guide to the approach and techniques in secondary rhinoplasty. It builds on the knowledge and concepts in the world-renowned Dallas Rhinoplasty: Nasal Surgery...