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Challenges in paediatric airway management

Paediatric airway emergencies are high-stakes, but training, simulation and updated guidelines help ENT teams manage risks and build confidence. Congratulations to the ENT Masterclass® on its forthcoming 20th birthday. Over the past two decades, Shahed Quraishi has grown it to...

How will our grandchildren view COVID-19?

Alan Johnson, known to our readers as the former President of ENT UK, gives us his thoughts on the COVID pandemic, looking at it through the lens of other health crises. As I write, COVID-19 is displacing almost all other...

Covid-19 Tips and insights

The following blog articles have been kindly provided by Eric Levi. For more from Eric Levi, visit https://ericlevi.com/blog/ COVID19 affects everyone Posted on 01/04/2020 by Eric Levi Here’s a report from the Center for Disease Control and Prevention looking at...

Shifting paradigms – how a visionary can change a specialty

The Tarabichi-Stammberger Ear and Sinus Institute came about because of a close working relationship and friendship between two senior figures in the specialty. Professor Muaaz Tarabichi tells us the story. My first meeting with Heinz Stammberger was in 1988 in...

Random-pattern skin flaps: part 4 - transposition flaps

In the final part of our series on local skin flaps (see Part 1, Part 2 and Part 3) in ENT, the authors describe the usefulness of the transposition-type flap and highlight some examples. Rotational advancement flap Useful for defects...

Current management of unilateral sporadic vestibular schwannoma

Vestibular schwannoma is the commonest tumour of the cerebellopontine angle (80%) and accounts for around 8% of all intracranial tumours. The commonest primary presenting symptoms are audio vestibular. Hearing health professionals are often the first contact for patients with potential symptoms of vestibular schwannoma, with the majority then being seen and diagnosed by otorhinolaryngologists.

To monitor the nerves or not?

Whilst intraoperative nerve monitoring has become the standard of care for mastoid and parotid surgery, its benefit in thyroid surgery remains unclear. In the UK NICE was agnostic on the subject in 2008, stating that it was potentially helpful and...

What are the non-inflammatory causes of a conductive loss?

This retrospective study looked at patients with an intact tympanic membrane with non-inflammatory causes – i.e. otitis media and cholesteotoma. They document their findings based on exploratory tympanotomy. They operated depending on the findings with either a stapedectomy or a...

Robot controlled mastoid surgery!

This is a fascinating piece of work by a Korean team developing a human-robot collaborative control. Their model uses image guidance surgery to locate the drill tip’s position. Important structures can be highlighted – in this case the facial nerve....

Risk factors for post laryngectomy fistula

This is a meta-analysis looking at the postoperative pharyngocutaneous fistula rates following total laryngectomy. The authors ended up with 34 studies with about 2500 patients. The most striking finding was that preoperative radiotherapy was a significant risk factor as well...

What’s the risk of regrowth with partial (intracapsular) tonsillectomy

Partial (intracapsular) tonsillectomy is enjoying somewhat of a revival offering the potential for less postoperative pain and bleeding whilst relieving the obstructive element. The authors look at 303 patients, 82 of whom had partial tonsillectomy using coblation. They measured pre...

Risk factors for post tonsillectomy bleeds

This paper reviews post-tonsillectomy bleeding in 692 patients and attempts to tease out risk factors. The overall bleed rate of 11.6% seems very high. The return to theatre rate was 2.6%. The paper identifies male patients and adult patients as...