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The Oxford Textbook of Otolaryngology
JGG Ledingham was a famously affable man, the very epitome of the Oxford academic clinician with a legendarily unruffled bedside manner and razor-sharp intellect. He was awarded a personal Chair in Medicine in 1989 and such was his sangfroid, I...Balance and fall prevention in individuals with hearing impairments: clinical insights
Exploring how hearing loss heightens fall risk and how integrated audiologic, vestibular and technological strategies can transform balance care and prevention. Hearing impairment is one of the most common chronic health conditions worldwide, affecting an estimated 466 million people according...
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...
Laryngeal cleft in a 66-year-old man!
This is a fascinating case report of a 66-year-old man who presented with a carcinoma of the piriform sinus. During chemoradiotherapy, he developed dyspnoea, dysphagia and aspiration pneumonia. His chemoradiotherapy was stopped and he underwent a pharygnolaryngectomy. When the surgical...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.
