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Random-pattern skin flaps: part 3 - Z-plasty flaps

In this third (see Part 1 here, Part 2 here and Part 4 here) of four articles outlining, in some detail, the practical steps for some important local skin flaps, Christopher Thompson and Miles Bannister describe the Z-plasty; a very...

Modified barium swallow studies: what is the radiation risk?

A modified barium swallow study (MBSS), also called a videofluoroscopy swallowing study uses ionising radiation to assist the clinician in visualising swallowing biomechanics from the oral cavity to the oesophagus. This procedure is currently one of the best methods used...

Early hearing loss detection in low-resource school settings

This review summarises a narrative article examining why childhood hearing loss in low- and middle-income nations remains widely undiagnosed, and outlines strategies to improve detection. The authors highlight that although childhood hearing loss is highly prevalent and clinically significant, many...

The EU Medical Device Regulation (MDR)

Back in May 2017, the EU Medical Device Regulation (MDR 2017/745) entered into force, replacing existing directives: Active Implantable Medical Devices (AIMD) In-vitro Diagnostic Directive (IVDD) Medical Device Directive (MDD) By 26 May 2020, the new regulation will have completed...

Anaesthesia for excision of vestibular schwannomas

The ‘shared airway’ relationship between ENT surgeons and anaesthetists is well documented. But ENT surgery and anaesthesia interact in numerous other ways, particularly in complex skull base surgery. What do our anaesthetic colleagues want us to know about vestibular schwannoma...

Resolving dysphagia – can we distinguish mild dysphagia from no dysphagia?

Many patients with dysphagia following neurological events can and do experience a resolution of their swallowing difficulties, sometimes without any intervention. However, it is challenging for clinicians to distinguish mild dysphagia from no dysphagia. The question of where to draw...

Tactile Sensing and Displays: Haptic Feedback for Minimally Invasive Surgery and Robotics

This book has a catchy title and due to my interest in developing simulation systems for training in surgery I was delighted to be asked to review. However, I found it very hard going and the first few chapters are...

Delayed facial palsy post vestibular schwannoma resection

This article presents findings of a retrospective evaluation of 489 patients who underwent vestibular schwannoma surgery and developed delayed facial palsy. The authors define delayed facial palsy as deterioration of at least two HB grades between postoperative days five and...

Surgical and non-interventional management of laryngomalacia

In this elaborate review article, the authors have described various aspects of laryngomalacia and its surgical management with supraglottoplasty or otherwise, gleaned from an extensive review of the literature which provided evidence or the lack of it in relation to...

Plunging new depths for the treatment of ranulas

Within our scope of practice, we encounter a number of salivary gland pathologies, including the sublingual gland. Clinical signs are often subtle, and even with meticulous surgical management, morbidity can easily occur. Textbooks advocate excision of the gland as the...

Nasal deformity following CPAP injury

Nasal continuous positive airway pressure (nCPAP) is commonly used as a non-invasive alternative to endotracheal intubation and tracheotomy to provide respiratory support to very low birth weight (VLBW) (<1500 g) neonates. Nasal injury is a well recognised complication and figures...

Not so innocent, after all: a meta-analysis of the effects of intranasal corticosteroids on growth

The use of intranasal corticosteroids has revolutionised the management of allergic rhinitis and rhinosinusitis and there is now significant evidence of their safety. The problem with side-effects is that clinical studies are designed to demonstrate efficacy, but are underpowered to...