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Which factors affect the postoperative CSF leak following endoscopic skull base surgery?

Endoscopic skull base surgery is being increasingly performed worldwide for skull base tumours. Common indications include pituitary tumours, rathke cleft cysts, chordomas, craniopharyngiomas and olfactory neuroblastomas. The most common and important complication following endoscopic skull base surgery is postoperative CSF...

Endoscopic DCR

In this interesting article, our experienced colleagues describe their favoured technique for performing endoscopic DCR and share with us the key steps for a successful outcome. Dacrocystorhinostomy (DCR) was historically performed by ophthalmologists for nasolacrimal obstruction using external techniques. The...

Nasal septal perforation repair

Nasal septal perforation repair has traditionally been a great challenge. Many surgical techniques are described, however the success rate of closure has often been poor. Experience from the use of pedicled vascularised mucosal flaps in skull base surgery has been...

Facial Surgery: Plastic and Reconstructive

Following Professor Cheney’s first popular publication in 1995 on flaps and reconstruction and subsequent second edition, he has now co-edited with Tessa Hadlock a comprehensive two-volume production. They have put together an extensive range of plastic and reconstructive surgery in...

Microvascular surgery - does size matter

Success rates for microvascular free tissue transfer performed for head and neck reconstruction are currently very high. As the recipient vessel diameter decreases, questions of reliability and ease of access are raised. This retrospective analysis looked at 89 flaps in...

Malignant lesions and reconstruction of the pinna

External ear reconstruction can be challenging. Baskaran Ranganathan and Amr Abdelhamid describe how careful assessment, planning and surgery following the subunit principles and reconstructive ladder will ultimately lead to good aesthetic outcomes with restored form and function. The external ear,...

Sellar surgery – when to prepare for repair

Endoscopic sellar surgery, especially for adenomas, is a relatively safe, straightforward surgery with (mostly) reproducible results and few complications. One of the commonest complications is the creation of a CSF leak with the subsequent need for repair (there is usually...

Should we leave a reconstructed auricle exposed?

Microtia results in psychological and functional morbidity and total auricle reconstruction offers the affected individual a more cosmetically pleasing ear. The art of dressing postoperatively can be heterogenous between surgeons. This single-centre retrospective study based in China compared complication rate...

Surgery plus radiotherapy keeps the helical keloid scar away

Keloid scars lead to significant psychological and cosmetic morbidity. As the pinna is a key component of facial cosmesis, pinna keloid scar formation can be aesthetically displeasing. Their stubbornness and high recurrence rate can be challenging to treat. This department,...

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...

Total lower lip reconstruction: a review

Total or near total defects of the lower lip may result from trauma, cancer ablation or congenital causes. Defects usually involve the full thickness and include skin, muscle and mucosa. There are a number of techniques for the one stage...

Use of Elasticated Hooks in Open Rhinoplasty

Introduction Good exposure is an essential requisite in open rhinoplasty and often requires appropriate assistance to aid surgery. Frequently, surgeons lack adequate assistance in theatre and often have to depend on the scrub nurse for retraction. A self-retaining retractor is...