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Evidence based guidelines for ONS treatment in occipital neuralgia

Occipital neuralgia (ON) can flummox otolaryngologists especially when it follows mastoid surgery. The paroxysms of sharp, electrical pain originating from the occiput can extend along the posterior aspect of the scalp and even up to the mastoid. Although the aetiology...

Endoscopic ear surgery in children

The benefits of endoscopes in otologic surgery, which have become increasingly widely appreciated in recent years, are very well suited to the management of paediatric middle ear disease. Although one might imagine that the smaller ear canal of a child...

Theory of mind and deaf children

Theory of mind relates to a person’s ability to understand the perspectives of others, to be aware that they may differ from one’s own perspectives and the ability to use this knowledge to navigate social situations. Dr Helen Chilton explores...

Join us at CI2023

Registration is now open for CI2023: Cochlear Implants in Children and Adults, 7-10 June, in Dallas, Texas, USA, with early bird rates until 7 April 2023. The conference will explore current and emerging topics for CI patients across the lifespan....

A multidisciplinary approach to the management of frontal sinus fracture

Frontal sinus fractures account for about 5% of all facial trauma. Fractures of the posterior wall may result in cerebrospinal fluid (CSF) leak and meningitis, while obstruction of the outflow tract can cause sinusitis and mucocele formation. However, there are...

Outpatient closure of CSF leaks: a good idea or a step too far?

After day-case septoplasty, day case thyroidectomy, now day case CSF leak repair – has the pendulum moved too far? The authors put forward a convincing case for what, only 10 years ago, would have sounded like a provocation. They quote...

Laser for active mucosal chronic otitis media

Active mucosal chronic otitis media (COM) is a condition characterised by otorrhoea secondary to chronic inflammation of the middle ear and mastoid mucosa associated with granulations and a tympanic membrane perforation. Surgical intervention is often required, but concurrent mastoidectomy with...

What is the evidence for duration of antibiotic prophylaxis in head and neck free-flap cases?

The topic of this systematic review is one which is commonly heard in discussions between microbiologists and head and neck surgeons – what is the evidence for antibiotic prophylaxis in clean-contaminated free-flap cases, and crucially, how long should antibiotics be...

Measuring the ‘impact’ of preoperative immunonutrition

Using preoperative nutritional supplements as part of ‘enhanced recovery’ in surgical patients is not a new concept. This interesting paper looks at the latest development in optimising patients undergoing head and neck oncological surgery. Immunonutrition (Nestle’s ‘Oral Impact’ in this...

Combined endoscopic and transcutaneous approach for removal of parotid stones

The authors describe a small case series (n=8) of patients with obstructive symptoms from sialolithiasis of the parotid gland. A combined endoscopic and transcutaneous approach was used. The position of the stone in Stensen’s duct was identified by endoscopic transillumination....

Gardasil vaccination – an effective adjuvant therapy for RRP?

The clinical manifestations of recurrent respiratory papillomatosis (RRP) can vary hugely from individual to individual. Whilst some affected children will outgrow the disease, a subset of patients will experience frequent recurrences and require multiple surgical procedures over the course of...

Consider PCR testing in culture negative necrotising otitis externa

Necrotising otitis externa (NOE) often does not yield identification of a causative organism to treat although in 90% of cases it is a member of the pseudomonas species. The incidence of fungal NOE is not to be forgotten and this...