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Semi dynamic reconstruction of the lower lip

The main goal of reconstructive surgery for facial paralysis is the restoration of smiling and function of eye closure. The deformity of the lower lip in paralysis is ptosis of the corner of the mouth, eversion of the vermillion and...

Argh! Facial pain! What to do??

We often come across patients with presentation of facial pain, but unless this is sinugenic in origin, our understanding and management of it can often be found wanting. Craniofacial pain is in fact highly complex and encompasses a wide range...

Patient-reported outcome measures in septorhinoplasty

Patient-reported outcome measures (PROMs) are used increasingly in surgical research to quantify the efficacy of surgical interventions. This can help to fill an ‘evidence gap’ where healthcare rationing threatens particular treatments. Procedures aimed at improving quality of life, especially with...

What are the best minimal surgical techniques used for concha bullosa?

This prospective endoscopic and radiologic evaluation studied 42 patients who underwent concha bullosa surgery, amounting to a total of 55 conchae surgeries. The patients were allocated consecutively to either of the two groups. The presurgical and one year postsurgical endoscopic...

Preoperative tumour embolisation

This review article analyses the role of preoperative endovascular tumour embolisation in the treatment of a variety of hypervascular head and neck lesions including juvenile nasal angiofibroma, glomus tumour, carotid body tumours, and meningioma. Although the concept of tumour embolisation...

Nasal peak inspiratory flow (NPIF) as a diagnostic tool for differentiating decongestable from structural nasal obstruction

Identification of the cause of nasal obstruction is critical before surgical intervention such as septoplasty. This study assesses changes in nasal peak inspiratory flow (NPIF) as a tool for discriminating decongestable versus structural obstruction. A cross-sectional study of 52 patients...

Primary ossicular chain reconstruction in open-cavity mastoidectomy

The authors performed a retrospective analysis of 21 patients who had undergone primary reconstruction of the ossicular chain during canal-wall-down mastoidectomy. The ossiculoplasty technique used consisted of removal of the malleus head and division of tensor tympani, and rotation of...

Treatment of olfactory dysfunction

The sense of smell is crucial to our being able to relish food and experience our environment. Olfactory dysfunction has been trivialised or ignored previously, but the negative consequences of the loss of sense of smell are being increasingly highlighted....

Office-based intralesional corticosteroids injections for subglottic stenosis. Is it effective?

Subglottic and proximal tracheal stenosis in adults has three main aetiologies: (a) prolonged endotracheal intubation; (b) idiopathic; (C) rheumatologic related. Endoscopic dilation is the mainstay treatment strategy for subglottic and proximal tracheal stenosis. Its major limitation is restenosis requiring repeated...

Delirium post-op

This is a retrospective study from Japan analysing 102 patients who underwent oral cancer resection and free flap reconstruction. Postoperative delirium occurred in a third of these patients. An increased risk was identified in those with high preoperative albumin, postoperative...

A review of significant issues in the management of obstructive sleep apnoea in children

There are considerable variations in the management of obstructive sleep apnoea in children and this suggests a need for more research and evidence-based information. In this review article, the authors address four key issues. Literature compares tonsillectomy with tonsillotomy, the...

Consequences of tonsillectomy rationing?

This article examines Hospital Episode Statistics and Office for National Statistics data to investigate the change in rates of tonsillectomy and admissions for tonsillitis and its complications, over a 20-year period. Between 1991 and 2011, 44% fewer tonsillectomies were performed....