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Evidence based practice in paediatric audiology

Audiology, like most of the health sciences professions, has been working on integrating evidence-based practice principles since the mid-1990s [1]. Professional organisations and regulatory colleges have produced evidence-based clinical practice guidelines, disseminated them to audiologists and collaborated with practitioners to...

Blindness after orthognathic surgery

This is a case report and review of the literature of this rare, but well recognised alarming complication. The authors discuss the possible mechanisms, suggesting that it does not arise from a direct injury to the optic nerve and is...

Long-term outcomes after (adeno) tonsillectomy

Patient-reported outcome measures (PROMs) are used increasingly to fill an ‘evidence gap’ where healthcare rationing threatens particular treatments. Tonsillectomy is a long-established and effective treatment for recurrent tonsillitis and obstructive sleep apnoea (OSA) in children. The T-14 outcome measure examines...

Malignant craniopharyngiomas

Craniopharyngiomas are successfully managed with surgery and / or adjuvant chemoradiotherapy. The transnasal endoscopic route has become increasingly utilised in the management of these challenging tumours. This paper reviews 23 cases from the literature of the rarely reported malignant transformation....

Maxillomandibular advancement and airway morphology

This is a cadaveric study comparing alterations in airway volume. Seven advancements of the maxillomandibular complex were undertaken, each with a 2 mm incremental advancement being scanned with a total of eight scans per cadaver. They showed that comparisons between...

Innovation in medical product technologies

There is a point in all innovation projects where the clinician has exhausted their knowledge and needs expert help to create a prototype. Mark Prince, Design Engineer, discusses this phase of the project and how engineers’ analytical thinking brings a...

Middle Ear and Mastoid Surgery

I enjoyed reading Middle Ear and Mastoid Surgery by Sanna et al. The authors are to be commended on the excellence of the illustrations within this text, both in schematic line drawings and operative images. I found both to be...

Three-dimensional endoscopy for sinonasal procedures: is it really better?

In this interesting study the authors looked at the efficacy of two-dimensional (2D) versus 3D high-definition endoscopes in novice users, not those already trained in 2D. Ninety-two medical students used 2D and 3D endoscopes to complete two validated tasks and...

Tonsillectomy in or out?

Although tonsillectomy is the most common surgical act performed in ENT practice, there is still some concern about the safety of outpatient or day surgery scheduling, especially in adults. Although this has been common practice in many departments for some...

Which technique is better for cholesteatoma surgery?

There continues to be debate over the benefits and limitations of different techniques for cholesteatoma surgery. This retrospective review of 132 cases over a 10 year period with primary cholesteatoma from Turkey tried to establish which technique [canal wall up...

Leadership in healthcare

There is often a great deal of confusion over the words ‘management’ and ‘leadership’. Sometimes they are used interchangeably. Sometimes they are used to represent opposite ends of a spectrum. Sometimes both are used as collective nouns, or to describe an activity.

Medicine and Seamus Heaney

Seamus Heaney grew up in the 1940s. Infectious diseases – diphtheria, poliomyelitis, mumps, measles and rubella – were rife. Stepping Stones recalled talk among older neighbours of ‘a-waiting on’ when they were close to death. Aunts and uncles succumbed to...