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The middle way: treating idiopathic facial nerve palsy
Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...
Is medical therapy without surgical treatment sufficient in treating peritonsillar abscess?
Standard treatment of peritonsillar abscess (PTA) has typically involved both medical therapy and surgical drainage either in the form of needle aspiration, or incision and drainage. However, is medical without surgical treatment sufficient? The authors suggest that medical therapy without...
Scalp reconstruction a new algorithm
Reconstruction of the scalp after acquired defects remains a common challenge for the reconstructive surgeon, especially in light of a history of radiation to the area. Wound healing by secondary intention or with a wound vacuum assisted closure are viable...
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...
Factors affecting the occurrence of salivary fistula after total laryngectomy
It is generally believed that patients should be fed by nasogastric tube for 7-10 days after undergoing total laryngectomy or laryngopharyngectomy to avoid the occurrence of post-operative salivary fistula. This study challenges this belief and looks into various factors that...
Cerebrospinal fluid leaks after vestibular schwannoma surgery
This study analyses 30-day readmission data after vestibular schwannoma surgery using a multicentre longitudinal State of California dataset. The authors studied risk factors, and timing of readmission in 6820 patients over 15 years. Of these, 490 readmissions were reported for...
Vascularised tissue in salvage total laryngectomy
Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...
Reducing the risk of Frey’s syndrome after parotidectomy – which methods are best?
Gustatory sweating or Frey’s syndrome is a well-recognised complication of parotid surgery. The reported incidence is highly variable, from 4% to 96%, with around 30% of patients reporting symptoms. A number of intraoperative techniques can be used to reduce the...
Ramifications of the pandemic on acute paediatric mastoiditis: a national UK audit
Acute mastoiditis is a common presentation in the paediatric population across ENT services worldwide. An initial expectation of a rise in the numbers of acute mastoiditis associated with the initial findings of SARS-CoV-2 (COVID-19) virus presence in middle ear in...
Is it beneficial for children to undergo bilateral cochlear implantation before 12 months old?
Universal newborn hearing screening has allowed early diagnosis and, subsequently, early intervention in hearing loss. In 2020 the Food and Drug Administration candidacy criteria for cochlear implants (CI) expanded to include profound sensorineural hearing loss (HL) in children as young...The costs of applying to ENT specialty training
Training doctors is costly. In the UK, medical school costs an estimated £230,000 made up of £163,000 in government grants and £65,000 in student loans [1]. Repayment of the student loan begins once the graduate earns above a certain threshold,...
