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25 years of forearm free flaps – 1 vein or 2?

This is a prospective 25-year study from 1998 to 2023 of 368 forearm free flaps, 314 of which were radial and 54 ulnar in 364 patients. Of these, 68 had 1 venous anastomosis whilst 238 had 2. These were assessed...

Patient experience of necrotising otitis externa

Necrotising otitis externa is increasing in incidence in the UK and becoming a rising burden to patients and health services. Despite a growing body of literature on this condition, we know very little about patient experience of necrotising otitis externa....

Treating middle ear conditions in developing countries

This month’s journal issue discussed global health in otolaryngology with this paper focusing on the management of chronic middle ear disease in the developing world. Chronic suppurative otitis media (CSOM) is more common in developing countries. The reason for this...

Use of topical steroids and antibiotics, compared to systemic antibiotics in the treatment of acute rhinusinusitis

Acute rhinusinusitis is mainly initiated by viral infections. Bacterial infection is usually superadded. The inflammatory cascade upregulates the pro-inflammatory mediators resulting in pain, nasal obstruction and nasal discharge. Local application of steroids and antibiotics could provide a higher concentration of...

Hope for neural hearing loss

A new review shows significant promise of improved clinical outcomes for patients from the treatments in development for neural hearing loss (NHL), alongside better diagnosis.

Machine learning and the future of otolaryngology

If you are over 30 years of age, you have witnessed a technology revolution that has grossly affected how we live: computers have come from being an oddity to an everyday feature in our households and places of work; the...

Nasal sidewall reconstruction

Expert reconstruction of nasal sidewall defects requires careful selection of techniques across nasal layers, balancing aesthetics, structural support and patient needs. When reconstructing a nasal skin defect, a variety of factors should be taken into account in order to achieve...

Effects of age on neuro-physiological processing of speech at brainstem level

Degenerative changes associated with ageing may affect processing of spectral and temporal cues in speech at cortical and subcortical levels, even though these individuals may have normal audiometric thresholds. These changes are more likely to be picked up by speech...

Swallow this: management of dysphagia in progressive neurological conditions

Whether the person with the swallowing difficulty has an acquired or progressive neurological condition, understanding the aetiology will allow the speech and language therapist assessing the swallow to have a better understanding of the likely implications for future swallow management...

Radiation-induced dysphagia in head and neck cancer

This is a helpful reference paper that provides an overview of the biomolecular effects of radiation on the tissues of the upper aero-digestive tract. The authors explain that radiation injuries occur in a repetitive and accruing manner over the duration...

New ventilation technique FCV: improvement for patient, anaesthetist/intensivist and surgeon

Per-oral surgical access to the larynx can be hampered by the presence of an endotracheal tube. Various systems have been developed for tubeless ventilation, but these all carry a risk of aerosolisation of secretions with obvious inherent risks. We hear...

Head and neck cancer multidisciplinary team

Why do we have MDTs? Do they make a difference to outcomes? Jon Bernstein explores the whys and wherefores of the head and neck cancer MDT, and wonders where things might go from here… Head and neck (upper aerodigestive tract)...