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ENT In this issue...Robotics in Head and Neck Surgery

Robotic surgery is here to stay. Within the specialty of otolaryngology, robotics has made headway across all of the subspecialties, although some advances may still be at the pre-clinical stage. The clinical applications are most acutely evident in the practice of head and neck cancer surgery, specifically transoral robotic surgery (TORS).

Setting up a robotic surgical practice: view from India

Transoral robotic surgery has an established role in head and neck cancer surgery. But how easy is it to set up a service in a resource-constrained environment? Gouri Pantvaidya and Ameya Pai give us a view from the Indian subcontinent....

The tip in rhinoplasty

Getting the tip right (both its position and its shape) is vital in rhinoplasty. George Marcells eloquently gives us his perspective on how to get it right. “Many surgeons overly concentrate on the profile at the expense of the frontal...

Cartilage conduction hearing aids: the third pathway for sound transmission and its application

Air-conduction and bone-conduction are familiar terms; now enter ‘cartilage conduction’. This new term offers a novel approach sound transmission. Hiroshi Hosoi explains the concept and proposes some future applications. The new sound pathway ‘cartilage conduction’ can provide various types of...

Imaging and management of head and neck vascular anomalies

Vascular anomalies are a diffuse spectrum of abnormalities which often involve the head, neck and oral cavity. They are frequently misnamed, often being generically labelled as haemangiomas. This lack of basic understanding can cause confusion leading to a cascade of...

Diagnosing and managing somatic tinnitus

Interactions between auditory and somatosensory pathways can lead to interesting tinnitus experiences which can be very bothersome. Dr Sarah Michiels describes her pioneering work in this area, and the possibilities of physiotherapy based therapy. Background Somatic (also called somatosensory) tinnitus...

The future of facial plastics and rhinoplasty

Interest in facial plastic surgery and in particular rhinoplasty has never been greater. From his wealth of experience in the field, Professor Palma outlines the potential problems of this increasing popularity and how they may be addressed, areas on which...

Cutting burr otoplasty and conchal setback to correct prominent pinna: a ‘step by step approach’

Prominent ears can cause significant social and psychological effects on an individual. The two most common anatomical defects for a prominent pinna are an underdeveloped anti-helical fold and / or enlarged conchal bowl. In the senior author’s practice over the...

The ‘bus stop’ incision for bone-anchored hearing aid placement: a step-by-step approach to soft tissue preparation

There have been many descriptions of soft tissue preparation in the era when subcutaneous tissue was routinely removed with the Nijmegen technique [1] or with the dermatome [2]. More descriptions continue to evolve with the advent of tissue preservation techniques,...

Persistent postural-perceptual dizziness (PPPD), psychosomatic or not? The debate continues

PPPD continues to provoke debate since the diagnostic criteria emerged in 2017. This review covers two commentaries because they are best considered together: the first one, by HK and BS-U, concluded that PPPD is a psychosomatic disorder (in fact, ‘a...

Malignant lesions and reconstruction of the pinna

External ear reconstruction can be challenging. Baskaran Ranganathan and Amr Abdelhamid describe how careful assessment, planning and surgery following the subunit principles and reconstructive ladder will ultimately lead to good aesthetic outcomes with restored form and function. The external ear,...

The changing landscape of thyroid and parathyroid surgery

How has clinical practice in the management of thyroid and parathyroid disease has evolved in recent years? I perform very few head & neck operations where the patient tells me just one week following surgery that they ‘feel much better’....