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Tongue tie – just a snip?

This article regarding ankyloglossia raises an eyebrow; surely it’s just a snip isn’t it? Seemingly not. The authors describe two types of tongue tie – the first being posterior, with the frenulum being short and tight, the second being anterior,...

Clonidine based vs Remifentanil based hypotensive anaesthesia in FESS

A study investigating the use of clonidine preoperatively in FESS surgery. A double blinded trial of 47 patients in Barcelona randomised into receiving clonidine (20 minutes preoperatively) versus Remifentanil (continuous infusion). Propofol and fentanyl were used for induction and then...

Quality of life after FESS or balloon sinuplasty

This randomised control trial compared the SNOT-22 questionnaires both pre-operatively and three months post-operatively in patients with chronic rhinosinusitis undergoing either FESS or balloon sinuplasty to the maxillary sinus. Forty two patients participated in the study, 21 in each treatment...

Facial Landmark localisation by curvature maps and profile analysis

The detection of three dimensional (3D) landmarks by scanning surfaces is a well established method in medical science. Anatomical landmarks are visually or palpably detectable and act as reference points for clinical measurements. When measuring these landmarks with a sliding...

One stage nasal reconstruction with local flaps

This is an excellent and authoritative review of an often difficult and controversial (as there are so many options or so few) clinical subject. Better education and earlier diagnosis of skin tumours allows defects with limited size and depth to...

QOL studies for anterior skull base surgeries

The Anterior Skull Base Nasal Inventory-12 (ASK Nasal-12) is a standard tool for assessment of quality of life (QOL) in patients who have undergone endonasal transsphenoidal surgery. As nasal trauma and rhinological complications following endonasal transsphenoidal surgery can influence QOL,...

Sinonasal undifferentiated carcinoma – slowly getting there

The rarest of the rare, sinonasal tumours form only a small part of the total number of head and neck tumours and undifferentiated carcinoma (SNUC) is one of the rarest of this group. There is some data (and some expert...

An unrecognised anatomical variant which may help frontal sinus surgery

Anatomic variants in the frontal sinus have significant implications in endoscopic sinus surgery. In this illustrative study, the authors describe a newly-observed anatomical variant – a mucosa lined prism‑shaped space between the most superior part of the nasal septum and...

What about the older adults?

The authors of this paper propose that significant changes in the delivery of services, including speech and language therapy management of swallowing difficulties, may be required. Among the most common causes of dysphagia in older adults are stroke, progressive neurological...

Radiological diagnosis of mastoiditis in patients screened for acoustic neuroma

Magnetic resonance imaging is the ‘gold standard’ for screening patients suspected to have acoustic neuroma. Various abnormalities are picked up through this investigation, one of which, not uncommonly reported, is mastoiditis. This requires referral to otolaryngology and further evaluation. In...

How effective are our two-week-wait guidelines in picking up head and neck cancer?

With a 30% increase in the incidence of head and neck cancer since 1999 in the UK, it is important that the two-week wait referral guidelines safely encompass all risk factors but also render these urgent referrals based on signs...

Location, location, location: How to get the steroid where you need it, in chronic rhinosinusitis

What almost all current guidelines on chronic rhinosinusitis have in common is the importance of intranasal steroid (INCS) use. However, it is increasingly understood that the efficacy of INCS depends on their efficient delivery to the point of need, i.e....