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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...
You’re under arrest, you damned post-tonsillectomy bleed!
Tonsillectomy is a common, well-tolerated procedure most commonly performed in children for recurrent tonsilitis and sleep apnoea. Post-tonsillectomy bleeding (PTB) is a relatively uncommon complication that poses significant risks to patients and high rates of readmission and reintervention. Institutional guidance...Targeted CMV screening and hearing management of children with congenital cytomegalovirus infection
Congenital cytomegalovirus (cCMV) infection is a common congenital infection and is the leading infectious cause of sensorineural hearing loss (SNHL) in children. Prof Karen Fowler discusses current research and the exciting future of screening for cCMV in newborns. Figure 1....Mentorship and its role in surgical training
Is there a principle which could help address multiple challenges in surgical training? One which has potential to improve recruitment and retention of staff to our specialty, quality of patient care and surgeon morale? Harry Spiers, an Academic Foundation Doctor...Addressing the hearing needs of people with dementia
Dr Dawes provides a comprehensive overview of hearing needs of persons with dementia coupled with recommended guidelines for hearing-related considerations when assessing and intervening with persons with dementia. With ageing populations, we face a global dementia challenge. Rates of both...
