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Patient-reported outcome measures in septorhinoplasty
Patient-reported outcome measures (PROMs) are used increasingly in surgical research to quantify the efficacy of surgical interventions. This can help to fill an ‘evidence gap’ where healthcare rationing threatens particular treatments. Procedures aimed at improving quality of life, especially with...
Post-operative tonsillectomy bleeding with a normal clinical exam
Tonsillectomy is amongst the most common surgical procedures performed across the western world. For patients who report bleeding post-tonsillectomy, but have no clinical findings on examination, the management can be unclear. The accepted current management in most centres would be...
Rationales to explore the neck in penetrating injuries
Penetrating neck injuries in the UK are more commonly associated with low velocity objects such as knives and blades as opposed to gunshots. To explore the neck requires careful consideration of the need to do so in line with Burgess...
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...
A histological test for LPR?
Laryngopharyngeal reflux (LPR) is often considered to be a contributory factor to the development of a spectrum of laryngeal abnormalities including vocal cord leukoplakia and dysplasia. This is especially the case when traditional risk factors, such as tobacco smoking, are...
Head injury and prolonged bed rest, but not inner ear disease, predict poorer outcome after Epley manoeuvre in posterior semicircular canal benign paroxysmal positional vertgo (P-BPPV)
This Japanese study included 197 patients with P-BPPV treated over a two and a half year period. The vast majority had idiopathic BPPV (n=157). The remaining 40 had secondary BPPV, eight following head trauma, 14 due to prolonged bed rest...
How effective and safe is audiologist-led screening of acoustic neuroma in patients with asymmetrical hearing loss and unilateral tinnitus?
About two out of 100 patients presenting with asymmetric hearing and unilateral tinnitus have acoustic neuroma. The traditional method in which these patients first attend a clinician and then undergo screening through an MRI, can be expensive and prolong the...
Hypoglossal nerve stimulation for OSA
Hypoglossal nerve stimulation has been lauded as the great new surgical treatment panacea for obstructive sleep apnoea (OSA). This meta-analysis includes 12 studies with a total of 350 patients, including the five-year follow-up data from the STAR trial which was...
Dead regions in patients with cochlear implants
The very nature of a dead region (DR) in a cochlea means that they are often found in patients who are eligible for cochlear implants. However, a variety of different hearing configurations are found in those with DRs because of...
Vestibular migraine or BPPV?
There are close similarities between benign paroxysmal positional vertigo (BPPV) and vestibular migraine (VM) as both can be presented by positional nystagmus. Though BPPV remains the commonest cause of pure positional vertigo, VM can mimic this condition. This study is...
Simple preoperative tests predicting outcomes for ESS patients?
We are all familiar with patients suffering extensive nasal polyps who relapse all to soon after careful and thorough endoscopic sinus surgery (ESS). This paper looks to answer whether we can predict which patients will do well, and which less...
