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Mastoid surgery for cholesteatoma

Landmark Paper: Toner JG, Smyth GDL. Surgical Treatment of Cholesteatoma: a comparison of three techniques. Am J Otol 1990;11(4):247-9. Canal wall up or canal wall down? Chris Aldren discusses the landmark paper that attempted to provide a definitive answer for...

Direct intratemporal facial nerve to hypoglossal nerve coaptation for facial reanimation

The hypoglossal nerve is a common axonal source for dynamic facial nerve rehabilitation. In its regular and modified forms of splitting the nerve it is associated with tongue hemiatrophy, speech and swallow dysfunction, facial movement and hyper contracture. This case...

Role of ultrasonography-guided fine-needle aspiration in management of the neck after chemoradiotherapy

Primary chemoradiotherapy (CRT) is a well-established treatment for locally advanced head and neck squamous cell carcinoma (HNSCC). However, not every patient has a complete response to this treatment modality, necessitating eventual salvage neck dissection. Some patients with persistent adenopathy following...

Delayed facial palsy post vestibular schwannoma resection

This article presents findings of a retrospective evaluation of 489 patients who underwent vestibular schwannoma surgery and developed delayed facial palsy. The authors define delayed facial palsy as deterioration of at least two HB grades between postoperative days five and...

Sulcus vocalis in patients attending voice clinics: A retrospective study

Sulcus vocalis was first described by Giacomini. This includes a variety of anatomic indentations of the vocal fold, ranging from shallow longitudinal furrows to deep vocal cord pits. This retrospective study was conducted at King Saud University between 2006 and...

Free flap reconstruction in stage three bisphosphonate-related osteonecrosis

There is no widely accepted gold standard for the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Early BRONJ is managed conservatively but there is controversy regarding the treatment of the later stages. Stage three is defined as exposed bone...

Do parents sleep better after paediatric adenotonsillectomy?

Paediatric adenotonsillectomy for sleep disordered breathing (SDB) is amongst the commonest surgical procedures performed in ENT. In the outpatient clinic, parents routinely express their concern about their child’s breathing but the impact of sleep disordered breathing on the parent is...

What is the right balance to strike in the management of anaplastic thyroid cancer?

This is a pragmatic article on a difficult and much debated subject. Management of anaplastic thyroid cancer (ATC) can feel like making decisions between a rock and a hard place, and this article suggests one path to help navigate some...

Olfactory protective effect of omega-3 supplements during healing after endoscopic sellar and parasellar resection

This multicentre study, led by researchers from Stanford, demonstrates another use for omega-3 supplements. The study analysed cohorts equally divided between control arm and omega-3 supplementation. Post endoscopic sellar and parasellar resection, better olfactory function was observed at three and...

Does pregabalin help with post-tonsillectomy pain?

This is a small double-blind randomised controlled trial conducted on tonsillectomy and lateral pharyngoplasty operations. Both of these operations are terrifically painful, and I am sure most of us are looking for a way of reducing the suffering for our...

Volume changes in hemiglossectomy reconstruction

This paper analyses the volume changes in 10 patients, five of whom had hemiglossectomy reconstruction with a radial forearm free flap, whilst the other five patients had reconstruction with an anterolateral thigh flap. Both groups underwent postoperative radiotherapy. The volume...

Gastrostomy tube dependence following TORS

Transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC) is now a well-established treatment modality for early (T1-T2) disease. Accumulating evidence suggests that one of its main benefits relative to conventional chemoradiotherapy is superior long-term functional outcome, especially with...