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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...

Treating middle ear conditions in developing countries

This month’s journal issue discussed global health in otolaryngology with this paper focusing on the management of chronic middle ear disease in the developing world. Chronic suppurative otitis media (CSOM) is more common in developing countries. The reason for this...

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...

Parapharyngeal space tumours – is the transoral approach effective?

Several approaches are described to the parapharyngeal space to permit resection of tumours in this region, with the most commonly employed approach being the transcervical route. The transoral approach remains somewhat controversial as it is felt that this approach can...

How to deliver bad news better

Delivering bad news well takes experience and time. The Ida team recommend the SPIKES protocol; providing structure for relaying bad news, giving confidence to those delivering it, and leaving recipients feeling cared for and informed. It’s among the most distressing...

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Assessment of genetic disorders: congenital sensorineural hearing loss

Severe or profound sensorineural hearing impairment (SNHI) is a common birth defect, affecting approximately 1 in 1000 newborns [1]. SNHI may result from environmental causes or have a genetic basis. The genetic causes can be further subdivided into non-syndromic (isolated...

Audiological monitoring in ototoxicity - Are we doing enough?

In this article Ghada Al-Malky explores the dichotomy of life-saving, yet hearing loss-causing medication, and questions whether the hearing healthcare community is doing enough to prevent preventable hearing loss. Ototoxicity is the damage to hearing and / or balance functions...

Team proves secure pathway to the inner ear

An international team of surgeons and scientists has, for the first time, validated safe surgical access to the central core of the human cochlea.

Does salvage treatment in sudden sensorineural hearing loss work?

Many treatment strategies for sudden sensorineural hearing loss (SSNHL) have been discussed, but the high spontaneous recovery rate (32-65%) of idiopathic SSNHL and differing treatment guidelines make comparing outcomes difficult. Systemic steroids are the most common first-line therapy with significant...