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Clinical leadership and management: the ‘Darzi’ experience

The Fellowship in Clinical Leadership programme, more commonly known as the ‘Darzi Fellowship,’ commenced in 2009. It was designed to provide junior doctors at the registrar level with postgraduate training in clinical leadership and change management in order to develop...

BACO: The Master’s role

Ian Mackay is this year’s BACO Master, with Valerie Lund taking over for the next meeting. As the senior overseer of the conference, the role of Master is a crucial one, and Ian tells us how he has gone about...

Ultrasonic bone aspirators for internal auditory meatus ‘drilling’ in retrosigmoid vestibular schwannoma resection

In this article, the authors describe the retrosigmoid approach to a vestibular schwannoma, using an ultrasonic bone aspirator as an alternative to the standard drill. Vestibular schwannomas (VS) are benign, usually slow-growing tumours of the vestibular nerve. Management of VS...

Recurrent respiratory papilloma treatment in the office

In this interesting new article, Markus Hess and Susanne Fleischer describe their technique for managing recurrent laryngeal papillomatosis in an outpatient setting using channelled endoscopes. The recurrent respiratory papillomatosis (RRP) of the larynx is a chronic HPV-associated viral disease. Clinical...

REARRANGED: An Opera Singer’s Facial Cancer And Life Transposed

Rearranged is a wonderfully positive memoir telling of Kathleen Watt’s ordeal through maxillary osteosarcoma. As an early career opera singer in the New York Metropolitan Opera’s chorus, her dreams are derailed and life transformed when this most rare diagnosis hits....

Revising pinna embryology and anatomy

This forms an introductory article for a group of papers discussing the reconstruction of the pinna. It is a succinct yet adequately detailed article that all of us, at whatever stage of our careers should endeavour to read, as it...

Which is the best graft for myringoplasty?

This is a systematic review and meta-analysis of retrospective studies for type 1 tympanoplasty (myringoplasty) surgery comparing temporalis fascia and cartilage autograft materials for reconstruction. Inclusion criteria was patients with more than 50% perforated tympanic membrane with intact ossicular chain....

Risk factors in free flap failure

This is a retrospective analysis from China of 881 free flaps over nearly four years, 49 of which were ‘taken back’, 26 of which were lost, giving a 97% success rate. The commonest cause of flap failure was venous thrombosis....

One anastomosis or two

This is a cumulative meta-analysis from Hong Kong reviewing 27 articles and a total of 7,389 flaps. The authors, at the outset, acknowledge that the number of anastomoses is not the only factor of venous compromise and flap failure. Nonetheless...

Is there time for intraoperative scans?

Intraoperative imaging plays an integral role in orthopaedic surgery during the repair of long-bone fracture. Given the complexity of the facial skeleton, intraoperative imaging has the potential for similar benefits in reconstructive surgery. The objectives of the study were to...

Two for one forearm flaps

There are many and varied free flaps available for reconstructions. Here is a variant on the workhorse radial free forearm flap. The modification involves a longer, narrower flap that can be rotated back on itself to increase the flap width...

Postauricular advancement flap for partial helix defect repair

Ear defects can be the result of trauma, burns or ablative surgery. The three dimensional structure of the pinna presents a difficult reconstructive challenge as successful ear reconstruction requires both similar tissue cover and a supporting framework. Partial ear reconstruction...