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The perils of poor postop blood pressure control

This retrospective case control study reviews 621 patients undergoing thyroid surgery over a 10-year period from 2002-2012 looking at postoperative haemorrhage rates. This potentially catastrophic complication warrants close analysis in order to best discern how it can be minimised. The...

Risk factors for TORS treatment failure in HPV-related oropharyngeal cancers

HPV-related squamous cell cancers are an increasingly common cause of malignancy in the oropharynx. There is evidence that these cancers are associated with a significantly improved overall survival compared to conventional HPV-negative tumours. The optimal treatment for such cancers is...

Velopharyngeal insufficiency after adenotonsillectomy

The authors retrospectively reviewed the clinical records of 320 paediatric patients who underwent either tonsillectomy, adenoidectomy or adenotonsillectomy, under a single paediatric ENT surgeon. Patients with pre-existing velopharyngeal insufficiency (VPI) were excluded, as assessed by preoperative testing for nasal air...

Thalidomide in HHT

An interesting paper from a specialist centre in the Netherlands regarding the use of thalidomide in HHT patients. The St Antonius hospital has 1238 patients with HHT and 1% of these use thalidomide. The aim was to assess the benefits,...

No soup for you…! Early identification of postoperative perforation increases the success of conservative management

Iatrogenic perforation of the hypopharynx or cervical oesophagus is a well-recognised life-threatening complication. Previous studies have demonstrated that conservative management with broad-spectrum antibiotics and withholding oral feeding may avoid morbidity associated with surgical repair. This study addresses when conservative management...

Hearing intervention to prevent dementia

People with hearing impairment have an increased risk of incident all-cause dementia proportional to the severity of loss compared to those with normal hearing. Treating hearing impairment may therefore serve to slow or prevent the onset of cognitive decline. This...

Efficacy of interventions for stuttering: literature review

This is the first part of a two-article review of the efficacy of different modalities of treatments used for treatment of stuttering / stammering. In this article, the authors describe their efforts to identify and quantify evidence on various interventions...

Predictors of complications in patients undergoing oral cavity cancer surgery

Surgical management of oral cavity cancers is complex, frequently involving extensive resections and complicated reconstructions. Quantification of risk in an individual patient may allow surgeons to more effectively identify patients at higher risk of complications and develop strategies for prevention,...

Are upper respiratory symptoms and macroscopic changes in children always due to gastro-oesphageal reflux?

In children, symptoms such as chronic cough, wheezing, stridor, voice changes, persistent asthma and dental erosion are often presumed to be due to gastro-oesophageal reflux and empirical treatment with PPIs is offered. Usual investigations, such as a barium meal, gastroscopy...

Guidelines for management of orbital infections

Orbital infections predominantly affect the paediatric population and complications can be very serious. The cellulitis can be preseptal or orbital and the abscess can be confined within the periosteum or extend into the orbit. Cavernous sinus thrombosis can complicate the...

Horizontal nystagmus: vestibular neuritis or lateral canal BPPV?

A horizontal nystagmus due to lateral canal (LSC) BPPV that is present in the upright position, that changes direction with head turn in the horizontal plane has been termed ‘pseudo-spontaneous nystagmus’ (PSN) because it mimics that of vestibular neuritis. The...

Do I need Google maps in here?

Image guidance surgery (IGS) has grown in popularity. This review article discusses its application in endoscopic sinus surgery (ESS). IGS technology has vastly improved with smaller, more mobile platforms that are easy to set up and use. IGS allows validation...