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Endoscopic middle ear surgery for cholesteatoma treatment
A critical question when any new technique is proposed is ‘does it work?’ In this article Daniele Marchioni and Davide Soloperto discuss the success rates of endoscopic ear surgery for cholesteatoma. Introduction Surgical management of cholesteatoma is still a controversial...
First signs of late nodal metastases
This is a retrospective review of 65 patients who had late metastases during follow-up after initial curative treatment. They analyse the detection methods of palpation, ultrasound, CT and subjective symptoms. Palpation detected the nodes in 31 patients, ultrasound in 17,...
Sarcoidosis and the nose
This retrospective case note review from Mount Sinai in New York looked at just 14 patients with sarcoidosis. Individual ENT units in the UK are likely to see relatively few of these patients, unless there is a major tertiary referral...
Do we need to intervene after complications of acute sinusitis in children?
omplications of acute sinusitis in children are not uncommon and some are managed surgically. The authors of this paper reviewed their experience of subsequent chronic rhinosinusitis (CRS). Nine of 86 patients required surgery in the 12 months after their initial...
Do bicycle helmets prevent facial injuries?
This is an analysis from Germany where they reviewed over 7000 bicycle accidents over a 16-year period that met their inclusion criteria. Over 1000 had a facial injury (bone or soft tissue) with helmets being worn in 11.8% of accidents....
To drain or not to drain
These two separate papers neatly tie together the same ideas. The first, a retrospective study of 107 patients and 116 procedures over a 10-year period who underwent a CSF leak repair, 82.2% without a lumbar drain and 17.8% with. The...
Incidental thyroid nodules: should we observe or operate?
Thyroid nodules are extraordinarily prevalent, detected by physical examination in 7% and by imaging studies in 67% of the population. Although most of these nodules are benign, up to 20% are found to be malignant on excision. It’s a very...
Treatment algorithm for olfactory disorders
The purpose of this paper is to review the current evidence in diagnosing olfactory disorders and suggest an algorithmic approach to patients with relevant complaints. Age-associated olfactory loss is often multifactorial and requires a careful history and physical exam. A...
Food impaction in children is associated with eosinophilic oesophagitis
There is an increasing amount of evidence to suggest that chronic oesophageal inflammation and motility disorders play a more significant role in oesophageal food impaction (EFI) in children compared to structural defects. The authors conducted a retrospective study of children...
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...
ENT Expert Opinion
The creator of ENT Expert Opinion, Dr Niall Jefferson, was in the midst of his surgical training in Ear, Nose and Throat Surgery in Australia in 2012. In contemplating his upcoming Fellowship exams, he began to seek out resources that...
