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The middle way: treating idiopathic facial nerve palsy
Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...
Is medical therapy without surgical treatment sufficient in treating peritonsillar abscess?
Standard treatment of peritonsillar abscess (PTA) has typically involved both medical therapy and surgical drainage either in the form of needle aspiration, or incision and drainage. However, is medical without surgical treatment sufficient? The authors suggest that medical therapy without...
Scalp reconstruction a new algorithm
Reconstruction of the scalp after acquired defects remains a common challenge for the reconstructive surgeon, especially in light of a history of radiation to the area. Wound healing by secondary intention or with a wound vacuum assisted closure are viable...
Measuring the ‘impact’ of preoperative immunonutrition
Using preoperative nutritional supplements as part of ‘enhanced recovery’ in surgical patients is not a new concept. This interesting paper looks at the latest development in optimising patients undergoing head and neck oncological surgery. Immunonutrition (Nestle’s ‘Oral Impact’ in this...
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...Tish Gaffney – AAA President
From a sunny Southend, UK, Gareth Smith takes 10 minutes to dial into the Sunshine State, USA, and catch up with Tish Gaffney for a lightning-speed chat on the movements and motivations of the 35th president of the American Academy...
