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Middle ear pressures with different anaesthetic agents
The use of appropriate anaesthetic agents is essential to avoid complications during middle ear surgery. This Turkish study attempted to identify whether intravenous (IV) anaesthetics (propofol) or inhalational agents (sevoflurane) cause more variations in middle ear pressures. The authors performed...
Shoulder function in patients undergoing neck dissection: its effects on work and leisure activities
Shoulder dysfunction is common after neck dissection and includes shoulder pain, limited abduction and scapular winging. Modifications of the radical neck dissection were designed to limit morbidity, however, even with accessory nerve-sparing neck dissections, shoulder dysfunction can be seen. Shoulder...
Intermediate risk factors SCC tongue
This retrospective review from Japan assessed 89 patients who underwent surgery for squamous cell carcinoma of the tongue, specifically they reviewed the evidence of perineural and vascular invasion (27.0% and 23.6%). Their results suggest, not unsurprisingly, that perineural and vascular...
Delirium post-op
This is a retrospective study from Japan analysing 102 patients who underwent oral cancer resection and free flap reconstruction. Postoperative delirium occurred in a third of these patients. An increased risk was identified in those with high preoperative albumin, postoperative...
A novel way to reduce postoperative nausea and vomiting
This is an interesting RCT which evaluates the prophylactic effect of bilateral endoscopic injection of local anaesthetic in the sphenopalatine ganglion (SPG) on postoperative nausea and vomiting (PONV). It has a robust design, and is sufficiently powered and blinded, with...
The septum and breathing
The authors compared the improvement in nasal obstructive symptoms in two groups of patients. One group underwent septoplasty alone and the other septoplasty accompanied with compensatory turbinoplasty. They used the Nasal Obstruction Symptom Evaluation (NOSE) [12] and visual analog scale...
Update on cholesteatoma
Surgery for cholesteatoma should be tailored to individual patients, considering patient and disease factors, to obtain a dry, safe and functional ear. In this article, the authors discuss the current definitions and classification system of middle ear cholesteatoma, as well...
Canal wall down with obliteration of cavity for paediatric cholesteatoma
The authors present evidence that canal wall down (CWD) surgery with primary obliteration is an effective way to treat paediatric cholesteatoma. Fifty-eight ears were operated on and follow-up was for five years on average. Residual cholesteatoma rate was 9.9% with...
CT and intraoperative nerve monitoring to identify non-recurrent laryngeal nerve during thyroid surgery
A non-recurrent laryngeal nerve (NRLN) is a rare (incidence 0.3% to 1.3%) anatomical variant that results in a higher rate of vocal cord palsy following thyroid surgery. This team from China examined the utility of preoperative CT and intraoperative nerve...
Endoscopic stapes surgery - pearls and pitfalls
Endoscopic ear surgery has gained popularity in recent years with wide panoramic visualisation of the operative field one of its key strengths. This article summarises the approach, set-up and outcomes of patients undergoing endoscopic stapes surgery. A key step during...
