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Another use for Tisseel – plugging of the round window
After insertion of a cochlear implant electrode through the round window, there are several methods of sealing the perilymph leak and in my experience fascia (with varying amounts of attached muscle) seems to be most commonly used. Stephen O’Leary’s group...
Pharyngocutaneous fistula after total laryngectomy
Pharyngocutaneous fistula (PCF) after total laryngectomy is a serious complication post-surgery, and can lead to prolonged hospitalisation, adding delays in postoperative chemoradiotherapy. This Turkish retrospective study looked at 166 patients who underwent total laryngectomy for laryngeal cancer, although it is...
Does trainee participation in cochlear implant surgery affect operative times?
The role of surgical education is a very sensitive issue in spite of the obvious need and the obligation of doctors to pass on their knowledge and experience to the next generation. This study is very interesting as it assesses...
Surgery of vestibular schwannomas with peritumoral oedema
This is an interesting retrospective study evaluating peritumoral oedema on magnetic resonance images and correlating it with the intra-operative tumour characteristics and outcome. The study results found that vestibular schwannomas with peritumoral oedema were associated with greater incidence of hypervascularity...
Mindfulness meditation versus relaxation therapy for tinnitus
Tinnitus, defined by McFadden as “a conscious experience of sound that originates in the head of its owner, without an external acoustic source”, has a high prevalence and variable psychological impact. It results from maladaptation of the brain to a...
All about velopharyngeal dysfunction
The velopharynx functionally separates the oral from the nasal cavities. Inadequate or abnormal function of this muscular valve affects speech and swallow. Velopharyngeal dysfunction can be subdivided into insufficiency, incompetence and mislearning. This is a review paper and indeed a...
Submental island flap to reconstruct the lower lip
The lips are necessary for oral competence, cosmesis, speech and feeding. Non-melanoma cancers can affect the lips, and the lower lips are about 80% more likely to be affected. A large number of these cancers are squamous cell carcinomas. Treatment...
A move away from bony free flaps in reconstruction
Techniques for facial reconstruction have come on in leaps and bounds since the world wars. The use of titanium implants is more recent and the technology for manipulating the metal and how we use it is rapidly developing. Here the...
Preserving hearing in NF2 patients
Neurofibromatosis type 2 (NF2) is known to result in bilateral hearing loss, even when there is no significant tumour growth. The cause is postulated to be multifactorial: stretching and compression of the cochlear nerve by the tumour, impairment of labyrinthine...
Surgically improving pharyngeal paralysis and associated dysphagia
This was an interesting article explaining the current methods used to try and improve dysphagia and in some cases associated problematic aspiration following vagal injury. These patients are often those with other associated cranial neuropathies, with skull base lesions, brain...
Safety of outpatient thyroid and parathyroid surgery
This study examined the safety and outcomes of matched groups of patients, undergoing either inpatient thyroid / parathyroid surgery or being discharged within eight hours of surgery. There were 2,362 patients in each group who were matched by a ‘propensity...
