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Risk factors for pharyngocutaneous fistula after laryngectomy

Pharyngocutaneous or salivary fistula is a feared complication following laryngectomy, causing significant morbidity, prolonged hospital inpatient stay / cost and mortality. Previous radiotherapy / chemoradiotherapy is a well recognised risk factor and leads many surgeons to recommend onlay pectoralis major...

Listening in noise to predict learning disability

Noise disrupts the neural coding of consonants more than vowels. Listening in noise presents a challenge for everybody, but particularly to children whose language skills are underdeveloped. This team views background noise as a disruption to the necessary neural mechanisms...

Identifying early flap failure

The holy grail of flap monitoring is an easy, reliable and predictive method to identify impending compromise. Does this paper provide it? Various methods have been used to improve our ability to monitor the viability of a flap and here...

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...

Combined sprays for allergic rhinitis maintenance

This meta-analysis looked at the reported efficacy for allergic rhinitis control of various topical sprays, particularly comparative studies. There were fewer ‘head to head’ studies than we would have hoped to exist. This review included intranasal anti-histamines, intranasal steroids and...

Postoperative pain in septoplasty

This is a prospective Turkish study that looked at factors affecting the postoperative pain response after septoplasty, a common ENT surgical procedure. Sixty patients were included in the study who underwent septoplasty. The authors looked at the influence of demographics...

‘FOX’ – a new software programme in cochlear implant fitting for audiologists

Taking into account the complex parameters involved in cochlear implant fitting, it appears that the procedure is becoming more and more difficult and variable across cochlear implant centres. For this reason, a software programme called FOX was designed attempting to...

Aerosols and polypi

Infection in the operative cavities after endoscopic sinus surgery for sinonasal polyposis leads to recurrence of symptoms and mucopurulent discharge. The usual therapies include systemic antibiotics sometimes with steroids. The authors hypothesised that the use of a topical antimicrobial (tobramycin...

Surgical anatomy for central auditory device implantation

This cadaveric study by researchers in the USA and Japan examined the cerebellopontine angles with the aid of the surgical microscope and 45o endoscope via the retrosigmoid and translabyrinthine approach. Using fibre dissection technique, the ascending auditory pathways between the...

Post-cancer prosthodontic reconstruction

A functional outcome after head and neck cancer resection is aimed at restoring speech and swallow. Dental reconstruction greatly facilitates this, particularly by enabling the patient to chew food. The authors reinforce the need for careful presurgical planning with treatment...

Hereditary haemorrhagic telangiectasia

This is a very nicely written overview of this difficult condition by two expert rhinologists with a tertiary practice. The genetic basis, pathophysiology, diagnosis, natural history and available management options are all discussed. Clearly there is a large spectrum of...

Budesonide irrigation in polyposis

It is very well known through many RCTs and now meta-analyses that saline-based irrigation is beneficial in patients after sinus surgery. It is also demonstrated that intranasal steroids are beneficial postoperatively but there is also a trend for steroid based...