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The use of THRIVE in laryngology and phonosurgery

The team in Lewisham has been using THRIVE for our phonosurgical cases for about a year. Here, we discuss the pros, cons and potential pitfalls of setting up and using THRIVE as ventilation during anaesthesia rather than using an ML...

Clinical Management of Swallowing Disorders, Third Edition

This is a comprehensive and readable text on swallowing disorders. The covered topics include the physiology of normal swallowing, aetiologies and mechanisms of abnormal swallowing, as well as assessment and management (including surgical, prosthetic and non-surgical). There is a detailed...

Intracranial complications of otitis media – the difference between kids and adults

Despite a decrease in intracranial complications from otogenic infections since the introduction of antibiotics, there is still morbidity and mortality associated with this. This group from the Netherlands conducted a retrospective review of all the patients treated for intracranial complications...

Should we be doing earlier MRIs in sudden sensorineural hearing loss?

There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....

Sound sensitivity in children

Sound tolerance symptoms in young patients can be a challenge, Veronica Kennedy and Claire Benton share their clinical experience in navigating the issues that can arise in diagnosis and management. In any noisy environment, it’s a common sight to see...

Running a post-COVID smell clinic

Over the past year, much of our effort as a speciality has been directed towards crisis management and keeping services afloat. Our practice has changed in untold ways, but unprecedented numbers of patients with smell disorders will increasingly require our...

Keep the condyle if you can

This is a study of 41 patients who underwent benign tumour resection and reconstruction over a four year period. Patients fell into three groups; condyle preserved, condyle sacrificed, condyle frozen in combination with a DCIA free flap. Following this, they...

Fibula free flap virtual or freehand planning and the efficiency of surgery

This is a systematic review from surgeons in Italy and Florida where, from an initial 799 potentially relevant articles, only six could be included. Efficiency was assessed by the mean ischemia time which, for the virtual group, was 73.8 minutes,...

Complication rates for grommet insertion in H&N cancer patients

Otitis Media (OM) can be the direct result of H&N malignancy itself or secondary to treatment of malignancy. Both surgery and radiotherapy can cause lasting changes to the physiologic function of the ET, middle ear, tympanic membrane and ear canal....

Transtympanic plugging for chronic patulous eustachian tube

The authors developed a silicone plug (Kobayashi plug) to manage severe intractable patulous eustachian tube dysfunction (PET). This retrospective study investigates ET function after Kobayashi plug surgery, based on postoperative tympanic membrane (TM) findings and active opening (AO) of the...

Posterior TM perforations carry greater hearing loss: practical pointers for clinic

This single-centre prospective study of 100 adults with central pars tensa perforations examined how perforation size and quadrant relate to hearing loss. Using video-otoscopy to estimate perforation area and pure tone audiometry for thresholds, the authors found hearing loss in...

What is the evidence for duration of antibiotic prophylaxis in head and neck free-flap cases?

The topic of this systematic review is one which is commonly heard in discussions between microbiologists and head and neck surgeons – what is the evidence for antibiotic prophylaxis in clean-contaminated free-flap cases, and crucially, how long should antibiotics be...