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A global view of thyroid surgery practices

The incidence of thyroid cancer continues to increase, and both surgery for benign and malignant disease carries an important and persistent incidence of perioperative complications. This paper reports the results of an electronic survey sent to members of seven surgical...

Should patients with dysphagia be allowed water freely?

Patients with dysphagia often experience dehydration as a consequence of “nil by mouth” or having to consume thickened fluids due to aspiration of thin fluids. However, not all incidents of aspiration develop into an infection. Factors that contribute to aspiration...

Do you use the evidence or do you just know to do that?

In this day and age we generally consider healthcare practice to be evidence-based. Unfortunately there are not always the plethora of research articles available that address the dilemmas of day-to-day clinical practice. This piece of work considers what factors influence...

Microsurgical trainees to avoid strenuous exercises?

It is commonly believed among microsurgeons that over-exertion can impair microsurgical performance. The authors aimed to investigate if they could prove this theory and compared the performance of medical students, postgraduate trainees and expert controls who were microsurgery tutors. A...

Results of hypoglossal-facial nerve anastamosis techniques for facial palsy

Preserving facial nerve function is of prime importance in acoustic neuroma surgery. A comprehensive knowledge of anatomy, experience and surgical precautions can reduce the incidence significantly. Important considerations are when and how to repair if injury occurs. Several options include:...

A multidisciplinary approach to the management of frontal sinus fracture

Frontal sinus fractures account for about 5% of all facial trauma. Fractures of the posterior wall may result in cerebrospinal fluid (CSF) leak and meningitis, while obstruction of the outflow tract can cause sinusitis and mucocele formation. However, there are...

Parathyroid pearls

This article serves to deliver some pearls of wisdom in parathyroid surgery for the ‘low volume parathyroid surgeon’. They have been divided into those relating to the preoperative diagnosis, imaging and localisation techniques and surgical difficulties. Recognised sources of error...

Self-report of hearing aids handling difficulties

The authors have raised an interesting subject concerning the ability of customers to self-assess their hearing aid handling skills. Previous studies showed that 96% of customers when asked if they are able to manage their hearing aids answered ‘yes’. However,...

Managing high flow head and neck arteriovenous malformations (AVM)

Vascular malformations are lesions where the traditional network of capillaries linking arteries and veins are lacking. Patients usually present with bleeding, pain, disfigurement and tissue expansion and destruction. High flow lesions can be challenging to manage in the head and...

Outcome of TORS to tongue base and epiglottis in patients with OSA intolerant of conventional treatment

The use of transoral robotic surgery (TORS) in ENT is rather controversial, but the use of robotic surgery for obstructive sleep apneoa (OSA), makes it doubly so. Previous studies on TORS in OSA have been performed with other types of...

Botulinum toxin injection for bilateral recurrent laryngeal nerve paralysis

All traditional surgical treatments for bilateral recurrent laryngeal nerve (RLN) paralysis are essentially a balance between maximising airway patency and ensuring adequate phonation / airway protection. This paper highlights the potential role of botulinum toxin (Botox) injection into the cricothyroid...

Darn it! It’s going to take longer to get good at stapes surgery!

Traditionally, it has been said the learning curve for a particular operation lies between 20 and 30 cases. In stapedotomy, a surgeon is deemed successful and perhaps competent if closure of the air-bone gap (ABG) is reached to within 10dB...