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2020 Unmasked - By Paul Howard Surridge

Throughout human existence, metaphorical masks have been worn to conceal emotional and physical imperfections, whether imagined or real. We mask the way we look; we mask the way we feel. We’re vulnerable creatures, psychologically wired to present socially acceptable characteristics...

Treatment regret in head and neck cancer – trading function for survival

Treatment for H&N cancer can be extremely tough for patients. How do we explain the likely impact as they try to make decisions? And what happens when they regret their choice? Treatment regret is a form of decision regret, involving...

Treating voice disorders in singers

There are few ENT surgeons who have as much insight into singers’ problems as Nick Gibbins. A good knowledge of working patterns, repertoire and the physiology of ‘vocal athletes’ is essential. He shares a few thoughts with us. When deciding...

History of innovation in ENT

Innovation seems to have been in the strapline of every meeting, conference and course for the last few years. You would be forgiven for thinking it is a new a concept, but as Neil Weir beautifully details, innovation has been...

Does endoscopic tympanoplasty give better results than a conventional approach?

This is a retrospective review looking at two groups of patients who had undergone middle ear surgery for chronic otitis media (perforation, retraction pocket/cholesteatoma) either open or endoscopic. Four hundred and five patients underwent open ear surgery and 501 endoscopic,...

Sellar surgery – when to prepare for repair

Endoscopic sellar surgery, especially for adenomas, is a relatively safe, straightforward surgery with (mostly) reproducible results and few complications. One of the commonest complications is the creation of a CSF leak with the subsequent need for repair (there is usually...

Does ‘weekend effect’ alter post tonsillectomy haemorrhage rates?

Staffing levels are generally low over the weekends and senior physicians are less easily available. It is generally believed that this affects patients undergoing high-risk surgery. Whether doing tonsillectomy at weekends adds to the risks of post tonsillectomy haemorrhage is...

Active intervention in small schwannomas associated with higher incidence of long-term hearing loss

This article represents collaborative data of hearing outcomes from tertiary centres in Norway and the United States. They studied data of patients with less than or equal to 3cm vestibular schwannoma who underwent observation, primary microsurgery and Gamma Knife surgery...

Scoring system to predict hearing impairment following hemifacial spasm surgical treatment

The authors analysed brain stem auditory evoked potentials prospectively in 100 patients undergoing endoscopic microvascular decompression for management of hemifacial spasm over a period of two years. They then developed a scoring system based on electrophysiological events to predict the...

Close monitoring of patients for delayed hyponatremia post-transsphenoidal surgery

he incidence of delayed hyponatremia is 16-28% and usually accounts for unplanned readmission of the patient within 30 days after transsphenoidal surgery. One of the surrogate measures of quality of care adopted by the government and regulatory agencies is 30-day...

A new bio-glue for neurosurgical wound closures

Dural closures need to be tight to prevent cerebrospinal fluid leaks. Traditional wound closure techniques involve sutures and DuraSeal which is the only FDA approved polyglycol hydrogel sealant with proven safety and efficacy profile. This article describes a new sealant,...

Chronic rhinosinusitis and sleep

This is an interesting article from the Chung Shan Medical University in Taiwan. One-hundred-and-thirty-nine patients were enrolled into this five-year study. They all had chronic rhinosinusitis with or without polyposis and underwent sinus surgery. The aim was to investigate a...