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Scalp reconstruction a new algorithm

Reconstruction of the scalp after acquired defects remains a common challenge for the reconstructive surgeon, especially in light of a history of radiation to the area. Wound healing by secondary intention or with a wound vacuum assisted closure are viable...

Measuring the ‘impact’ of preoperative immunonutrition

Using preoperative nutritional supplements as part of ‘enhanced recovery’ in surgical patients is not a new concept. This interesting paper looks at the latest development in optimising patients undergoing head and neck oncological surgery. Immunonutrition (Nestle’s ‘Oral Impact’ in this...

Factors affecting the occurrence of salivary fistula after total laryngectomy

It is generally believed that patients should be fed by nasogastric tube for 7-10 days after undergoing total laryngectomy or laryngopharyngectomy to avoid the occurrence of post-operative salivary fistula. This study challenges this belief and looks into various factors that...

Cerebrospinal fluid leaks after vestibular schwannoma surgery

This study analyses 30-day readmission data after vestibular schwannoma surgery using a multicentre longitudinal State of California dataset. The authors studied risk factors, and timing of readmission in 6820 patients over 15 years. Of these, 490 readmissions were reported for...

Vascularised tissue in salvage total laryngectomy

Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...

Reducing the risk of Frey’s syndrome after parotidectomy – which methods are best?

Gustatory sweating or Frey’s syndrome is a well-recognised complication of parotid surgery. The reported incidence is highly variable, from 4% to 96%, with around 30% of patients reporting symptoms. A number of intraoperative techniques can be used to reduce the...

Is it beneficial for children to undergo bilateral cochlear implantation before 12 months old?

Universal newborn hearing screening has allowed early diagnosis and, subsequently, early intervention in hearing loss. In 2020 the Food and Drug Administration candidacy criteria for cochlear implants (CI) expanded to include profound sensorineural hearing loss (HL) in children as young...

Hear me out – tiny steroid implants for fighting meningitis-induced deafness

Sensorineural hearing loss is the most common neurological complication of pneumococcal meningitis. Bacterial infiltration into the inner ear triggers inflammation, leading to cochlear fibrosis and sclerosis – damage that, in over a third of cases, affects both ears. Current Infectious...

Global hearing rehabilitation – an SFORL/IFOS collaboration

International collaboration is more important than ever, and we hear from Prof Bernard Fraysse about a collaboration that grew out of the very successful IFOS meeting in Paris in 2017. The IFOS meeting in Paris in June 2017 was obviously...

Foundations of Aural Rehabilitation: Children, Adults, and Their Family Members – Fifth Edition

Nancy Tye-Murray leaves no stone unturned in her fifth edition of Foundations of Aural Rehabilitation: Children, Adults and Their Family Members. The exhaustive but not exhausting content offers a three-dimensional insight into the process of (re)habilitation in the clinical setting...

Coupler microvascular anastomoses: how good?

This paper is written by a group of reconstructive surgeons and a school of computing. The study used computational fluid dynamics to model blood flow through idealised sutured and coupled vessels, to investigate if differing anastomotic techniques affect intravascular blood...

Diagnosing and managing somatic tinnitus

Interactions between auditory and somatosensory pathways can lead to interesting tinnitus experiences which can be very bothersome. Dr Sarah Michiels describes her pioneering work in this area, and the possibilities of physiotherapy based therapy. Background Somatic (also called somatosensory) tinnitus...