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Random-pattern skin flaps: part 4 - transposition flaps
In the final part of our series on local skin flaps (see Part 1, Part 2 and Part 3) in ENT, the authors describe the usefulness of the transposition-type flap and highlight some examples. Rotational advancement flap Useful for defects...
Voice change after total thyroidectomy with intact laryngeal nerves – a common but temporary problem
It has been reported that up to 87% of patients have a degree of voice dysfunction after thyroidectomy, even when the laryngeal nerves are preserved. Postoperative inflammation, laryngeal oedema due to vascular congestion, direct damage to the cricothyroid muscles and...
Cochlear implant electrode insertion technique
Atraumatic cochlear implant insertion techniques (so-called ‘soft surgery’) are now standard practice in most centres for all cases (no longer just for attempted hearing preservation cases). This has led to several studies examining cochlear trauma and electrode insertion force. In...
A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth
It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...
KTP laser ablation for early glottic cancer
TLM for glottic carcinoma has historically been performed with a carbon dioxide (CO2) laser. A much smaller literature base has examined the use of potassium titanyl phosphate (KTP) laser in this context. This retrospective chart review aims to fill that...
Anterior skull-base surgery: current opinion
This review examines the changes in the field of anterior skull-base surgery and the rapid advancement that has taken place in the last 10–15 years. Tumours of the anterior skull base that were once considered inoperable are now routinely resected...
Management of patients with advanced otosclerosis
This paper discusses the management options of advanced otosclerosis. There are several definitions for advanced otosclerosis in the literature but, more recently, the diagnosis of advanced otoscletosis has been reserved for patients who have less than 30% aided speech discrimination...
Early cochlear implant activation and its effects on the cochlea
In this article, Alhabib et al consider the changes to electrode impedance with early device activation (day one) compared to conventional activation (day 30). Activation at day 30 is a cautious approach, which has been popular for many years. However,...
Semicircular canal dehiscence and cochlear implantation
Semicircular canal dehiscence (SCD) is thought to occur in 3% of the population, it is mostly asymptomatic, but patients may present with sound-induced vestibular symptoms, low-frequency conductive hearing loss, autophony, hyperacusis and aural fulness. With the increasing utilisation of cochlear...
Robotic insertion of electrode array in cochlear implantation
Cochlear implants (CIs) are commonly used for profound bilateral hearing loss. They have specific national guidance for their insertion, however patients with a substantial residual acoustic hearing are potential CI candidates. Preservation of this residual hearing can be sought with...
The push towards scarless parotid surgery
When dealing with benign parotid pathology, high expectations are placed on the operating surgeon to preserve key neurovascular structures, especially the animating facial nerve, through meticulous dissection. With time, there has been a greater emphasis on improving cosmesis in parotid...
