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Do ENT surgical patients need VTE prophylaxis?
In the UK, current NICE guidance for venous thromboembolism (VTE) prevention does not give specific advice about patients undergoing otolaryngology/head and neck surgery (OHNS). This systematic review provides up-to-date information based on available, although limited, evidence about the incidence of...
Hilotherapy for facial surgery patients?
Hilotherapy involves administering regulated cold compression through a facemask. The principle of this treatment involves cyotherapy as a traditional treatment for reducing inflammation, pain and swelling following trauma. It is believed that using hilotherapy (Hilotherm®), which uses a mask to...
Beware the skinny patient…
The adverse health impacts of an excessive BMI are well known. This study highlights one laryngeal pathology for which a low BMI appears to be a significant risk factor. The records of 28 patients treated for arytenoid cartilage dislocation were...
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...
Does pre-op intratympanic gentamicin improve balance control after vestibular schwannoma surgery?
This retrospective study was based on data from 44 patients selected from a cohort of 153 who had undergone surgical resection of vestibular schwannoma over a 10-year period. The aim was to evaluate the dynamics of the postural control system...
What is the prognostic value of lymph node yield and density in head and neck cancer?
Neck dissection in addition to surgery of the primary site is commonly recommended in head and neck cancer treatment. However, there has been no consensus on the number of nodes that need to be removed to constitute a sufficient neck...
Cochlear implantation in children with congenital long QT syndrome
Jervell and Lange-Neilsen syndrome is a condition where sensorineural deafness coincides with inherited abnormalities of the heart, resulting in prolonged ventricular repolarisation, frequently shown on an ECG with a prolonged QT interval. These children can present at implant centres for...
Can and should vestibular schwannoma surgery be carried out via the endoscopic transcanal approach?
The extent and scope of endoscopic ear surgery has rapidly progressed in recent years, and this paper, from one of the leading proponents of this technique, reports on the outcomes of a case series of patients who have had total...
Stapedotomy in osteogenesis imperfecta
Osteogenesis imperfecta (OI) is a rare connective tissue disease caused by a defect in collagen structure. Hearing loss is a characteristic feature of OI. It typically presents with conductive hearing loss initially, followed by a superimposed sensorineural component later in...
Risks of tracheostomy in head and neck cancer
Tracheostomy is associated with several complications, with rates quoted as high as 8-45%, including: bleeding; displacement; obstruction; surgical emphysema; pneumothorax; fistulae and failure to decannulate. There are now many studies that confirm the increased length of stay and complications of...
Biologicals for severe chronic rhinosinusitis with nasal polyps. Any use?
Recent advances and knowledge of inflammatory endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP) led to introduction of biological agents such as monoclonal antibodies targeting IgE (omalizumab) and Interleukins (ILs) such as IL4R alpha (dupilumab) and IL5. The European Academy...
