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Thoughts on war: von Clausewitz revisited
We few, we happy few, we band of brothers; For he to-day that sheds his blood with me Shall be my brother; be he ne’er so vile, This day shall gentle his condition: And gentlemen in England now a-bed Shall...
Head and neck high dependency unit - an alternative to ITU?
Close observation of the airway is a primary requirement for patients undergoing major head and neck surgery. It is also necessary for patients with upper airway infection and trauma. Wound care, drains, feeding and analgesia also require specific attention. Whilst...
Postop follow up of oral squamous cell carcinoma: a new protocol
Oral and oropharyngeal cancers together are the sixth most common malignancy in the world, with an increasing incidence of oral squamous cell carcinoma (OSCC). The recurrence rate of OSCC is reported to be approximately 10-26%. About two-thirds of all recurrent...
Paediatric coblation intracapsular tonsillectomy
The ENT-UK tonsillectomy audit in 2005 created understandable caution in the promotion of Coblation techniques. This prospective study on 100 consecutive paediatric patients looked at outcomes following ‘cold’ radiofrequency ablation (Coblation) intracapsular tonsillectomy. This series shows the technique to be...
Four (more) ways to reduce turbinates
Setting aside the issue of when/if to reduce inferior turbinates, the issue of how to reduce turbinates is a never-ending story. This edition of rhinology carries two articles looking at this subject, both prospective randomised trials comparing two different methods...
Argon plasma coagulation for epistaxis in HHT
In this study from the Czech Republic, the authors looked at the effectiveness of argon plasma coagulation (a non-contact form of monopolar electrocoagulation) in treating recurrent epistaxis in patients with hereditary haemorrhagic telangiectasia (HHT). The advantage of argon plasma coagulation...
Using autologous blood to reduce postoperative infections
The removal of impacted wisdom teeth is a common surgical procedure with possible complications including postoperative bleeding and wound infection and alveolar osteitis. Preventing osteitis is dependent on retaining the blood clot in the socket with no infection. There are...
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...
Sphenopalatine ganglion block in endoscopic sinus surgery reduces intra and post-operative morbidity
The authors present results of a meta-analysis to investigate the role of sphenopalatine ganglion block (SPGB) in reducing postoperative pain in endoscopic sinus surgery (ESS). An electronic database search (Pubmed, SCOPUS, Google Scholar, Embase, and the Cochrane Register of Controlled...
Tonsillectomy in or out?
Although tonsillectomy is the most common surgical act performed in ENT practice, there is still some concern about the safety of outpatient or day surgery scheduling, especially in adults. Although this has been common practice in many departments for some...
