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Is there time for intraoperative scans?

Intraoperative imaging plays an integral role in orthopaedic surgery during the repair of long-bone fracture. Given the complexity of the facial skeleton, intraoperative imaging has the potential for similar benefits in reconstructive surgery. The objectives of the study were to...

Intraoperative nerve monitoring: 2017

Having written the definitive text on laryngeal nerves, Gregory Randolph and Dipti Kamani describe the benefits of intraoperative neural monitoring and, importantly, how to proceed if the nerve is pathologically involved or there is loss of signal. Over the years,...

Intraoperative MRI use during pituitary tumour resection

This article provides an overview of intraoperative MRI (iMRI) use in transphenoidal surgery (TSS) for pituitary tumours. Traditionally imaging of the surgical field during surgery involves intraoperative fluoroscopic imaging or neuronavigation which help to avoid injury to critical structures but...

Does Tranexamic acid reduce intraoperative bleeding during FESS?

Intraoperative bleeding during FESS can reduce visibility and obscure important landmarks. This can result in longer operative times, increase risks of complications and even lead to incomplete surgery. Tranexamic acid is a drug which prevents fibrinolysis and stabilises blood clots....

X-ray vs. intraoperative testing for determining cochlear implant placement

Most cochlear implant centres confirm electrode position after surgery using X-rays to ensure optimal electrode placement. As well as transorbital view X-rays, this team check placement using impedance measures and neural response telemetry (NRT) performed intraoperatively. The former indicates whether...

An easy way to take intraoperative videos and pictures using a smart phone

Intraoperative visual documentation is a useful addition for personal archiving and for research purposes. Many commercially available systems are available for video and or photo documentations but these often require costly equipment. Smart phones would make ideal recording devices. However,...

Intraoperative identification of primary tumours in unknown primary head and neck cancer using transoral laser microsurgery with frozen sections

The aim of the study was to compare the sensitivity and specificity of intraoperative identification of primary tumours in patients with unknown primary head and neck squamous cell carcinoma (UP HNSCC) using transoral laser microsurgery (TLM) with frozen sections, with...

CT and intraoperative nerve monitoring to identify non-recurrent laryngeal nerve during thyroid surgery

A non-recurrent laryngeal nerve (NRLN) is a rare (incidence 0.3% to 1.3%) anatomical variant that results in a higher rate of vocal cord palsy following thyroid surgery. This team from China examined the utility of preoperative CT and intraoperative nerve...

Can intraoperative electrically evoked auditory brainstem responses predict the outcome of cochlear implantation?

Electrophysiology during cochlear implant surgery remains an issue of debate among the various centres. In the present study, the latencies and quality of the eABR waveforms from 74 adult implanted patients were analysed. In addition, four children with severe cochlear...

The Recurrent and Superior Laryngeal Nerves, 1st edition

Exactly 60 years after Dr William Rustad’s 47 page publication on the recurrent laryngeal nerve and thyroid surgery, Prof Gregory Randolph from Boston has edited a unique state-of–the-art review of the recurrent and laryngeal nerves for thyroid and parathyroid surgeons....

To monitor the nerves or not?

Whilst intraoperative nerve monitoring has become the standard of care for mastoid and parotid surgery, its benefit in thyroid surgery remains unclear. In the UK NICE was agnostic on the subject in 2008, stating that it was potentially helpful and...

Anaesthesia for free-flap surgery

Adel Hutchinson is one of those calm and controlled anaesthetists for whom nothing seems too difficult. In this article, she describes the key perioperative factors for one of the highest complexity operations in ENT; free-flap surgery. It makes good reading...