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How should I excise sinonasal tumours, open or endoscopic? En bloc or piecemeal?
Sinonasal tumours often present late because initial symptoms mimic benign disease. They tend to produce more unilateral nasal symptoms, and patients with advance disease often describe paraesthesia and other cranial neuropathies. They only account for approximately 3% of upper aerodigestive...
Use of tranexamic acid in ENT surgery
Postoperative bleeding in otolaryngologic procedures causes delayed discharge, requires re-admission and adds considerably to the cost of patient care. Whether the anti-fibrinolytic activity of tranexamic acid should be used routinely to prevent haemorrhagic complications after ENT operations is speculation but...
Predicting swallowing outcomes post radiotherapy for head and neck cancer
A videofluroscopic swallow study (VFSS), also known as modified barium swallow (MBS) offers a dynamic view of swallow biomechanics and associated swallowing physiology. The authors of this paper investigated whether quantitative timing and displacement measures of key structures involved in...
Surviving oropharyngeal squamous cell carcinoma – does subsite matter?
Human papilloma virus (HPV) status is a known prognostic factor in oropharyngeal squamous cell carcinoma (OPSCC). The eighth edition of American Joint Cancer Committee (AJCC) has modified the TNM staging to reflect this. However, subsite as an independent prognostic factor...
Why do septoplasties fail?
If you are amongst the ones who wonder what keeps your patient blocked in spite of a reasonable septoplasty, it will be worth your time going through the chapter on nasal valve management. The concise table detailing the surgical techniques...ENT in this issue...Rhinoplasty
Joanne Rimmer, MBBS, MA(Hons)Cantab, FRCS(ORL‑HNS), Consultant Otolaryngologist / Rhinologist, Monash Health, Melbourne, Australia. E: rimmer.joanne@gmail.com Rhinoplasty may be done purely for aesthetic reasons, as an essential part of a functional septorhinoplasty, or for a combination of both cosmetic and functional...Winter Meeting of the Midland Institute of Otorhinolaryngology
By Edwin Halliday, ST6 Otolaryngology, Birmingham Children’s Hospital. The Winter Meeting of the Midland Institute of Otorhinolaryngology (MIO) took place over Zoom on 15 January 2021. The meeting, normally held biannually, had been cancelled in the summer due to the...
Predicting CSF leaks pre FESS: Gera classification - a new tool?
An interesting study from Italy looking at an anterior skull base classification that may be useful in predicting risk of intraoperative CSF leak during FESS surgery. Traditionally we have used the Keros classification system, developed in 1962 to categorise olfactory...OBITUARY: Nobuhiko Isshiki (1930–2022)
Ushering in a new era, the pioneer of laryngeal framework surgery remains an inspiration to this day. Prof Nobuhiko Isshiki in 2016 (courtesy: Mr Yakubu Karagama). The laryngological world has lost a great man. Professor Nobuhiko Isshiki passed away in...
Clinical assessment in OSA
This paper divides the assessment up into anatomical (nasal and oropharyngeal), endoscopic and imaging. It points out the salient features to look out for in OSA patients with regards the nasal valve and also oropharyngeal anatomy, with tonsil hypertrophy grading...
Rhinotillexomania - how bad can nose picking get?
This is a fascinating first case report of rhinotillexomania associated with empty nose syndrome (ENS). Rhinotillexomania encompasses compulsive, pathological nose picking and is a variant of self-harm. Tranchito and Chhabra describe an elderly patient presenting with longstanding symptoms of nasal...
