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Metaplasia of the concave septum
This group conducted a one year prospective study and sampled mucosa from 42 randomly selected patients with septal deviation at a single centre. They found significantly higher rate of squamous metaplasia and lymphocytic infiltration in septal mucosa on the concave...
Role of intratympanic corticosteroid for treatment of Bell’s palsy and Ramsay Hunt syndrome
Acute peripheral facial palsy occurs annually in 30 in 1,000,000 individuals in the general population. Bell’s palsy and Ramsay Hunt syndrome account for about 70% of cases of peripheral facial palsy. They are believed to be caused by viral reactivation...
The debate: endoscopic vs microscopic ear surgery – meta-analysis of outcomes
Although the endoscopic approach to ear surgery has become more common in clinical practice, the debate about its role versus the traditional microscopic approach continues in many ENT units. This meta-analysis from the Mount Sinai ENT department in New York...
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....
What is the evidence for duration of antibiotic prophylaxis in head and neck free-flap cases?
The topic of this systematic review is one which is commonly heard in discussions between microbiologists and head and neck surgeons – what is the evidence for antibiotic prophylaxis in clean-contaminated free-flap cases, and crucially, how long should antibiotics be...
Steroids pre-FESS
This meta-analysis and systematic review from the Netherlands and the UK aims to answer the question of whether corticosteroids inhaled and / or taken orally are beneficial to patients with chronic rhinosinusitis undergoing functional endoscopic sinus surgery. Refreshingly 18 RCTs...
Evidence based outcomes for canal wall up, canal wall down and subsequent canal wall reconstruction for primary cholesteatoma
There has been a long standing controversy over whether to treat primary cholesteatoma with open or closed technique. The general consensus is that limited disease can be treated with closed technique whereas the canal wall down approach helps reduce recidivism...
Changes in airway dimensions after orthognathic surgery
This is a systematic review of meta-analysis evaluating the effect of different types of orthognathic surgery on the cross sectional area and volume of the upper airway as assessed using CT or MRI. They found 28 articles of which only...
Risk factors for post laryngectomy fistula
This is a meta-analysis looking at the postoperative pharyngocutaneous fistula rates following total laryngectomy. The authors ended up with 34 studies with about 2500 patients. The most striking finding was that preoperative radiotherapy was a significant risk factor as well...
Bone anchored implant stability predicted one week after implantation
Bone conduction (BC) devices can now be implanted as a single stage procedure with minimal soft tissue thinning to reduce the complications in the surrounding skin. The question of optimal loading time has to my mind not been answered. Here...
Head and neck cancer recurrence: a prospective analysis
The ‘cancer journey’ is synonymous for many individuals worldwide with frequent post-treatment hospital visits where the spectre of possible recurrence hangs over the consultation. This is a prospective analysis of 401 follow-up visits in Melbourne, Australia looking at follow-up in...
