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Treating keloid scarring with pressure clips following excision: does it work?
Keloid scars can pose a difficult management problem. Whilst not harmful in themselves they can be cosmetically unappealing and lead to social embarrassment and resulting isolation, and following surgical excision they often reoccur. Mechanical pressure is an adjuvant to surgical...
Botulinum toxin and drooling – how much, how often and where?
This was an incredibly useful article covering all aspects of the use of botulinum toxin as a treatment modality in sialorrhoea. The article starts by outlining why treating sialorrhoea is important and describes the non-pharmacological and pharmacological options, highlighting that...
Chemo-radiation in elderly patients with head and neck cancers
Chemo-radiotherapy is the standard of care for organ preservation in stage three and four oropharyngeal cancer, prospective data on patients over 65 has not been available as they are usually excluded from randomised trials. This paper reviews the experience of...
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...
Chronic facial pain: types and long-term treatment
This publication discusses the details and differences between chronic tension type headache and migraine and followed a cohort of 240 patients over 36 months. The authors applied strict criteria to distinguish between chronic tension headache and migraine, these essentially being...
Fungal rhinosinusitis
Allergic fungal rhinosinusitis (AFRS) has been defined by the following characteristics: presence of nasal discharge, nasal obstruction, decreased sense of smell or facial pressure for 12 weeks, mucin within the sinus cavity containing fungal hyphae and degranulating eosinophils, endoscopic evidence...
Modified subciliary approach to the orbital floor
Fractures involving the lateral midface and orbital floor are routinely treated by maxillofacial surgeons. The surgical management requires access to the facial skeleton to reposition and free the soft tissues. There are three main approaches to the orbital floor: infraorbital;...
To use or not to use: absorbable sutures for facial wounds
This systematic literature review looked at studies comparing facial skin closure with absorbable versus non-absorbable sutures. Studies not published in English or looking at areas other than the head and neck, and studies focused on suture technique rather than material...
Allergic rhinitis, the usual suspects
Allergic rhinitis (AR) is characterised by allergen binding to IgE on mast cells and basophils and subsequent histamine, prostaglandine D2 (PGD2) and cysteinyl leukotrienes (cysLTs) release causing early-phase response. This is followed by late-phase response mediated by eosinophils. Other cells,...
Laryngeal evaluation during COVID-19 using transcervical ultrasonography
In light of the COVID-19 pandemic, the authors highlight their protocol of transcutaneous laryngeal ultrasonography as an alternative to flexible fibreoptic laryngoscopy when appropriate. This is to reduce the risk of aerosolisation posed by laryngoscopy. Ultrasonography is a rapid, non-invasive...
A novel graft material for endoscopic tympanoplasty using the pre-tragal SMAS layer
The traditional biological graft materials for providing a scaffold for tympanic membrane reconstruction include temporalis fascia as well as conchal and tragal perichondrium/cartilage. This group from Taiwan present a novel graft option using the superficial musculo-aponeurotic system (SMAS) layer. They...
