How I Do It
Partial reconstruction of the pinna
Reconstruction of the pinna is one of the most challenging procedures in facial plastic surgery. Although there has been significant progress since one of the earliest recorded descriptions by Sushruta in 600 BC, the complex three-dimensional structure of the pinna...
Functional Endoscopic Sinus Surgery (FESS) - Part 1
In the first of a two-part series, Martyn Barnes and colleagues discuss indications for functional endoscopic sinus surgery (FESS), the surgical objectives and techniques, patient expectations and the risks of surgery. In part two, the authors will discuss how to...
Selective upper airway stimulation
Obstructive sleep apnoea (OSA) is one of the most common diseases in industrialised countries and is characterised by an intermittent obstruction of the upper airway during sleep. The standard treatment for OSA is continuous positive airway pressure (CPAP) therapy, which...
KTP laser in the office
KTP laser surgery offers a new way of selectively targeting microvasculature within laryngeal lesions and leaving normal surrounding tissues like epithelium and lamina propria intact – and thus preserving physiological phonation. This kind of selective photoangiolysis can be performed in...
A practical approach to tinnitus
Tinnitus is the perception of sound without an external source. The estimated prevalence in adults is between 10-15% [1]. In patients with significant tinnitus, prompting them to seek medical attention, 50% will have improved to mild or no tinnitus by...
Use of a diode laser for the removal of a frontal sinus osteoma
In this How I Do It, Professor Sergei Karpischenko introduces a gentle method of reduction of mobilised frontal sinus osteoma which has been successfully used in five patients in his university clinic using a diode laser in contact mode. Osteoma...
Isshiki Thyroplasty Type 2
Indication Adductor spasmodic dysphonia is a neurological condition of unknown aetiology. The symptoms are believed to be caused by involuntary contraction of the adductor muscles of the vocal cord as a result of an abnormality of neurotransmitters in the basal...
How to safely image patients with cochlear implants
Cochlear implants have quickly become a widely used aid for hearing-impaired people. As these implants include metal elements, the choice of an appropriate imaging modality for patients carrying such devices should receive special attention. This is important due to image...
Open septorhinoplasty approach for closure of medium sized septal perforations
Septal perforations are difficult problems to treat. There are various causes described in literature such as trauma, inflammatory, cocaine abuse but most often they are due to iatrogenic cause (such as septoplasty) or due to trauma. The symptoms due to...
CO2 Laser Dohlmans: Does It Still Have A Role In Pharyngeal Pouch Management?
Background The commonest active management of a pharyngeal pouch is the division of the “interparty” wall using a stapling device [1, 2]. The technique is relatively straight forward to perform and theoretically should have less complications than other techniques such...
Cutting burr otoplasty and conchal setback to correct prominent pinna: a ‘step by step approach’
Prominent ears can cause significant social and psychological effects on an individual. The two most common anatomical defects for a prominent pinna are an underdeveloped anti-helical fold and / or enlarged conchal bowl. In the senior author’s practice over the...
Reduction thyroplasty
Introduction Male to female transgendered patients are referred to ENT for reduction thyroplasty – a procedure to reduce the external appearance of the thyroid cartilage of the larynx, and feminisation of the voice. Reduction thyroplasty, often erroneously called ‘tracheal shave’,...