How I Do It archive for 2022

Photo showing good marginal clearance and aesthetic reconstruction usually requires excision of the whole alar subunit

Random-pattern skin flaps: part 4 - transposition flaps

2 September 2022 | | ENT, Head and Neck, Rhinology / Sinus

In the final part of our series on local skin flaps (see Part 1, Part 2 and Part 3) in ENT, the authors describe the usefulness of the transposition-type flap and highlight some examples. Rotational advancement flap Useful for defects...

Image with Chester-gel technique - heath is held firmly against lense of scope by the gel.

Chester-gel technique

5 July 2022 | | ENT, Rhinology / Sinus

Umesh Nagalotimath and Robert Temple describe a simple and effective technique for enhancing vision during endosheath use for flexible nasendoscopy. Endosheaths are used to complement the cleaning of flexible scopes. The advantages are time saving for clinicians as this reduces...

Photo showing how damp swab is used to flatten the cuff between the index, middle, ring fingers, and thumb.

The ‘umbrella furling’ deflation technique for cuffed tracheostomy tube - a useful tip for an easier tracheostomy insertion

27 June 2022 | | ENT, Head and Neck, Laryngology / Swallowing / Voice

In this article, the authors describe a quick and effective technique to assist with the maximal deflation of a tracheostomy tube cuff prior to insertion, thus making the process easier with less chance of damage to the cuff and a...

The flap lobes and their apposing surfaces are undermined deeply to provide adequate closure - photo image.

Random-pattern skin flaps: part 3 - Z-plasty flaps

3 May 2022 | | ENT, Head and Neck

In this third (see Part 1 here, Part 2 here and Part 4 here) of four articles outlining, in some detail, the practical steps for some important local skin flaps, Christopher Thompson and Miles Bannister describe the Z-plasty; a very...

Table showing prescribed incremental escalating doses of aspirin as per the protocol.

Aspirin desensitisation for aspirin-exacerbated respiratory disease (AERD)

2 March 2022 | | ENT, Rhinology / Sinus

In this article, the authors describe the importance of identifying aspirin-exacerbated respiratory disease in patients with chronic rhinosinusitis refractory to standard medical treatment. This can then open the door to considering aspirin desensitisation treatment which, in their hands, has proven...

Photo showing dimensions of the first lobe are approximately equal to that of the defect, whereas the second lobe may need to be up to twice as long, though half as wide.

Random-pattern skin flaps: part 2 - rhomboid and bilobed flaps

5 January 2022 | | ENT, Head and Neck

In the second of our series on local skin flaps (see Part 1 here, Part 3 here and Part 4 here), the authors describe more techniques and examples of various skin flaps that trainees should find very interesting. Rhomboid flap...