Journal Reviews archive for September 2016
Preoperative imaging for thyroid cancer according to 2015 ATA guidelines
The 2015 American Thyroid Association (ATA) management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer suggest that thyroid sonography with survey of the cervical lymph nodes should be performed in all patients with known or suspected thyroid...
CAD/CAM assisted mandibular reconstruction or freestyle?
The gold standard for the reconstruction of the mandible is a free bone flap and the fibula is commonly used. The fibula is a straight bone and presents considerations and difficulties in the formation of a U-shaped neo-mandible. Computer aided...
Can junior doctors provide immediate help in airway and other ENT emergencies?
In the present trends for centralisation of ENT emergency services, availability of immediate middle grade or senior help in acute ENT emergencies does not always exist on site and hence the role of junior doctors in handling this is enhanced...
Factors affecting compliance of follow-up of patients with chronic otitis media
Patients with retraction pockets and small cholesteatomas need good surveillance as well as those surgically treated for cholesteatomas. This is particularly important in closed techniques where a second look or diffusion weighted MRI can pick up any recurrence or residual...
Using cVEMPs to distinguish between vestibular migraine and from Ménière’s
Vestibular migraine (VM) and Ménière’s disease (MD) could overlap or mimic each other. Since the use of cVEMPs became routine, attempts have been made by researchers to explore its clinical utility in these two conditions. In this prospective study, the...
Persistent dysphonia due to cricothyroid muscle dystonia – should we be requesting laryngeal EMGs for non-resolving ‘functional’ dysphonia?
This article is an interesting report of a case of persistent voice problems affecting a 43-year-old physician that significantly compromised her ability to converse and communicate at work. Specifically, she had a fluctuating voice quality that would ‘choke off’, combined...
High definition tractography to identify cranial nerves
It has always been challenging to visualise cranial nerves on traditional imaging as the cranial nerves have a fine structure and complex anatomy. This is especially true regarding the cochlear nerve. In congenitally hearing impaired children, the visualisation of the...
Do endonasal approaches for meningiomas have more CSF leaks?
Rarely, patients presenting to the ENT surgeon with anosmia may have an anterior skull base neoplasm such as a meningioma. Historically, the traditional approaches have focused on several transcranial, external routes, including the pterional craniotomy, and the subfrontal craniotomy. The...
Carotid paragangliomas and their management
Paragangliomas in the head and neck are most frequently associated with the carotid artery, classically at its bifurcation and splaying the internal and external vessels. Despite their commonality at this site, large studies of these rare tumours are still lacking...
Preoperative risk factors: when do you need to refer to the haematologist?
It is essential that clinicians are able to identify and assess which patients are in the high risk category for bleeding during ENT surgery. A full history, including medications, herbal remedies taken, any other medical co-morbidities and family history of...
New MRI technique assesses treatment response in skull base osteomyelitis
This paper describes another useful imaging technique to monitor Necrotising Otitis Externa (NOE). Echoplanar diffusion weighted magnetic resonance (DW MR) shows high signal on the ‘ADC map’ with active disease and this reduces in signal intensity as symptoms improve. This...
Safety of outpatient thyroid and parathyroid surgery
This study examined the safety and outcomes of matched groups of patients, undergoing either inpatient thyroid / parathyroid surgery or being discharged within eight hours of surgery. There were 2,362 patients in each group who were matched by a ‘propensity...
