Journal Reviews archive for September 2014
Vascularised tissue in salvage total laryngectomy
Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...
Head injury and prolonged bed rest, but not inner ear disease, predict poorer outcome after Epley manoeuvre in posterior semicircular canal benign paroxysmal positional vertgo (P-BPPV)
This Japanese study included 197 patients with P-BPPV treated over a two and a half year period. The vast majority had idiopathic BPPV (n=157). The remaining 40 had secondary BPPV, eight following head trauma, 14 due to prolonged bed rest...
Is there a cause-and-effect relationship between allergic rhinitis and chronic rhinosinusitis?
This review examines the possible causative relationship between allergic rhinitis (AR) and chronic rhinosinusitis (CRS) that has long been proposed. Many observational and experimental studies exist, however no clear and definitive connection has been established. This is mainly due to...
Evidence and nasal polyp treatments
The change in the routine management of nasal polyps in the past 2-3 decades has been fascinating and this review from Charleston covers the topics of systemic treatment, local treatment, perioperative treatment and immunotherapy and touches on the lower airway...
Improving smell outcomes after sinus surgery: impregnated dressings?
There is much we can do to improve the airway of patients with chronic sinus disease, especially those with polyps. However, the olfactory outcomes are usually disappointing and patients miss this important sensory modality, which has an effect on their...
What do we put in our nasal douches? Anything?
The rise of the popularity of saline nasal douches, with several commercial preparations available, may be a rediscovery of an age-old tradition, but it has been shown to benefit patients. The question then arises as to whether this can be...
Consequences of tonsillectomy rationing?
This article examines Hospital Episode Statistics and Office for National Statistics data to investigate the change in rates of tonsillectomy and admissions for tonsillitis and its complications, over a 20-year period. Between 1991 and 2011, 44% fewer tonsillectomies were performed....
Trends in parathyroidectomy
The authors retrospectively analysed Hospital Episode Statistics data for parathyroidectomy between 2000 and 2010. Overall, parathyroidectomy rates nearly doubled from 3.3/100,000 population in 2000 to 5.8/100,000 in 2010, with particularly significant increases in elderly patients. The authors attribute this rise...
3D ultrasonography for evaluation of muscles following facial palsy
Reconstructive surgery for facial nerve palsies is not recommended beyond two to three years after a degenerative facial nerve lesion. Since the time course of muscle atrophy is variable, this timeline is a rough guideline. The only assessment method currently...
Balloon dilatation of the eustachian tube: An evidence based review
Eustachian tube dysfunction has long provoked debate among otolaryngologists with wide-spread variation in management. Establishing a safe and effective surgical technique to bring about resolution would be of benefit to those affected, with an estimated incidence of 0.9% in the...
Clinical coding: variability and error in otolaryngology
The ever topical spectre of coding in otolaryngology is comprehensively evaluated in this article. It attempts to debunk the mystique of current coding practices and the challenge of health informatics in the modern NHS. A total of 3131 randomly selected...
National analysis of outcome of head and neck cancer surger
Patient outcomes continue to become ever more visible in the NHS with ongoing drives to demonstrate transparency in our delivery of healthcare. This article reviews unit-level data publication using Hospital Episode Statistics data in all units undertaking head and neck...
