An overview of microsurgical reconstruction of the head and neck worldwide

Microsurgical reconstruction is an integral part of the treatment following ablation for malignancy or trauma. Currently there are no clear treatment guidelines following tumour resection. This was recognised a few years ago and in 2008 various collaborative groups were founded...

Facial reconstruction with polyethylene implants

Planning reconstructive surgery for complex craniofacial defects challenges even the most experienced of surgeons. In most cases surgery is undertaken to improve anatomical functioning. However the anatomical structure of these regions is also critical to facial aesthetics and patient satisfaction...

Postop follow up of oral squamous cell carcinoma: a new protocol

Oral and oropharyngeal cancers together are the sixth most common malignancy in the world, with an increasing incidence of oral squamous cell carcinoma (OSCC). The recurrence rate of OSCC is reported to be approximately 10-26%. About two-thirds of all recurrent...

Are upper respiratory symptoms and macroscopic changes in children always due to gastro-oesphageal reflux?

In children, symptoms such as chronic cough, wheezing, stridor, voice changes, persistent asthma and dental erosion are often presumed to be due to gastro-oesophageal reflux and empirical treatment with PPIs is offered. Usual investigations, such as a barium meal, gastroscopy...

Does teaching affect patient satisfaction?

Teaching practice on real patients has several advantages in terms of lower costs and genuine clinical material but it is often a concern that using real patients for undergraduate teaching may result in patient dissatisfaction and many patients would prefer...

Guidelines for management of orbital infections

Orbital infections predominantly affect the paediatric population and complications can be very serious. The cellulitis can be preseptal or orbital and the abscess can be confined within the periosteum or extend into the orbit. Cavernous sinus thrombosis can complicate the...

Perception of verticality during attacks of Ménière’s

Ménière’s disease (MD) affects the cochlea and all peripheral vestibular receptors. The perception of verticality, a function of the utricle, is evaluated by the subjective visual vertical (SVV) test. The authors studied SVV in two groups of MD patients: a)...

Horizontal nystagmus: vestibular neuritis or lateral canal BPPV?

A horizontal nystagmus due to lateral canal (LSC) BPPV that is present in the upright position, that changes direction with head turn in the horizontal plane has been termed ‘pseudo-spontaneous nystagmus’ (PSN) because it mimics that of vestibular neuritis. The...

New diagnostic criteria for Ménière’s disease – an international consensus

Most readers are familiar with the American Academy diagnostic criteria for Ménière’s disease (MD) but a significant minority will be aware of other criteria from Japan and Korea. This new effort is a collaboration between these three bodies and the...

Spasmodic dysphonia – is greater awareness needed?

Spasmodic dysphonia (SD) is a focal dystonia of the laryngeal musculature. Previously considered to be a rare disorder, it has more recently been suggested that SD is in fact not rare but is frequently misdiagnosed or undiagnosed. This paper would...

Botox application for drooling shrinks salivary glands

The large majority of sialorrhoea (drooling) in paediatric patients is managed conservatively. However in severe cases, often where there is associated developmental delay or a motor disorder, medical and surgical techniques can be used to decrease salivary flow. Botulinum toxin...

Margin control using optical techniques in head and neck surgery

Emerging optical techniques such as high-resolution microendoscopy (HRME) are currently being examined for their reliability in discriminating benign from neoplastic epithelium. These techniques may offer the potential to detect the margin of an upper aerodigestive tract tumour in a non-invasive...