Journal Reviews
Balloon dilatation of the eustachian tube - largely very safe but not entirely without risk
Consent is a fundamental part of our daily working lives. This is something as simple as consent to examine a patient, consent to undertake a procedure as minor as taking blood, through to consent for a major operation. Whatever the...
How much does FESS improve the sense of smell?
We are all familiar with patients who undergo a seemingly successful FESS but, in spite of this, have persistent smell dysfunction postoperatively. This study compares a surgical group with a control group, measuring olfactory function pre and postoperatively using Sniffin...
Herpes zoster and SSNHL
Some studies suggest that viral infections may increase the risk of a sudden sensorineural hearing loss (SSNHL). The described longitudinal study explored whether herpes zoster may be a factor that increases the risk of SSNHL. Medical history in reference to...
Modified barium swallow studies: what is the radiation risk?
A modified barium swallow study (MBSS), also called a videofluoroscopy swallowing study uses ionising radiation to assist the clinician in visualising swallowing biomechanics from the oral cavity to the oesophagus. This procedure is currently one of the best methods used...
Delirium post-op
This is a retrospective study from Japan analysing 102 patients who underwent oral cancer resection and free flap reconstruction. Postoperative delirium occurred in a third of these patients. An increased risk was identified in those with high preoperative albumin, postoperative...
Risk factors in free flap failure
This is a retrospective analysis from China of 881 free flaps over nearly four years, 49 of which were ‘taken back’, 26 of which were lost, giving a 97% success rate. The commonest cause of flap failure was venous thrombosis....
Blood type and epistaxis
In this Turkish study, the authors attempted to determine if there was an association between ABO blood type and epistaxis. They looked at 359 epistaxis admissions at the same hospital over a three-year period. Only patients with idiopathic epistaxis were...
Bad splits
This is a meta-analysis of reported risk factors of a ‘bad split’ in a sagittal split mandibular osteotomy. They identified 30 observational articles and therefore acknowledged it is based on low quality studies. It is compounded by the definition of...
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...
Intermediate risk factors SCC tongue
This retrospective review from Japan assessed 89 patients who underwent surgery for squamous cell carcinoma of the tongue, specifically they reviewed the evidence of perineural and vascular invasion (27.0% and 23.6%). Their results suggest, not unsurprisingly, that perineural and vascular...
What’s the risk of regrowth with partial (intracapsular) tonsillectomy
Partial (intracapsular) tonsillectomy is enjoying somewhat of a revival offering the potential for less postoperative pain and bleeding whilst relieving the obstructive element. The authors look at 303 patients, 82 of whom had partial tonsillectomy using coblation. They measured pre...
Thyroid nodule update
This excellent article summarises the current diagnostic difficulties with an endocrine gland that frequently produces nodules, some of which may harbour malignancy. At 50 years of age and over there is about a 50% chance of having a nodule; at...
