Measuring is understanding: an unsupervised PROM clustering of CRS patients

It has been clear for quite some years, at least for anyone dealing daily with chronic rhinosinusitis (CRS) patients, that CRS is an ‘umbrella’ diagnosis. There are significant differences between patients, including different demographic data, different endoscopic and radiographic images,...

Getting your nose dry: endoscopic vidian neurectomy – an old technique given new life

We are often faced with patients with intractable watery rhinorhea – patients with no demonstrable allergy, a diagnosis of NAR and no response to ipratropium or capsaicine. For such patients, vidian neurectomy has been devised – an old technique that...

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...

No difference upper or lower lip

This is a retrospective review from the Netherlands over a 20-year period to 2009 of squamous cell carcinoma (SCC) of the lip. In total, 979 cases of the lower lip were identified and 126 of the upper lip, with men...

Bone anchored implant stability predicted one week after implantation

Bone conduction (BC) devices can now be implanted as a single stage procedure with minimal soft tissue thinning to reduce the complications in the surrounding skin. The question of optimal loading time has to my mind not been answered. Here...

How young is too young for tympanoplasty?

This paper presents the largest series of pre-school age children undergoing tympanoplasty compared with older children. The authors have collected much prospective data on 259 children undergoing 284 surgeries so were able to perform multivariate analysis. The age groupings of...

Do anticoagulanis and facial plastic surgery mix?

Some surgeons think that antiplatelet and anticoagulant therapies (aspirin, warfarin sodium and clopidogrel bisulphate) increase perioperative bleeding and infections. However, the current evidence base provides conflicting data with respect to the risk of true complications. In this case-control study a...

Is there time for intraoperative scans?

Intraoperative imaging plays an integral role in orthopaedic surgery during the repair of long-bone fracture. Given the complexity of the facial skeleton, intraoperative imaging has the potential for similar benefits in reconstructive surgery. The objectives of the study were to...

Medialisation laryngoplasty can relieve pain related to voice use

Odynophonia, or pain associated with voice use, is a relatively uncommon manifestation of glottal insufficiency related to vocal fold motion impairment (VFMI). Its incidence is approximately 15% in patients with vocal fold paresis. Medialisation laryngoplasty (ML) was popularised by Isshiki...

Octreotide in the medical management of chyle fistula post neck dissection

Chyle leak, although rare (1% and 2.5%), is a well-documented complication following surgical dissection of the neck. Although the left side of the neck is the most common site, chyle fistulas have been reported in the right side of the...

Marginal gains

Many consider facial nerve monitoring compulsory in parotid surgery yet few do the same for the marginal mandibular nerve in a submandibular approach, even though the nerve is finer and more difficult to identify. Here a group map the nerve...

Two for one forearm flaps

There are many and varied free flaps available for reconstructions. Here is a variant on the workhorse radial free forearm flap. The modification involves a longer, narrower flap that can be rotated back on itself to increase the flap width...