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To monitor the nerves or not?

Whilst intraoperative nerve monitoring has become the standard of care for mastoid and parotid surgery, its benefit in thyroid surgery remains unclear. In the UK NICE was agnostic on the subject in 2008, stating that it was potentially helpful and...

Radiosurgery for large vestibular schwannomas

The authors conducted a retrospective study of patients with large Koos grade 4 vestibular schwannomas undergoing gamma knife radiosurgery. A total of 68 patients with tumour size greater than 4 cm3 with baseline serviceable 60% hearing who received 12 Gray...

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...

Surgery for drooling

This paper looks at the surgical options for sialorrhoea once the first two options of behavioural and physiotherapy interventions and pharmacotherapy have been exhausted. The social impact of sialorrhoea on patients and their families is significant and often lifelong therefore...

Monitored safe medical practice: minimising patient harm will reduce medical negligence bill for the NHS

Patrick Bradley ruminates on a celebrated career in ENT head and neck surgery and suggests that increasing the possibility of positive outcomes to contemporary patient safety initiatives by the NHS must involve efforts to develop an enthusiastic contented workforce willing...

Congratulations on being elected BRS President

Mr Raj Bhalla has been elected next President of the British Rhinological Society following a recent vote by the membership. He works as a Consultant Rhinologist at both Manchester Royal Infirmary and Salford Royal Hospital. He will take up...

Which da Vinci surgical system? Novel flexible, single-port versus current multiport, rigid-arm robotic surgical system

The da Vinci robotic surgical system has transformed how oropharyngeal head and neck surgery can be delivered. The existing da Vinci Si model has challenges: the dimensions of this are larger than would be ideal for head and neck surgery...

Management of oral white patches with malignant potential

This paper focuses on a rare but aggressive form of leukoplakia with malignant potential and is an important reminder of the need for specialist management to those in allied specialties such as ENT that may initially be referred these oral...

Use of angular vessels in head and neck free-tissue transfer – a comprehensive preclinical evaluation

Free tissue transfer (FTT) has transformed the capabilities in head and neck reconstruction. Rotational and pedicled flaps are limited by the pedicle length, the type of tissue required and the size of the defect. FTT helps lessen the impact of...

REARRANGED: An Opera Singer’s Facial Cancer And Life Transposed

Rearranged is a wonderfully positive memoir telling of Kathleen Watt’s ordeal through maxillary osteosarcoma. As an early career opera singer in the New York Metropolitan Opera’s chorus, her dreams are derailed and life transformed when this most rare diagnosis hits....

Salivary duct clipping for drooling

Drooling can be a challenging problem to manage in paediatric ENT. The variety of medical and surgical treatments suggests that there is no gold standard treatment. Nicola Stobbs and Ravi Thevasagayam describe an approach to ligating the salivary ducts. Drooling...

Panetti Endoscopic Ear Instruments

Giuseppe Panetti is a renowned otologist and one of the forerunners of endoscopic ear surgery. One of his major contributions to ENT has been through designing bespoke equipment to assist in some of the challenges of operating endoscopically. In this...