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Surgical management of refractory osteoradionecrosis
This is a French single-centre, 10-year experience of 55 surgical resection and reconstruction procedures. They claim an overall effectiveness rate of 92.3%. A total of 36 segmental and 19 marginal mandibulectomies were performed. A variety of free flaps were used,...
Hierarchy of orthognathic surgical stability
This study was designed as “an overview” of secondary studies and analysed 15 articles. Two procedures were considered highly unstable: a bilateral sagittal split osteotomy for clockwise rotation of the mandible with bi-cortical screw rigid internal fixation, and posterior maxillary...
Bright young things: executive functioning in younger, older and aphasic people
Executive function comprises several higher order cognitive processes such as planning, organisation, adaptation, maintenance, monitoring and decision making. It is thought that difficulties in cognitive flexibility in people with aphasia are associated with difficulties in executive function rather than the...
Diagnosing complications of acute mastoiditis in emergency situations
In many cases, acute mastoiditis is manageable with intravenous antibiotics and hospitalised care. However, the decision whether to intervene surgically remains crucial and reliance is based on radiological findings – CT scans for bony changes and MRI for possible intra-cerebral...
Is posterior epistaxis really ‘posterior’?
In absence of any clear bleeding points seen on the septum, it is generally presumed that the epistaxis is posterior, especially when simple cauterisation of the septum does not help and may progress to sphenopalatine ligation. In this publication, the...
Salivary pepsin – a simple test for LPR?
A diagnosis of laryngopharyngeal reflux (LPR) can be made on the basis of characteristic symptoms and nasendoscopy findings. Objective tests exist for this condition; for example, 24-hour dual-channel pH-metry which is considered to be the gold standard. Such tests are,...
Do parents sleep better after paediatric adenotonsillectomy?
Paediatric adenotonsillectomy for sleep disordered breathing (SDB) is amongst the commonest surgical procedures performed in ENT. In the outpatient clinic, parents routinely express their concern about their child’s breathing but the impact of sleep disordered breathing on the parent is...
More than words: looking at all the evidence
Evidence based practice (EBP) is a three-pillared approach whereby information on the research evidence, factors relating to the patient and clinical experience are all considered to inform a care decision. Unfortunately, there is frequently very little research evidence to inform...
Is the greater auricular nerve important in parotid surgery?
The greater auricular nerve (GAN) is often partially or totally sacrificed during parotidectomy procedures. This was a retrospective study comparing auricular sensation and quality of life in patients that either had their GAN preserved or sacrificed. In the shortterm, patients...
Surviving oropharyngeal squamous cell carcinoma – does subsite matter?
Human papilloma virus (HPV) status is a known prognostic factor in oropharyngeal squamous cell carcinoma (OPSCC). The eighth edition of American Joint Cancer Committee (AJCC) has modified the TNM staging to reflect this. However, subsite as an independent prognostic factor...
The search for the holy grail of rhinosinusitis: another step towards phenotyping in CRS wNP?
For many years, scientists and clinicians have been trying to understand the infinite variability within the term ‘rhinosinusitis’ using radiology, basic science, epidemiology and then using their insights to solve the riddle of management: how to explain why some patients...
