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Access to and uptake of cochlear implants in the UK

Assessing demands on cochlear implant (CI) services is very important for both commissioners and clinicians in anticipating clinical need and funding requirements. Commercial CI’s were introduced in the late 1980s. Initial funding was from charitable sources. The first major advance...

Robotic assisted orbital surgery (RAOS) – a novel approach to orbital malignancy surgery

Robotic technology in ENT surgery has been used in certain areas of head and neck cancer care but, in this article, we hear of an exciting development from the team at Guy’s & St Thomas’. Advances in surgical robotic technology...

Anaesthesia for sleep nasendoscopy and snoring / obstructive sleep apnoea surgery

Surgery for sleep disordered breathing inevitably requires surgeon and anaesthetist to share the airway. Here, Edward Bick gives us the anaesthetic viewpoint, reiterating that communication is the key. A specific note is made of the anaesthetic technique for sleep nasendoscopy,...

In conversation with Professor John Fenton

John Fenton, Republic of Ireland, has recently been appointed President of the Union Européene Des Médicins Spécialistes (UEMS) ORL or European Union of Medical Specialists ORL Section. We caught up with him to find out a little more about his...

The EU Medical Device Regulation (MDR)

Back in May 2017, the EU Medical Device Regulation (MDR 2017/745) entered into force, replacing existing directives: Active Implantable Medical Devices (AIMD) In-vitro Diagnostic Directive (IVDD) Medical Device Directive (MDD) By 26 May 2020, the new regulation will have completed...

Retrieval of an aspirated voice prosthesis in the awake laryngectomised patient

In this article, the authors describe a simple and effective technique for extracting an aspirated voice prosthesis from within the tracheobronchial tree in the awake laryngectomised patient using the Ambu® aScopeTM 4 Broncho endoscope. Surgical voice restoration remains the dominant...

Semi dynamic reconstruction of the lower lip

The main goal of reconstructive surgery for facial paralysis is the restoration of smiling and function of eye closure. The deformity of the lower lip in paralysis is ptosis of the corner of the mouth, eversion of the vermillion and...

Difficult consultations with HPV-positive oropharnyeal cancer patients

The aetiological role of human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OPSCC) is well established, and its incidence has massively increased over the last decade, whilst the incidence of HPV-negative OPSCC is declining. Although we know that HPV-positive OPSCC...

Pain control for patients with chronic pain following surgery

There is an increasing number of patients with a background of chronic pain presenting to the otolaryngologist. Patients with chronic pain require extra consideration in postoperative pain control due to risk of tolerance and dependence. This article summarises postoperative management...

Auditory deprivation and single-sided deafness

In cases of bilateral auditory deprivation, there is clear evidence of an inverse relationship between performance after cochlear implantation and the length of severe to profound deafness prior to implantation (i.e. the longer the deprivation the poorer the outcome on...

Innovative approaches to treating deafness

Shahar Taiber and Karen Avraham give us a summary of gene therapies for hearing loss, with an overview of limitations and what the future holds. Hearing loss is the most common sensory disorder. The last two decades have seen a...

Surgical technology and operating room safety failures: lessons from vascular and general surgery

Background – surgical technology and otolaryngology An estimated 234 million major surgical procedures are performed annually worldwide. This requires the interaction of multidisciplinary teams with varying contributions of surgical technology and therefore makes surgical procedures prone to multiple sources of...