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What is the evidence for duration of antibiotic prophylaxis in head and neck free-flap cases?
The topic of this systematic review is one which is commonly heard in discussions between microbiologists and head and neck surgeons – what is the evidence for antibiotic prophylaxis in clean-contaminated free-flap cases, and crucially, how long should antibiotics be...
Measuring the ‘impact’ of preoperative immunonutrition
Using preoperative nutritional supplements as part of ‘enhanced recovery’ in surgical patients is not a new concept. This interesting paper looks at the latest development in optimising patients undergoing head and neck oncological surgery. Immunonutrition (Nestle’s ‘Oral Impact’ in this...
Gardasil vaccination – an effective adjuvant therapy for RRP?
The clinical manifestations of recurrent respiratory papillomatosis (RRP) can vary hugely from individual to individual. Whilst some affected children will outgrow the disease, a subset of patients will experience frequent recurrences and require multiple surgical procedures over the course of...
Consider PCR testing in culture negative necrotising otitis externa
Necrotising otitis externa (NOE) often does not yield identification of a causative organism to treat although in 90% of cases it is a member of the pseudomonas species. The incidence of fungal NOE is not to be forgotten and this...
Prediction of morbidity and mortality in patients undergoing thyroid or parathyroid surgery
Major postoperative adverse events in thyroid or parathyroid surgery are uncommon. Various authors have developed risk indices to identify physical deficits in patients undergoing elective surgery. The literature is less clear about patients undergoing thyroid or parathyroid surgery. In this...
Loss of smell in the age of COVID-19
Loss of smell (LOS) is a debilitating symptom with increasing interest for the medical community due to its high prevalence in COVID-19. In the present paper, a team of 15 experts provide recommendations for the investigation and management of patients...
Outcomes at three years post-implantation of the Bonebridge device
This is a MED-EL-funded study of the hearing outcomes and complication rates of the Bonebridge active transcutaneous bone conduction implant (BCI). The authors have declared no conflict of interest. Follow-up occurred at intervals for 36 months post-implantation in all 57...
Laryngeal disorders associated with HIV infection
Following the introduction, and now widespread availability, of combined antiretroviral therapy, HIV has become a chronic disease with minimal or indeed no negative impact on life expectancy. As a result, there is a growing public health interest in establishing the...
Are quinsies worth draining?
Recent data is providing accumulating evidence that treatment failure in the management of peritonsillar abscesses (PTAs, aka ‘quinsies’) is similar when these are managed with medical treatment (MT) alone versus MT plus surgical drainage (M+ST). However, in the absence of...
Ramifications of the pandemic on acute paediatric mastoiditis: a national UK audit
Acute mastoiditis is a common presentation in the paediatric population across ENT services worldwide. An initial expectation of a rise in the numbers of acute mastoiditis associated with the initial findings of SARS-CoV-2 (COVID-19) virus presence in middle ear in...
A diagnosis-based scoring system to predict outcomes in necrotising otitis externa
Patients admitted with necrotising otitis externa have increased six-fold in the last 10 years. The prognosis is variable and dependent on co-existing morbidities. Charlston Comorbidity Index (CCI) is a weighted comorbidity scoring method, based on the presence or absence of...
