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From the editor September/October 2023

Declan Costello, MA, MBBS, FRCS(ORL-HNS),Consultant Ear, Nose and Throat Surgeon, Wexham Park Hospital, Slough, Berkshire, UK. E: d.costello@nhs.netTw: @Voicedoctor_uk Who do you think you are? And – perhaps equally important – how do you come across to other people? For...

A new free flap for the head and neck?

Reconstruction of major defects in the head and neck is usually an area where maxillofacial or plastic surgery colleagues come to assist, with consideration of the size and function any repair has to fulfil. Whilst the radial forearm free flap...

CRS vs. migraine: which is the culprit in most headaches?

‘Sinus headache’ is a common diagnosis according to patients and primary care physicians, but relatively infrequent in the eyes of otolaryngologists. This study examines 104 patients with a primary headache syndrome (PHS) and 130 patients with CRS, looking at SNOT-22...

Rib grafts for mandibular reconstruction

Reconstruction of the mandible following ablation requires good bone stock to allow optimal function and the placement of dental implants. In the developed world, vascularised bony flaps are accepted as the gold standard but these may not be widely available...

Accuracy of CT scans for cholesteatoma and its complications

Chronic ear disease with cholesteatoma generally requires active surgical management and the requirement for this needs precise assessment. A retrospective study was conducted to evaluate the accuracy of CT scan findings in terms of predicting cholesteatoma and its associated complications...

Relapse after bi-maxillary surgery in a class III malocclusion

This study analysed 90 patients who underwent a bi-maxillary osteotomy for a class III malocclusion. There were 30 in each of three groups of patients based upon the Frankfort mandibular plane angle (FMA). They were divided into: greater than 32°,...

Maxillomandibular advancement for sleep apnoea

This is a meta-analysis compiled from India. Of the initial 103 publications, 20 were analysed. Surgical cure was defined as postsurgical AHI of fewer than five events per hour. Of the 251 patients assessed for AHI, 12 were considered normal,...

Pedicle calcification – an uncommon problem

This paper from Germany describes an uncommon phenomenon of pedicle calcification in three cases. In patients from two centres that had fibula free flap reconstruction from January 2010 to January 2016, 68 cases had pedicle calcification and three cases were...

Peripheral nerve reconstruction using cell-enhanced acellular nerve grafts

Autologous nerve grafts are the current gold standard for peripheral nerve reconstruction. This systematic review analyses the role of cell-enhanced acellular nerve (ANA) grafts on the regeneration of peripheral nerve injuries. Several studies have been published to examine alternatives to...

The double-half bilobed flap or traditional bilobed flap: which is better?

Reconstruction of the nasal tip following ablative surgery can be taxing. The nasal tip is a very visible area with largely immovable skin and reconstruction needs an appreciation of the various subunits to achieve best results. The traditional superiorly based...

Inferior alveolar nerve recovery after ORIF fractured mandible

Mandibular fractures are quite common facial injuries, but aetiology varies with country and age. Common treatment options are open reduction and internal fixation via an intra-oral or extra-oral incision. Nerve injury or dysfunction is often seen preoperatively and may also...

A modification of the crescentic flap for nasal skin reconstruction

Non-melanoma skin cancers are the most frequent skin tumours and in over 25% of cases affect the nose. Following excision, the reconstruction may be challenging. Reconstruction aims to preserve the anatomical units, nasal functions and also an aesthetic final outcome....