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823 results found

Risk factors in free flap failure

This is a retrospective analysis from China of 881 free flaps over nearly four years, 49 of which were ‘taken back’, 26 of which were lost, giving a 97% success rate. The commonest cause of flap failure was venous thrombosis....

Diagnosis of obstructive sleep apnoea hypopneoa syndrome (OSAHS) without sleep studies

Polysomnography is considered the ‘gold standard’ in the diagnosis of sleep apnoea but it is expensive and difficult to perform in children. Diagnosis based on subjective judgement is often inaccurate. An accurate diagnostic scale based on clinical parameters could obviate...

Should intratympanic steroids be the first line treatment for sudden sensorineural hearing loss?

This article looked at whether intratympanic steroids (ITS) provide more benefits over systemic steroid therapy (SST) as initial therapy in patients with idiopathic sudden sensorineural hearing loss (ISSHL). This meta-analysis study, based on published RCTs, concluded that ITS treatment exhibited...

Surgery or medicine: when should we stop trying to be conservative?

Although most otolaryngologists would agree that surgery improves the outcomes of patients with CRS when medical treatment has failed, both Cochrane reviews state that there is no proof of improved efficacy of surgery over medicine – however, that was after...

Factors determining success of adenotonsillectomy in paediatric obstructive sleep apnoea

Patient selection is important for any successful surgical procedure. Adenotonsillectomy for obstructive sleep apnoea secondary to adenotonsillar hypertrophy is no exception. This retrospective Taiwanese study attempts to find preoperative factors that have a positive influence for this commonly performed operation....

Pharyngocutaneous fistula after total laryngectomy

Pharyngocutaneous fistula (PCF) after total laryngectomy is a serious complication post-surgery, and can lead to prolonged hospitalisation, adding delays in postoperative chemoradiotherapy. This Turkish retrospective study looked at 166 patients who underwent total laryngectomy for laryngeal cancer, although it is...

Is GERD linked to CRS?

We are all well aware that both chronic rhinosinusitis and reflux are prevalent in our populations. This meta-analysis looked at 25 studies investigating the association between GERD, LPR and CRS, therefore evaluating more than 117,000 patients. The results are fascinating...

Steroids pre-FESS

This meta-analysis and systematic review from the Netherlands and the UK aims to answer the question of whether corticosteroids inhaled and / or taken orally are beneficial to patients with chronic rhinosinusitis undergoing functional endoscopic sinus surgery. Refreshingly 18 RCTs...

Evidence based outcomes for canal wall up, canal wall down and subsequent canal wall reconstruction for primary cholesteatoma

There has been a long standing controversy over whether to treat primary cholesteatoma with open or closed technique. The general consensus is that limited disease can be treated with closed technique whereas the canal wall down approach helps reduce recidivism...

Changes in airway dimensions after orthognathic surgery

This is a systematic review of meta-analysis evaluating the effect of different types of orthognathic surgery on the cross sectional area and volume of the upper airway as assessed using CT or MRI. They found 28 articles of which only...

Risk factors for post laryngectomy fistula

This is a meta-analysis looking at the postoperative pharyngocutaneous fistula rates following total laryngectomy. The authors ended up with 34 studies with about 2500 patients. The most striking finding was that preoperative radiotherapy was a significant risk factor as well...

Remote consultations: bringing ENT in to the 21st century

The ongoing peaks and troughs of the COVID-19 pandemic have imposed unprecedented challenges on day-to-day healthcare provision that we all took as given across the globe prior to spring 2020! The pandemic has, in many ways, made us push boundaries...