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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...
Bone anchored implant stability predicted one week after implantation
Bone conduction (BC) devices can now be implanted as a single stage procedure with minimal soft tissue thinning to reduce the complications in the surrounding skin. The question of optimal loading time has to my mind not been answered. Here...
Head and neck cancer recurrence: a prospective analysis
The ‘cancer journey’ is synonymous for many individuals worldwide with frequent post-treatment hospital visits where the spectre of possible recurrence hangs over the consultation. This is a prospective analysis of 401 follow-up visits in Melbourne, Australia looking at follow-up in...
Rhinosinusitis in secondary school children - Part 2: main project analysis of MSNOT-20 Young Persons Questionnaire (MSYPQ)
Rhinosinusitis in secondary school children - Part 2: main project analysis of MSNOT-20 Young Persons Questionnaire (MSYPQ) This study used the modified SNOT-20 in Young Persons Questionnaire (MSYPQ) to evaluate the prevalence and effects of rhinosinusitis in adolescent children (aged...
