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DISE as a rationalising tool for sleep apnoea surgery
This retrospective study on 85 adult obstructive sleep apnoea (OSA) patients provides further interesting information for sleep surgeons. These patients were all investigated with polysomnography (PSG) and drug induced sleep endoscopy (DISE). They all then underwent a simple uvulopalatoplasty with...
Tonsillectomy in or out?
Although tonsillectomy is the most common surgical act performed in ENT practice, there is still some concern about the safety of outpatient or day surgery scheduling, especially in adults. Although this has been common practice in many departments for some...
Does Tranexamic acid reduce intraoperative bleeding during FESS?
Intraoperative bleeding during FESS can reduce visibility and obscure important landmarks. This can result in longer operative times, increase risks of complications and even lead to incomplete surgery. Tranexamic acid is a drug which prevents fibrinolysis and stabilises blood clots....
Are ENT surgeons better placed to perform cosmetic ear, nasal and facial procedures?
Cosmetic surgery is an essential component of plastic surgery training and is required in order to CCT. However, the training opportunities in plastic surgery in UK are limited. The current operative requirements for plastic surgery trainees are 100 procedures during...
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...
Sinonasal Complications of Dental Disease and Treatment: Prevention - Diagnosis - Management
As otorhinolaryngologists, we are trained to examine the computed tomography (CT) scans of all patients with maxillary chronic rhinosinusitis (CRS) for potential dental disease. The mainstay of managing this is generally limited to referring the patient to their dentist or...
Infection and other factors influencing post-tonsillectomy haemorrhage
In this detailed narrative review article, the authors have addressed several factors which could be related to postoperative bleeding after tonsillectomy. As regards to microbiology, the significance of micro-organisms present both on surface and within the tonsils is emphasised and...
The sleep nasendoscopy learning curve
There seems to be no accepted way of surgically assessing patients with sleep disordered breathing (SDB). Because of this, clinicians fall roughly into three camps: those who just use one operation for all patients, those who have given up surgery...
5-cm incision for neck dissection and free flap reconstruction
Patients with oral cavity squamous cell carcinoma (SCC) will commonly require neck dissection as it is associated with a higher rate of overall and disease free survival. Free flap reconstruction of the defect following surgical resection is considered the gold...
Low risk options following failure of intratympanic gentamicin for Meniere’s
This article is a useful summary of the options available when intratympanic gentamicin (ITG) fails to adequately control vertigo episodes in Meniere’s patients. The authors describe the anatomical reasons that may impede drug delivery to the round window with the...
Incidental thyroid nodules: should we observe or operate?
Thyroid nodules are extraordinarily prevalent, detected by physical examination in 7% and by imaging studies in 67% of the population. Although most of these nodules are benign, up to 20% are found to be malignant on excision. It’s a very...
