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Clinical leadership and management: the ‘Darzi’ experience

The Fellowship in Clinical Leadership programme, more commonly known as the ‘Darzi Fellowship,’ commenced in 2009. It was designed to provide junior doctors at the registrar level with postgraduate training in clinical leadership and change management in order to develop...

General overview of endoscopic ear surgery: advantages and principles

The philosophy of endoscopic ear surgery presents surgeons with a tricky concept – does the magnificent view make up for the fact I need to operate with one hand? In this article, Jane Lea discusses the advantages of operating transcanal...

The role of macrolide antibiotics in chronic rhinosinusitis

The use of long-term antibiotics in the treatment of chronic rhinosinusitis is a contentious issue, not only because of the increasing problem with antibiotic resistance but also because of the potential cardiac risks, including sudden death. In this article, Anders...

Timing of surgery in chronic rhinosinusitis: does it matter?

While many patients with chronic rhinosinusitis respond to medical treatment, some do not. The next step for these patients is surgery, but how soon should this be offered? Sooner rather than later seems to be the answer, as Claire Hopkins...

Running a post-COVID smell clinic

Over the past year, much of our effort as a speciality has been directed towards crisis management and keeping services afloat. Our practice has changed in untold ways, but unprecedented numbers of patients with smell disorders will increasingly require our...

Endoscopic DCR

In this interesting article, our experienced colleagues describe their favoured technique for performing endoscopic DCR and share with us the key steps for a successful outcome. Dacrocystorhinostomy (DCR) was historically performed by ophthalmologists for nasolacrimal obstruction using external techniques. The...

The ‘umbrella furling’ deflation technique for cuffed tracheostomy tube - a useful tip for an easier tracheostomy insertion

In this article, the authors describe a quick and effective technique to assist with the maximal deflation of a tracheostomy tube cuff prior to insertion, thus making the process easier with less chance of damage to the cuff and a...

International consensus paper on implantable devices for conductive or mixed loss

This is a weighty but insightful ‘Special Feature’ paper in the June edition of Otology and Neurotology. It has the broad aim to gather current opinion from otologists, audiologists, manufacturers and health-economists from around the world on unilateral hearing implantation...

Reducing nasal changes in SARPE

This paper from Belgium highlights completing a sub-spinal cortectomy of the anterior nasal spine during the procedure of surgically assisted rapid palatal expansion (SARPE) as a means of reducing the alar and columella width as well as the nasolabial angle....

Laryngeal evaluation during COVID-19 using transcervical ultrasonography

In light of the COVID-19 pandemic, the authors highlight their protocol of transcutaneous laryngeal ultrasonography as an alternative to flexible fibreoptic laryngoscopy when appropriate. This is to reduce the risk of aerosolisation posed by laryngoscopy. Ultrasonography is a rapid, non-invasive...

Selective upper airway stimulation

Obstructive sleep apnoea (OSA) is one of the most common diseases in industrialised countries and is characterised by an intermittent obstruction of the upper airway during sleep. The standard treatment for OSA is continuous positive airway pressure (CPAP) therapy, which...

Maxillofacial and neck surgery in Iraq and Afghanistan

Introduction Over the past 150 years, military personnel wounded in action had a survival rate of approximately 80% [1]. During the current conflicts in Iraq and Afghanistan, those servicemen wounded in action have a 90.4% survival rate [2]. During the...