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Lateral wall augmentation for patulous eustachian tube

The problem more commonly attributed to the eustachian tube is lack of its patency rather than it being unduly patulous. This lesser recognised condition is due to loss of peritubal fat volume resulting in concavity of the lateral wall and...

Division of tongue tie helps breast feeding

The need for frenotomy in children with tongue tie is not universally accepted. It is however understood that among other problems, such as impaired speech, tongue tie impedes breast feeding possibly leading to early weaning. Therefore, with recent resurgence of...

Plunging new depths for the treatment of ranulas

Within our scope of practice, we encounter a number of salivary gland pathologies, including the sublingual gland. Clinical signs are often subtle, and even with meticulous surgical management, morbidity can easily occur. Textbooks advocate excision of the gland as the...

Pinnaplasty for prominent ears

Pinnaplasty is a challenging yet rewarding procedure for which many different techniques have been described. In this article the authors describe their favoured technique, including the important postoperative care. Prominent ears can be a source of significant psychological distress in...

A soprano’s demise: a cautionary tale for the thyroid surgeon

Prior to the mid-19th century, thyroid surgery was considered excessively dangerous. The emergence of anaesthetic, antisepsis and improved instrumentation, however, increased its feasibility and frequency in Europe. The unhurried, judiciously antiseptic and haemostatic approach, advocated by Kocher, was popularised and...

How good ideas become great products: in conversation with three medical innovators

Ever had a great idea for an innovation that would significantly improve your practice, but wondered how to go about developing it? Lucy Dalton interviewed three consultant ENT surgeons-come-successful innovators (one international, one novice and one experienced) who explain what...

Rhinoplasty: state-of-the-art

Rhinoplasty surgery has evolved over the years, and Pietro Palma introduces a further new concept. When flicking through the topics of major rhinoplasty meetings, the astute observer will realise that, at present, there are two mainstream schools of rhinoplasty, which...

Potential benefits of turbinate sparing medial maxillectomy

Whilst endoscopic medial maxillectomy (EMM) has good results as the standard treatment option for tumours arising in the maxillary sinus, postoperative problems of crusting, epiphora and paraesthesia are not uncommon. This paper looks at modified EMM aimed at sparing the...

How should I excise sinonasal tumours, open or endoscopic? En bloc or piecemeal?

Sinonasal tumours often present late because initial symptoms mimic benign disease. They tend to produce more unilateral nasal symptoms, and patients with advance disease often describe paraesthesia and other cranial neuropathies. They only account for approximately 3% of upper aerodigestive...

ENT/AUDIOLOGY in this issue March/April 2020

Emma Stapleton, MBChB, FRCS (ORL-HNS), Consultant Otolaryngologist, Cochlear Implant and Skull Base Surgeon, Manchester Royal Infirmary, UK. E: emmastapleton@doctors.org.uk Twitter: @otolaryngolofox Martin O’ Driscoll, Consultant Clinical Scientist; Head of Audiology and Hearing Implants, Audiology (Hearing and Balance) Centre, Manchester Royal...

The pioneers of endoscopy and the sword swallowers

Adolf Kussmaul drew inspiration from an unlikely source to further the development of endoscopy… The early pioneers of airway endoscopy and oesophagoscopy were bedevilled by two major and seemingly insurmountable problems. One was the paucity of light sources, with reliance...

Endoscopic CSF leak repair using nasoseptal flap

Many of us during training or in established practice will have encountered the complication of anterior skull base CSF leak. This can be a challenging problem to deal with and in this article the authors describe their favoured approach. Cerebrospinal...