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Identifying early flap failure

The holy grail of flap monitoring is an easy, reliable and predictive method to identify impending compromise. Does this paper provide it? Various methods have been used to improve our ability to monitor the viability of a flap and here...

The mark of the head and neck surgeon

Like Zorro, the head and neck surgeon leaves their mark. No more so than during parotid surgery. Various modifications have been put forward modifying the classic Blair incision. This latest modification camouflages the pre-tragal scar by running it on to...

Are upper respiratory symptoms and macroscopic changes in children always due to gastro-oesphageal reflux?

In children, symptoms such as chronic cough, wheezing, stridor, voice changes, persistent asthma and dental erosion are often presumed to be due to gastro-oesophageal reflux and empirical treatment with PPIs is offered. Usual investigations, such as a barium meal, gastroscopy...

Does teaching affect patient satisfaction?

Teaching practice on real patients has several advantages in terms of lower costs and genuine clinical material but it is often a concern that using real patients for undergraduate teaching may result in patient dissatisfaction and many patients would prefer...

Guidelines for management of orbital infections

Orbital infections predominantly affect the paediatric population and complications can be very serious. The cellulitis can be preseptal or orbital and the abscess can be confined within the periosteum or extend into the orbit. Cavernous sinus thrombosis can complicate the...

Perception of verticality during attacks of Ménière’s

Ménière’s disease (MD) affects the cochlea and all peripheral vestibular receptors. The perception of verticality, a function of the utricle, is evaluated by the subjective visual vertical (SVV) test. The authors studied SVV in two groups of MD patients: a)...

Horizontal nystagmus: vestibular neuritis or lateral canal BPPV?

A horizontal nystagmus due to lateral canal (LSC) BPPV that is present in the upright position, that changes direction with head turn in the horizontal plane has been termed ‘pseudo-spontaneous nystagmus’ (PSN) because it mimics that of vestibular neuritis. The...

Botox application for drooling shrinks salivary glands

The large majority of sialorrhoea (drooling) in paediatric patients is managed conservatively. However in severe cases, often where there is associated developmental delay or a motor disorder, medical and surgical techniques can be used to decrease salivary flow. Botulinum toxin...

Margin control using optical techniques in head and neck surgery

Emerging optical techniques such as high-resolution microendoscopy (HRME) are currently being examined for their reliability in discriminating benign from neoplastic epithelium. These techniques may offer the potential to detect the margin of an upper aerodigestive tract tumour in a non-invasive...

Do I need Google maps in here?

Image guidance surgery (IGS) has grown in popularity. This review article discusses its application in endoscopic sinus surgery (ESS). IGS technology has vastly improved with smaller, more mobile platforms that are easy to set up and use. IGS allows validation...

Endoscope assisted removal of jugular foramen schwannomas

This article, written by a renowned surgeon with extensive experience in removal of jugular foramen and skull base lesions, describes a new classification for jugular foramen schwannomas (JFS) and a template for selection of surgical approach for endoscope assisted removal....

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...