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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...

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...

T1 lip cancer and cervical lymph node metastases

The management of large lip squamous cell carcinoma (SCC) (T2, T3, T4 tumours) or those with nodal disease is well established. However the management of T1N0 tumours is controversial due to the assumed low risk of occult lymph node metastases....

Do anticoagulanis and facial plastic surgery mix?

Some surgeons think that antiplatelet and anticoagulant therapies (aspirin, warfarin sodium and clopidogrel bisulphate) increase perioperative bleeding and infections. However, the current evidence base provides conflicting data with respect to the risk of true complications. In this case-control study a...

Post-operative debridement following FESS

Postoperative treatment pathways for patients following functional endoscopic sinus surgery (FESS) vary widely with the topic of debridement of the nasal cavity a subject of conjecture. This article is the result of two independent reviewers using the consort guidance for...

Clival chordoma recurrence

Chordomas are generally slow growing and are histologically considered low grade tumours. Their high recurrence rate even after postoperative radiation renders them difficult to treat. This is particularly true for clival chordomas whose deep anatomic location and proximity to vital...

Damage to the cochlear nucleus with electrocautery to the cochlear nerve

This study is of importance to neurotologists and neurosurgeons. It is unclear why patients with NF2 have poorer outcomes with an auditory brainstem implant compared to non-tumour patients. This effect is postulated to be due to damage to certain cells...

Quality of life after FESS or balloon sinuplasty

This randomised control trial compared the SNOT-22 questionnaires both pre-operatively and three months post-operatively in patients with chronic rhinosinusitis undergoing either FESS or balloon sinuplasty to the maxillary sinus. Forty two patients participated in the study, 21 in each treatment...

Surgeons and swearing

We will all know colleagues who have raised the act of swearing to an art form; just as Malcolm Tucker in The Thick of It could cut a workmate in half with a well-placed swear word, surgeons can be equally...

Cambodian Children Surgical Centre: a junior’s perspective

The Children’s Surgical Centre (CSC) is a Non-Governmental-Organisation (NGO) hospital situated in Phnom Penh, the capital of Cambodia. CSC was developed for landmine victims over 20 years ago by Dr Jim Gollogly after the dark period under the Pol Pot...

Semi implantable bone conduction devices: challenges and developments

Bone conduction mechanisms and history of bone conduction aids Bone conduction hearing devices work by stimulating hair cells via the bone conduction hearing pathways. These pathways are less well understood than the air conduction pathways, but recent research has shown...

Diabetes and hearing loss: a review

As hearing health professionals we often ask, especially in older patients, if they have diabetes; but what is the link? How is it manifested and should it change current practice? Alec Lapira reviews the changing evidence. Early attempts to establish...