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Scalp reconstruction a new algorithm

Reconstruction of the scalp after acquired defects remains a common challenge for the reconstructive surgeon, especially in light of a history of radiation to the area. Wound healing by secondary intention or with a wound vacuum assisted closure are viable...

Depth of invasion of oral cancer should be incorporated in new AJCC staging system

Since 1977, when the first edition of the Manual for Staging of Cancer was published by the American Joint Committee on Cancer (AJCC), the primary tumour staging for oral squamous cell carcinoma (SCC) has remained unchanged. In the last four...

Is submandibular gland transfer effective in prevention of post irradiation xerostomia in head and neck cancer patients?

Post irradiation xerostomia is a common side effect of irradiation to the head and neck region, with up to 90% of patients reporting some symptoms. Submandibular glands account for 70% of resting saliva production. Surgically transferring the submandibular gland to...

Seeking medical attention with tonsillectomy complications depends on who you are. Lessons from the USA

In the current UK model, NHS care is free at point of access so there are no perceived economic barriers to seeking attention with postoperative complications. This study from the US examines surgical and emergency room databases from across California,...

When should we decompress the facial nerve in Bell’s Palsy?

It has been over three decades since Fisch popularised facial nerve (FN) decompression for Bell’s Palsy. Studies further exploring this have been few since, partly due to the major complications that can occur following this type of surgery. The current...

CT and intraoperative nerve monitoring to identify non-recurrent laryngeal nerve during thyroid surgery

A non-recurrent laryngeal nerve (NRLN) is a rare (incidence 0.3% to 1.3%) anatomical variant that results in a higher rate of vocal cord palsy following thyroid surgery. This team from China examined the utility of preoperative CT and intraoperative nerve...

‘Dead ear’ after mastoid surgery

The primary aim of surgery in the management of cholesteatoma is eradication of the disease which can potentially result in serious complications such as intracranial extension, facial nerve weakness and further hearing loss. A profound hearing loss resulting postoperatively considerably...

Clinical value of 3 T magnetic resonance imaging after intratympanic gadolinium injection in cases of delayed endolymphatic hydrops

Recurrent vertigo can continue after severe unilateral or bilateral hearing loss. This is a condition similar to Ménière’s disease, the diagnosis of which can be difficult. In this study intratympanic injection of gadolinium-diethylenetriamine penta-acetic acid dimeglumine was done in 25...

Which cross-over frequency is best for electro-acoustic stimulation?

Advances in technology and improved soft surgical techniques have led to individuals with better hearing thresholds, especially at the low frequencies, becoming candidates for cochlear implants (CI). Surgeons are more confident that residual hearing can be preserved thus making those...

Cochlear implantation in the over 85s

An ageing population globally, means that the individuals of some countries are now living longer and, as hearing loss is commonly associated with the elderly, there will be more elderly people eligible for cochlear implantation. Hearing loss itself is associated...

Transmastoid facial nerve decompression for persistent traumatic facial nerve paralysis

Facial nerve paralysis (FNP) can occur following trauma, with a small number of these patients requiring facial nerve decompression (FND) to aid recovery. The authors shared their experience in decompressing the facial nerve for persistent severe FNP via a transmastoid...

Coblation for laryngeal granulomas

Laryngeal granulomas remain notorious for their tendency to recur after surgical removal. Although high rates of complete remission have been reported with use of the potassium-titanyl-phosphate (KTP) laser, this equipment is expensive and not available in all units performing ENT...