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Results of hypoglossal-facial nerve anastamosis techniques for facial palsy
Preserving facial nerve function is of prime importance in acoustic neuroma surgery. A comprehensive knowledge of anatomy, experience and surgical precautions can reduce the incidence significantly. Important considerations are when and how to repair if injury occurs. Several options include:...
The middle way: treating idiopathic facial nerve palsy
Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...
Clinical assessment in OSA
This paper divides the assessment up into anatomical (nasal and oropharyngeal), endoscopic and imaging. It points out the salient features to look out for in OSA patients with regards the nasal valve and also oropharyngeal anatomy, with tonsil hypertrophy grading...
MRI in diagnosis Meniere’s disease: what is the evidence?
The utility of magnetic resonance imaging (MRI) in the diagnosis of Meniere’s disease (MD) has attracted a lot of interest recently. It is well accepted that the saccule is the most common vestibular organ affected by endolymphatic hydrops (EH) and...
Gadolinium enhanced MRI and the diagnosis of Ménière’s disease
Despite various criteria applied over the years to diagnose Ménière’s disease since the concept of endolymphatic hydrops was first observed in postmortem examinations of patients in 1938, the diagnosis still remains mainly clinical. To visualise endolymphatic hydrops in MRI imaging,...
What are the consequences of facial palsy on working life?
Facial palsy (FP) has multiple causes, including iatrogenic or idiopathic paralysis, trauma and tumours. Whilst for certain aetiologies, such as Bell’s palsy, recovery of function is expected, many patients will experience permanent symptoms due to incomplete recovery of the facial...
Is major ear surgery financially viable?
It is difficult to ignore the present reality in the NHS that understanding clinical coding is perhaps of more relevance to the practising clinician than the human genome! Clinician engagement is becoming more essential to protect patient care and maximise...Robotic surgery for squamous cell cancer: the new frontiers
Although the da Vinci platform was FDA approved for early-stage oropharyngeal cancers, the indications have expanded. In this article, John Hardman explains how surgeons, with greater understanding of the strengths and limitations of robotic surgery, have systematically set out to...
Variations in obstructive level with increasing depth of sedation in DISE
This study highlights some of the controversies surrounding DISE (Drug Induced Sedation Endoscopy, or otherwise known as sleep nasendoscopy in the UK). On one hand it provides some evidence that the BIS (BiSpectral Index), recordings of patients while they are...
