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Measuring the ‘impact’ of preoperative immunonutrition
Using preoperative nutritional supplements as part of ‘enhanced recovery’ in surgical patients is not a new concept. This interesting paper looks at the latest development in optimising patients undergoing head and neck oncological surgery. Immunonutrition (Nestle’s ‘Oral Impact’ in this...
What is the evidence for duration of antibiotic prophylaxis in head and neck free-flap cases?
The topic of this systematic review is one which is commonly heard in discussions between microbiologists and head and neck surgeons – what is the evidence for antibiotic prophylaxis in clean-contaminated free-flap cases, and crucially, how long should antibiotics be...
A multidisciplinary approach to the management of frontal sinus fracture
Frontal sinus fractures account for about 5% of all facial trauma. Fractures of the posterior wall may result in cerebrospinal fluid (CSF) leak and meningitis, while obstruction of the outflow tract can cause sinusitis and mucocele formation. However, there are...
Is there a ‘best’ ventilation tube?
Studies on grommet materials and sizes are not exactly new but this was a well-designed randomized study in Sweden with some useful findings. The extrusion rate and complications associated with four different ventilation tubes (grommets) were assessed prospectively in 400...
Facial reconstruction with polyethylene implants
Planning reconstructive surgery for complex craniofacial defects challenges even the most experienced of surgeons. In most cases surgery is undertaken to improve anatomical functioning. However the anatomical structure of these regions is also critical to facial aesthetics and patient satisfaction...
Combined endoscopic and transcutaneous approach for removal of parotid stones
The authors describe a small case series (n=8) of patients with obstructive symptoms from sialolithiasis of the parotid gland. A combined endoscopic and transcutaneous approach was used. The position of the stone in Stensen’s duct was identified by endoscopic transillumination....Drug side-effects on audiological and vestibular testing
Are they a malingerer? Or perhaps they are inattentive? It may be their drugs! Robert DiSogra considers the side-effects of medication on the test subject. The audiogram serves many purposes in clinical practice. For the audiologist, it helps to differentiate...The role of macrolide antibiotics in chronic rhinosinusitis
The use of long-term antibiotics in the treatment of chronic rhinosinusitis is a contentious issue, not only because of the increasing problem with antibiotic resistance but also because of the potential cardiac risks, including sudden death. In this article, Anders...From trauma to recovery: treatment at Defence Medical Rehabilitation Centre
This year (2014) is the centenary year of the beginning of the Great War. This conflict brought with it a cluster of emotional disorders that were called at the time, Shell-Shock. The present conflict in Afghanistan has been talked of...Innovating around access to hearing services during the pandemic
COVID-19 has also presented its challenges to hearing healthcare providers and to the industry and, similarly, called for innovation and creativity. Dr Bromwich describes how these sectors are rising to the challenge. The reality of COVID-19 has been a challenging...
