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The perils of poor postop blood pressure control
This retrospective case control study reviews 621 patients undergoing thyroid surgery over a 10-year period from 2002-2012 looking at postoperative haemorrhage rates. This potentially catastrophic complication warrants close analysis in order to best discern how it can be minimised. The...
No soup for you…! Early identification of postoperative perforation increases the success of conservative management
Iatrogenic perforation of the hypopharynx or cervical oesophagus is a well-recognised life-threatening complication. Previous studies have demonstrated that conservative management with broad-spectrum antibiotics and withholding oral feeding may avoid morbidity associated with surgical repair. This study addresses when conservative management...
Risk factors for pharyngocutaneous fistula after laryngectomy
Pharyngocutaneous or salivary fistula is a feared complication following laryngectomy, causing significant morbidity, prolonged hospital inpatient stay / cost and mortality. Previous radiotherapy / chemoradiotherapy is a well recognised risk factor and leads many surgeons to recommend onlay pectoralis major...
A review of significant issues in the management of obstructive sleep apnoea in children
There are considerable variations in the management of obstructive sleep apnoea in children and this suggests a need for more research and evidence-based information. In this review article, the authors address four key issues. Literature compares tonsillectomy with tonsillotomy, the...
Bone grafting in orthognathic surgery
In this systematic review of 48 articles the authors reviewed the complication, stability, aesthetics and healing of Le Fort I, sagittal split, chin and zygomatic osteotomies. They concluded that there was strong evidence that bone grafting promotes healing of a...
Everyone has the right to say no
Despite the introduction of the Mental Capacity Act in 2005, healthcare professionals remain uncomfortable with individuals who choose not to follow medical advice - who make informed decisions to decline a treatment or management plans. This paper highlights that speech...
Does use of pectoralis muscle myocutaneous flap (PMMCF) reduce postoperative pharyngocutaneous fistula complication after salvage laryngectomy?
Salvage laryngectomy for recurrent laryngeal carcinoma following failed radiotherapy or chemoradiotherapy is associated with high postoperative complication rate. The primary aim of this paper was to assess whether use of muscle myocutaneous flap (PMMCF) as an interposition graft reduces the...
Functional considerations in reconstruction after laryngectomy
With a plethora of different reconstructive options and techniques available after laryngectomy, it can be difficult to clearly see which give the lowest complication rates and best functional outcomes. This article aims to summarise the current evidence in swallowing and...
Long-term curative effects of microvascular decompression for hemifacial spasm
This article describes results of a multicentre prospective trial performed to evaluate long- and short-term outcomes and complications of patients who underwent microvascular decompression (MVD) for hemifacial spasm (HFS). The surgeries were performed by surgeons with more than 15 years...
Tympanostomy tubes outcomes by tympanic quadrants- a meta-analysis
Tympanostomy tube (TT) insertion is one of the most common ENT procedures, resulting in millions of TTs being implanted per annum and occurring complications that need to be addressed. Premature TT extrusion (PTTE) is a well-recognised such complication, affecting almost...
Dacryocystorhinostomy revisited
In this technical variant, instead of seeking the lacrimal sac, the authors describe a retrograde technique. They first identify the nasolacrimal duct at the level of the most anterior insertion of the inferior turbinate in the lateral nasal wall. The...
