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Harvesting the flexor hallucis longus: what is the increased morbidity?
The free fibula flap is now widely used in clinical applications for microvascular reconstruction and occasionally, to add bulk, the flexor hallucis longus (FHL) muscle is harvested along with the fibula. The post-operative morbidity is usually described as mild and...
Auditory processing in children with unilateral hearing loss
It is a common assumption that unilateral hearing loss (UHL) in children is of little consequence because appropriate development of speech and language can still occur with one normal hearing ear. Recent studies, however, suggest that there are significant differences...
A new era in the treatment of recalcitrant nasal polyps?
Chronic rhinosinusitis with nasal polyps (CRSwNP) can be difficult to treat effectively in patients with aggressive or recalcitrant disease. Omalizumab (Xolair) is a monoclonal anti-IgE antibody with proven benefits for patients with moderate/severe asthma and CRSwNP, but this study looks...
The relevance of rhinoplasty and septorhinoplasty from the commissioners
The rising costs of running the National Health Service and its overburdened resources has led to the constant monitoring of the low clinical value treatments. The operations of rhinoplasty and septorhinoplasty inevitably fall into this group and are subject to...
Zinc and rhinosinusitis
Patients with chronic rhinosinusitis (CRS) in general, and those with nasal polyps (CRSwNP) in particular, have been shown to have down-regulation of tight junction genes. Zinc, on the other hand, is well-known for its role in immune regulation and deficiency...
DIY Epley manoeuvre
This is an interesting paper that looks at getting patients to do their own particle repositioning manoeuvre (PRM) after having it done by a clinician (‘Epley’ to you and me although there are some slight differences) once a week for...
Painful temporomandibular joints
This paper is a meta-analysis of randomised controlled trials comparing arthrocentesis with conservative management in painful and restricted mouth opening temporomandibular joint symptoms. Temporomandibular joint dysfunction comprises a spectrum of disorders commonly involving facial pain and loss of oral function...
Allergen specific subcutaneous immunotherapy helps in prolonged control of allergic rhinitis
One of the commonest allergens involved in perennial allergic rhinitis is house dust mite. A good proportion of these cases prove intractable to treatment with oral and intranasal antihistamines and intranasal steroid sprays. Immunotherapy is considered a useful alternative and...
Surgery for snoring
The prevalence of sleep-disordered breathing is rapidly increasing. There is variable evidence for surgical treatments for snoring currently. This Belgian study was a retrospective review of 84 patients who underwent surgery for snoring between May 2011 and December 2015. A...
SpeechEasy® for stuttering
In this article, the authors describe their experiences with an altered auditory feedback (AAF) device: SpeechEasy® during a random clinical trial. AAF has been reported in other laboratory studies to reduce stuttering events without influencing the rate, intensity or frequency...
FESS for recurrent acute rhinosinusitis: at last, some data
As noted in both the EPOS 2012 and in the (more recent) ICARS 2016, there is a paucity of evidence on the effectiveness of surgery for recurrent acute rhinosinusitis (RARS). The authors used a control group of patients with CRSsNP,...
