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Intraoperative nerve monitoring: 2017

Having written the definitive text on laryngeal nerves, Gregory Randolph and Dipti Kamani describe the benefits of intraoperative neural monitoring and, importantly, how to proceed if the nerve is pathologically involved or there is loss of signal. Over the years,...

Preservation rhinoplasty

Hump reduction and osteotomies to close the open roof, or lowering the whole nasal dorsum? Charles East explains how preservation techniques can improve outcomes by maintaining the integral structures of the nose. What is preservation rhinoplasty? The origins of reduction...

Maturation of BC attenuation

The aim of this study was to clarify the reason for differences between bone-conduction hearing in adults and infants. The authors investigated how the sound pressure level in the ear canal changes depending on the bone-conduction transducer placement. By using...

Inferior alveolar nerve recovery after ORIF fractured mandible

Mandibular fractures are quite common facial injuries, but aetiology varies with country and age. Common treatment options are open reduction and internal fixation via an intra-oral or extra-oral incision. Nerve injury or dysfunction is often seen preoperatively and may also...

Comparing surgical freedom of four transsphenoidal approaches to the sella

Four transspenoidal approaches to the sella were performed and studied by the authors on eight silicon-injected cadaveric heads. Surgical freedom, that is, the ability of the surgeon to move his or her hands in a fixed space, was determined with...

Cochlear implantation in Tanzania: the journey and the outcomes

It is estimated that over 400 million people worldwide live with disabling hearing loss, 39.9 million of whom live in sub-Saharan Africa [1]. This article by Dr Aveline Kahinga and Mr Ali Jaffer demonstrates the effort that has been made...

Cochlear implants: recipient stories

The most powerful evidence for the remarkable achievements made with cochlear implants over 40 years comes from the life-changing, personal stories of those who have benefited from the technology. James Rylance I first noticed a problem with hearing when I...

Random-pattern skin flaps: part 4 - transposition flaps

In the final part of our series on local skin flaps (see Part 1, Part 2 and Part 3) in ENT, the authors describe the usefulness of the transposition-type flap and highlight some examples. Rotational advancement flap Useful for defects...

High definition tractography to identify cranial nerves

It has always been challenging to visualise cranial nerves on traditional imaging as the cranial nerves have a fine structure and complex anatomy. This is especially true regarding the cochlear nerve. In congenitally hearing impaired children, the visualisation of the...

3D ultrasonography for evaluation of muscles following facial palsy

Reconstructive surgery for facial nerve palsies is not recommended beyond two to three years after a degenerative facial nerve lesion. Since the time course of muscle atrophy is variable, this timeline is a rough guideline. The only assessment method currently...

A twitch in time with a flicker of knowledge

The middle ear muscles can be seen as one of the ear’s safety mechanisms, and the interplay between eyes and ears has been established; think vestibular ocular reflex (VOR) or semi-circular canal dehiscence (SCCD). But can this protective mechanism be...

Is benign intracranial hypertension underdiagnosed in patients with spontaneous CSF leaks?

In ENT practice we come across spontaneous CSF leaks. Patients present either as unilateral watery rhinorrhoea or otorrhoea, or sometimes as hearing loss with a watery middle ear effusion. Clinicians, after confirming the diagnosis of CSF leak with beta 2...