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Airway first in patients with facial trauma

Anyone that has ever been on an ATLS or indeed any other trauma course will be well indoctrinated with the principles of ABC. Securing the airway is of paramount importance; but what to do if the anatomy is altered or...

Evidence based outcomes for canal wall up, canal wall down and subsequent canal wall reconstruction for primary cholesteatoma

There has been a long standing controversy over whether to treat primary cholesteatoma with open or closed technique. The general consensus is that limited disease can be treated with closed technique whereas the canal wall down approach helps reduce recidivism...

Listening in noise to predict learning disability

Noise disrupts the neural coding of consonants more than vowels. Listening in noise presents a challenge for everybody, but particularly to children whose language skills are underdeveloped. This team views background noise as a disruption to the necessary neural mechanisms...

Long-term outcomes after (adeno) tonsillectomy

Patient-reported outcome measures (PROMs) are used increasingly to fill an ‘evidence gap’ where healthcare rationing threatens particular treatments. Tonsillectomy is a long-established and effective treatment for recurrent tonsillitis and obstructive sleep apnoea (OSA) in children. The T-14 outcome measure examines...

Two for the price of one - multiple parotid neoplasms

With advancing years come many benefits, but one drawback is the acquisition of parotid (or thyroid) neoplasms. Conventional teaching is that most are benign and slowly enlarge, and not infrequently are found bilaterally as in Warthin’s. Pleomorphic adenomas are also...

Adjuvant intratympanic steroid therapy in sudden sensorineural hearing loss

Sudden sensorineural hearing loss (SNHL) means abrupt hearing loss by 30dB affecting three consecutive frequencies within 72 hours. This is treated by high tapering doses of systemic steroids, the role of which is controversial and fraught with possible complications in...

Hearing preservation after Gamma knife in vestibular schwannomas

This retrospective study reports the outcomes of hearing preservation up to three years after Gamma knife radiosurgery for Gardner-Robertson Class I (SDS>70% and PTA <30dB) patients with vestibular schwannomas. The authors report that patients with no subjective or objective hearing...

Quality of life after FESS or balloon sinuplasty

This randomised control trial compared the SNOT-22 questionnaires both pre-operatively and three months post-operatively in patients with chronic rhinosinusitis undergoing either FESS or balloon sinuplasty to the maxillary sinus. Forty two patients participated in the study, 21 in each treatment...

Cascading communication skills to help children with autism

Inadequate workforce resource is an ongoing difficulty across the health professions. This study proposes a train the trainer model, with the ultimate goal of improving the communication skills of children with autism. The study describes an intervention called naturalistic developmental...

Early DCR may be better than delayed in acute dacrocystitis?

Traditionally, acute dacrocystitis has been treated conservatively with antibiotics, analgesia and warm compresses, with surgery reserved for later when the infection has subsided. This meta-analysis looks at early vs. late endonasal dacrocystorhinostomy (DCR) in the treatment of acute dacrocystitis, looking...

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...