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Should we be doing earlier MRIs in sudden sensorineural hearing loss?
There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....
Beware the skinny patient…
The adverse health impacts of an excessive BMI are well known. This study highlights one laryngeal pathology for which a low BMI appears to be a significant risk factor. The records of 28 patients treated for arytenoid cartilage dislocation were...
Suspect the unsuspecting in thyroid cancer
This article reminds readers of how often invasive thyroid disease can appear, as the symptomatology is minimal. Noticeable airway symptoms appear after 50% of the airway is involved and surgeons can often fall in the unsuspecting trap of discovering locally...
Allergy testing in children with beta-lactam hypersensitivity
The beta-lactam antibiotic is commonly used in treating ENT infections in childhood. However, its use can be limited by reported hypersensitivity or allergy to the antibiotic. This is largely attributed to the previous development of skin rashes while being on...
What is the evidence for contralateral tonsillectomy in TORS for known unilateral tonsil malignancy?
The concept of field changes by carcinogens within the upper aerodigestive tract is well established with reported rates of synchronous tumours of 4% and second primaries of 36%. The tonsil in particular has the highest rate of synchronous tumours, postulated...
Microsurgical trainees to avoid strenuous exercises?
It is commonly believed among microsurgeons that over-exertion can impair microsurgical performance. The authors aimed to investigate if they could prove this theory and compared the performance of medical students, postgraduate trainees and expert controls who were microsurgery tutors. A...
Low risk options following failure of intratympanic gentamicin for Meniere’s
This article is a useful summary of the options available when intratympanic gentamicin (ITG) fails to adequately control vertigo episodes in Meniere’s patients. The authors describe the anatomical reasons that may impede drug delivery to the round window with the...
Anterolateral thigh cutaneous flap or radial forearm free flap for tongue defect reconstruction?
Free flap reconstruction is the gold standard in tongue reconstruction, aiming to restore function such as swallowing, cosmesis and speech. The anterolateral thigh cutaneous flap and the radial forearm free flap are among the most popular free flaps used for...
Parathyroid pearls
This article serves to deliver some pearls of wisdom in parathyroid surgery for the ‘low volume parathyroid surgeon’. They have been divided into those relating to the preoperative diagnosis, imaging and localisation techniques and surgical difficulties. Recognised sources of error...
Does transoral robotic surgery improve outcomes among patients with head and neck cancer of unknown primary?
A tonsillectomy and tongue base mucosectomy is becoming increasingly accepted as the optimal surgical intervention to aid in identifying the primary source of a p16+ / HPV-related squamous cell carcinoma (SCC) of unknown origin, given that this disease almost exclusively...
