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Free flap reconstruction in stage three bisphosphonate-related osteonecrosis

There is no widely accepted gold standard for the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Early BRONJ is managed conservatively but there is controversy regarding the treatment of the later stages. Stage three is defined as exposed bone...

Chronic rhinosinusitis, are we treating the same disease?

Chronic rhinosinusitis (CRS) is a heterogenic disease. The effects of heterogeneity on treatment outcome are not very clear. Authors used clinical features such as endoscopic findings scores and full blood count findings in addition to analysis of 35 molecular markers....

How can we assess children with complex needs?

In the early days of cochlear implantation, children with additional disorders were being excluded as poor candidates whereas today a large number of children with complex needs are being referred for cochlear implant assessment. However, the related problems include difficulties...

A new criterion for diagnosing chronic tonsillitis?

It is essential to establish the diagnosis of recurrent tonsillitis in patients undergoing tonsillectomy. This is based mainly on history which itself can be inaccurate and is supported by clinical findings which are not truly specific. There seems to be...

Information to support decision-making: does it make sense online?

The internet has become a major source for health information, with many people preferring to use the internet to search for advice than speaking to health professionals. Yet much of the information available is very difficult to read for the...

Significance of abnormal retropharyngeal nodes in head and neck cancer

Abnormal retropharyngeal lymph nodes (RLN) have prognostic relevance for patients with oral, oropharyngeal or nasopharyngeal squamous cell carcinoma (SCC). However, consensus on the evaluation and management of abnormal RLN in these patients is lacking. The authors of this paper provided...

How effective are our two-week-wait guidelines in picking up head and neck cancer?

With a 30% increase in the incidence of head and neck cancer since 1999 in the UK, it is important that the two-week wait referral guidelines safely encompass all risk factors but also render these urgent referrals based on signs...

Endoscopic transsphenoidal surgery versus dopamine agonist therapy for microprolactinomas

This study addresses the importance of the location of microprolactinomas in determining prognosis after surgery. Long-term dopamine agonist treatment is the current standard of treatment for microprolactinomas. However, patients often seek surgical removal. The authors of this study retrospectively analysed...

Chorda tympani in middle ear surgery

This was a prospective study at a single Belgian centre that aimed to monitor postoperative taste problems after middle ear surgery. The authors also looked at the influence of pathology and manipulation of chorda tympani (CT) on its function. Taste...

A cost reducing protocol for magnetic resonance imaging in patients suspected to have acoustic neuroma

Magnetic resonance imaging is the ‘gold standard’ for screening patients suspected to have an acoustic neuroma. However, inappropriate referrals for imaging are not helpful, especially with the growing need to reduce costs. In this study the authors compared two audit...

Hearing outcomes after retrosigmoid resection of smaller vestibular schwannomas are better

The authors reviewed published literature reporting hearing outcomes in patients after retrosigmoid (RS) resection of vestibular schwannoma (VS). Aggregate hearing preservation of 31% and 35% under fixed and random models respectively was observed in the 2034 patients meeting eligibility criteria...

Location, location, location: How to get the steroid where you need it, in chronic rhinosinusitis

What almost all current guidelines on chronic rhinosinusitis have in common is the importance of intranasal steroid (INCS) use. However, it is increasingly understood that the efficacy of INCS depends on their efficient delivery to the point of need, i.e....