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Coupler microvascular anastomoses: how good?

This paper is written by a group of reconstructive surgeons and a school of computing. The study used computational fluid dynamics to model blood flow through idealised sutured and coupled vessels, to investigate if differing anastomotic techniques affect intravascular blood...

Local dexamethasone infiltration in tonsillectomy

Intravenous dexamethasone is routinely given during tonsillectomy for its effects on postoperative pain and nausea. This Chinese randomised study divided 240 children undergoing tonsillectomy into three groups, receiving either no steroid, intravenous dexamethasone, or the same amount of dexamethasone infiltrated...

Physiological mechanisms of hyperacusis: an update

Hyperacusis is a heterogeneous and complex clinical entity, and proposals about physiological mechanisms should reflect these issues. Ben Auerbach helps us navigate through present knowledge in this area, and proposes future directions for research. Hyperacusis is a debilitating hearing disorder...

Do intratympanic injections require local anaesthesia?

Intratympanic injections are becoming increasingly acceptable in the management of Meniere’s disease, tinnitus and sudden hearing loss. This is because they avoid the need for hospitalisation and can be performed as low-cost outpatient procedures. It is traditional to freeze the...

Postoperative recovery in children after ENT surgery

This Belgian prospective study reported on the postoperative recovery time after routine ENT surgery (grommets, adenotonsillectomy), and compared parental estimations of postoperative pain with those of the child themselves (however, the authors do admit that many of the children included...

A comparison of cold dissection, coblation and diode laser tonsillectomy

Excellence in tonsillectomy is based on the time taken, blood loss and rapid recovery with minimal pain. In this study, 120 children underwent tonsillectomy by three methods, namely cold dissection, coblation and diode laser dissection in three randomly allocated groups...

Sphenopalatine ganglion block in endoscopic sinus surgery reduces intra and post-operative morbidity

The authors present results of a meta-analysis to investigate the role of sphenopalatine ganglion block (SPGB) in reducing postoperative pain in endoscopic sinus surgery (ESS). An electronic database search (Pubmed, SCOPUS, Google Scholar, Embase, and the Cochrane Register of Controlled...

Tramadol soaked nasal packs for post-septoplasty analgesia

Having had a septoplasty a number of years ago for the potential treatment of snoring, I was intrigued by this paper which compared the analgesic effect of tramadol-soaked and lignocaine-soaked nasal packs following septoplasty. In my practice, I have always...

Hilotherapy for facial surgery patients?

Hilotherapy involves administering regulated cold compression through a facemask. The principle of this treatment involves cyotherapy as a traditional treatment for reducing inflammation, pain and swelling following trauma. It is believed that using hilotherapy (Hilotherm®), which uses a mask to...

Patient experience of necrotising otitis externa

Necrotising otitis externa is increasing in incidence in the UK and becoming a rising burden to patients and health services. Despite a growing body of literature on this condition, we know very little about patient experience of necrotising otitis externa....

Absorbing the hurt

In this article, taken from his blog, ENT surgeon John McGarva reminds us that while we can’t fix everything, we may still be able to help. It was a long time ago. I was a scarily young Houseman, barely 22,...

MRI scanning patients with cochlear implants and auditory brainstem implants

In the last five to six decades, MRI scanning has gone from physics experiments in Nottingham University through to Nobel prize-winning work by Sir Peter Mansfield and Paul Lauterbur, to a ‘routine’ imaging modality with an estimated 60 million MRI...