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Expanding the role of FNA in thyroid nodule decision-making

1 November 2016 | | BRAF, cytology, fine-needle aspiration (FNA), papillary thyroid cancer, preoperative diagnosis
Papillary thyroid cancer, the commonest histological type, has been extensively reported as having BRAF proto-oncogene mutations (most commonly the V600E mutation). There is great interest in BRAF as a molecular marker, particularly as a prognostic factor that may guide the...

Myringoplasty in a bottle?

1 September 2016 |
Management of large traumatic TM perforations can involve observation and water precautions or surgical repair. Closure rates for larger perforations can be 8-12 weeks and occurs for between 38-79%. Animal and human studies have shown that exogenous application of epidermal...

Preoperative risk factors: when do you need to refer to the haematologist?

1 September 2016 | | Anticoagulants, Bleeding risk, Coagulation disorders, Herbal medication, High-risk populations, Preoperative assessment
It is essential that clinicians are able to identify and assess which patients are in the high risk category for bleeding during ENT surgery. A full history, including medications, herbal remedies taken, any other medical co-morbidities and family history of...

Patient reported outcomes improve if antibiotic choice is directed from endoscopic culture results in chronic rhinosinusitis

1 January 2016 |
The use of antibiotics in chronic rhinosinusitis (CRS) has been established as part of the EPOS guidelines, as has the role of taking swabs for microbiology culture. There has not been much literature however on whether tailoring antibiotics in response...

Facial reconstruction with polyethylene implants

1 January 2016 | | Complication, Craniofacial reconstruction, Medpor(®), Porous polyethylene
Planning reconstructive surgery for complex craniofacial defects challenges even the most experienced of surgeons. In most cases surgery is undertaken to improve anatomical functioning. However the anatomical structure of these regions is also critical to facial aesthetics and patient satisfaction...

CSF leak – endoscopic or open repair?

1 January 2016 | | Cerebrospinal fluid, Endoscopic endonasal approach, Paranasal sinuses, Rhinorrhea
Cerebrospinal fluid (CSF) rhinorrhoea is well known to the ENT surgeon. It commonly occurs secondary to a predisposing event such as accidental or iatrogenic trauma. When it occurs spontaneously, it can be associated with benign intracranial hypertension. The commonest CSF...

Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture

1 November 2015 |
Placement of voice prosthesis at the time of trachea-oesophageal puncture is well described using 20-French prostheses. There is debate about the optimal size of the prosthesis with work in the 1980s and 1990s supporting larger prostheses. The rationale was that...

Superior semicircular canal dehiscence: transmastoid obliteration

1 September 2017 | | Audiology - Diagnostic, ENT, Head and Neck, Vestibular Disorders, Otology
Sometimes patients with dizziness turn out to have slightly more unusual causes of their problem. Thomas Milner and Georgios Kontorinis describe their technique for managing patients who have a diagnosis of superior canal dehiscence as an identified cause of their...

Training in the use of medical devices
– how should it be done?

1 March 2015 | | ENT
Adequate training in novel medical devices is imperative, not only to ensure patient safety, but also to give clinicians the confidence to use the device in question. In this article, Andrea Gillies explains the philosophy of one of the equipment...

Shifting paradigms – how a visionary can change a specialty

1 May 2019 | | ENT, Rhinology / Sinus, Otology
The Tarabichi-Stammberger Ear and Sinus Institute came about because of a close working relationship and friendship between two senior figures in the specialty. Professor Muaaz Tarabichi tells us the story. My first meeting with Heinz Stammberger was in 1988 in...

Preservation rhinoplasty

1 July 2019 | | ENT, Rhinology / Sinus, Rhinoplasty, Maxillofacial Surgery
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...

Elasticated retraction in head and neck surgery – a trainee’s perspective

1 May 2017 | | ENT, Head and Neck
The effectiveness of surgical technique and satisfactory outcome is greatly dependent on good surgical exposure. Retraction requires adequate traction and counter-traction of tissues in order to expose the tissue or organ under scrutiny for the surgeon. This is a universal...