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Transverse venous sinus stenosis – a risk factor for CSF leak in patients with idiopathic intracranial hypertension

This was a multicentre (six French tertiary hospitals) retrospective case-controlled study aiming to investigate the rate of transverse venous sinus stenosis (TVSS) in patients with idiopathic intracranial hypertension (IIH) with nasal cerebrospinal fluid (CSF) leaks. They compared the preoperative MRI...

Learning curve for sialendoscopy

Sialendoscopy represents a minimally invasive technique that permits direct salivary tree visualisation and treatment using endoscopic techniques. Previous studies have shown that it is an efficacious, safe and potentially gland preserving method to treat major salivary gland disease. However, it...

No soup for you…! Early identification of postoperative perforation increases the success of conservative management

Iatrogenic perforation of the hypopharynx or cervical oesophagus is a well-recognised life-threatening complication. Previous studies have demonstrated that conservative management with broad-spectrum antibiotics and withholding oral feeding may avoid morbidity associated with surgical repair. This study addresses when conservative management...

Do I need Google maps in here?

Image guidance surgery (IGS) has grown in popularity. This review article discusses its application in endoscopic sinus surgery (ESS). IGS technology has vastly improved with smaller, more mobile platforms that are easy to set up and use. IGS allows validation...

Tricky post-laryngectomy swallows

Despite improvements in chemoradiation therapy and the adoption of organ preservation for some head and neck cancers, total laryngectomy remains the treatment often providing best survival chances for advanced laryngeal cancer. This article reviews the causes of dysphagia post-laryngectomy and...

Aerosols and polypi

Infection in the operative cavities after endoscopic sinus surgery for sinonasal polyposis leads to recurrence of symptoms and mucopurulent discharge. The usual therapies include systemic antibiotics sometimes with steroids. The authors hypothesised that the use of a topical antimicrobial (tobramycin...

A comparison between biologic and surgical treatment (FESS) for chronic rhinosinusitis with polyposis

In recent years, it is being increasingly recognised that chronic rhinosinusitis with nasal polyps (CRSwP) is a type 2 chronic inflammation based on IL-4 and IL-13, and the novel monoclonal antibody, such as dupilumab, is likely to have a major...

Budesonide irrigation in polyposis

It is very well known through many RCTs and now meta-analyses that saline-based irrigation is beneficial in patients after sinus surgery. It is also demonstrated that intranasal steroids are beneficial postoperatively but there is also a trend for steroid based...

Endoscopic findings and prediction of outcome in unilateral vocal cord paralysis

Unilateral vocal cord paralysis which is not due to irreversible causes such as malignancy, systemic disease or trauma varies considerably in terms of full recovery and restoration of voice. Usually electromyography is used to make possible predictions, but this facility...

Timing of surgery in chronic rhinosinusitis: does it matter?

While many patients with chronic rhinosinusitis respond to medical treatment, some do not. The next step for these patients is surgery, but how soon should this be offered? Sooner rather than later seems to be the answer, as Claire Hopkins...

Is one glass of wine on call safe?

It’s a standard question for those about to sit a Specialist Training (ST) interview; you are on call and you call a senior colleague in to perform an operation. You smell alcohol on the breath of the surgeon, so what...

Emerging robotic systems for head and neck surgery

As of December 2020, seven robotic surgical systems have received approval for use in different jurisdictions, and many more task-specific robots are in the pipeline. Jack Faulkner takes us through what’s on the horizon for head and neck cancer surgery....