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Surgical indications for infantile haemangiomas

Infantile haemangiomas are embryonal tumours and represent the most common tumour of infancy, with an estimated incidence 4-5%. There is well-described natural history, usually becoming apparent in the first few weeks of life and proliferating rapidly in the first few...

Safeguarding Physician Wellbeing: Using Checklists for Personal, Professional and Psychological Safety

‘Checklists’ in the operating room make for safer surgery, better handovers and improved patient care. Can we apply the principles we have learned since Atul Gawande and the WHO pioneered this approach to surgery to our own wellbeing as doctors,...

Operate, Operate, Operate! A young surgeon in the 1970s

The book is a memoir of Douglas MacMillan’s experiences as a young surgeon in the 1970s. MacMillan describes his journey from medical school to training and becoming a consultant ENT surgeon. He shares stories about his challenges as a young...

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...

Salt in surgical simulation

Cheap, easily accessible and realistic methods of reproducing surgery through simulation are the ideal. Here a group from Tokyo, Japan report on a method of producing 3D printed skulls and mandibles to use for simulated surgery. A high resolution CT...

Pre-habilitation in head and neck cancer – a literature review to guide best practice

Curative treatment of head and neck cancer (HNC) often requires surgery; however, outcomes are impacted by the complexity of the surgery and the patient population. Increasingly ‘Enhanced Recovery After Surgery’ (ERAS) protocols are being used to maximise patient outcomes and...

A spoonful of sugar… helps the operated sinuses calm down?

Ottoviano et al. present a prospective double-blinded RCT to assess the effect of a nasal gel containing silver sucrose octasulfate (Silsos Gel) on wound healing after endoscopic sinus surgery. The placebo used was a glycol gel. Thirty-four consecutive patients were...

Does Tranexamic acid reduce intraoperative bleeding during FESS?

Intraoperative bleeding during FESS can reduce visibility and obscure important landmarks. This can result in longer operative times, increase risks of complications and even lead to incomplete surgery. Tranexamic acid is a drug which prevents fibrinolysis and stabilises blood clots....

Outpatient closure of CSF leaks: a good idea or a step too far?

After day-case septoplasty, day case thyroidectomy, now day case CSF leak repair – has the pendulum moved too far? The authors put forward a convincing case for what, only 10 years ago, would have sounded like a provocation. They quote...