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Results of hypoglossal-facial nerve anastamosis techniques for facial palsy
Preserving facial nerve function is of prime importance in acoustic neuroma surgery. A comprehensive knowledge of anatomy, experience and surgical precautions can reduce the incidence significantly. Important considerations are when and how to repair if injury occurs. Several options include:...
Anterolateral thigh cutaneous flap or radial forearm free flap for tongue defect reconstruction?
Free flap reconstruction is the gold standard in tongue reconstruction, aiming to restore function such as swallowing, cosmesis and speech. The anterolateral thigh cutaneous flap and the radial forearm free flap are among the most popular free flaps used for...
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...
Contemporary UK experience of oropharyngeal transoral laser microsurgery
It is well recognised that the current emergence of HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) as a distinct disease entity requires a fresh look at standard treatment modalities that are based on chemoradiotherapy for stage III/IVa OPSCC. The Newcastle experience...
Identifying CN IX and X using endotracheal tube electrodes
This clinical study describes the possible usefulness of endotracheal tube electrodes in monitoring vocal cord function during cerebellopontine angle surgery in 20 patients. Lower cranial nerves, especially IX and X are at risk of injury during skull base surgery although...
Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture
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...
Well drilling vs. subperiosteal pocket for cochlear implants – comparison of operative time, complications and cost-effectiveness
The choice of method for securing the receiver/stimulator (R/S) package during cochlear implant surgery is usually dependant on several factors, but primarily surgeon preference. The initial recommendation from manufacturers was to drill a bony well (WD technique) and use bony...The role of the maxillo-facial surgeon in the management of skull base malignancy
Whilst ablative surgery remains the principal treatment option for head and neck malignancy, the skull base is the last frontier. The complex anatomy, supreme functionality of the brain, and varied pathology provokes many a detailed discussion in the multidisciplinary team...The ear, nose and throat anaesthesia practice of Dr John Snow (1813-58)
News of the first successful public demonstration of general anaesthesia in Boston, Massachusetts in October 1846 reached Britain in mid-December of that year. James Robinson, a London dentist, gave the first anaesthetic in the United Kingdom when, on 19 December,...
Outcomes of larger glottic cancer volumes treated with radiotherapy
T3 glottic cancer is characterised as vocal cord fixation and/or invasion into pre-epiglottic, post-cricoid, paraglottic spaces and/or within the inner cortex of thyroid cartilage. Traditionally, laryngectomy was considered the primary option to treat T3 laryngeal glottic cancers until other options...
‘Dead ear’ after mastoid surgery
The primary aim of surgery in the management of cholesteatoma is eradication of the disease which can potentially result in serious complications such as intracranial extension, facial nerve weakness and further hearing loss. A profound hearing loss resulting postoperatively considerably...
