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Unilateral vocal cord mobility impairment and laryngopulmonary physiology

The concept of iatrogenic recurrent laryngeal nerve injury following thyroid surgery is often considered with respect to voice change but its potential impact on airway physiology has thus far not been evaluated. A cross-sectional observational study reviewed 21 patients with...

The Atlas of Cavityless Cholesteatoma Surgery: Volume I and II

The Atlas of Cavityless Cholesteatoma Surgery draws upon four decades of the authors’ experiences, based in the Jindal Institute in North India. Their aim is to showcase the inside out technique with obliteration of created mastoid cavities; and for the...

How common is dysphonia and dysphagia after cardiac surgery?

Patients undergoing cardiac surgeries, such as coronary artery bypass (CABG) and valve operations, are usually informed that there may be some risk of laryngeal complications that could result in a dysphonia or dysphagia. This may be due to factors including...

The electromagnetic larynx

Current treatment options for a bilateral vocal cord palsy (tracheostomy, posterior cordotomy, arytenoidectomy) are suboptimal, with a focus primarily on a static means of airway restoration at the expense of voice production and potentially swallow safety. This paper reports on...

Parapharyngeal space tumours – is the transoral approach effective?

Several approaches are described to the parapharyngeal space to permit resection of tumours in this region, with the most commonly employed approach being the transcervical route. The transoral approach remains somewhat controversial as it is felt that this approach can...

CT and intraoperative nerve monitoring to identify non-recurrent laryngeal nerve during thyroid surgery

A non-recurrent laryngeal nerve (NRLN) is a rare (incidence 0.3% to 1.3%) anatomical variant that results in a higher rate of vocal cord palsy following thyroid surgery. This team from China examined the utility of preoperative CT and intraoperative nerve...

Surgical management of permanent facial paralysis

This article explores the management of flaccid facial palsy focusing on weakness less than one to two years’ duration. As a general rule, primary nerve repair produces the best outcome and should be performed where possible. For long-standing paralysis of...

Is there a role for facial nerve decompression in Ramsay Hunt syndrome?

This is an interesting paper. The authors recommend a transmastoid facial decompression for patients with complete facial nerve paralysis with House Brackman HB 5/6 who do not show any sign of recovery after two weeks of treatment following a diagnosis...

Neurological complications associated with managing degenerative cervical myelopathy

Degenerative cervical myelopathy (DCM) is a common neuropathologic status due to degenerative changes to the cervical spine. There are multiple operative techniques available, including anterior cervical discectomy and fusion, anterior cervical corpectomy, laminoplasty, laminectomy and laminectomy with fusion. C5 palsy...

Voice change after total thyroidectomy with intact laryngeal nerves – a common but temporary problem

It has been reported that up to 87% of patients have a degree of voice dysfunction after thyroidectomy, even when the laryngeal nerves are preserved. Postoperative inflammation, laryngeal oedema due to vascular congestion, direct damage to the cricothyroid muscles and...

Laser for active mucosal chronic otitis media

Active mucosal chronic otitis media (COM) is a condition characterised by otorrhoea secondary to chronic inflammation of the middle ear and mastoid mucosa associated with granulations and a tympanic membrane perforation. Surgical intervention is often required, but concurrent mastoidectomy with...

Salivary gland blues…

Intravenous methylene blue is a well-described method to assist in intraoperative localisation of parathyroid glands. The technique does come with challenges as anybody will know who has had to run adjacent to a theatre-bound trolley to ensure that the infusion...