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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...
Incidental thyroid nodules: should we observe or operate?
Thyroid nodules are extraordinarily prevalent, detected by physical examination in 7% and by imaging studies in 67% of the population. Although most of these nodules are benign, up to 20% are found to be malignant on excision. It’s a very...
Approach to the orbital floor: which is better?
During skeletal surgery sufficient exposure is key – often a direct approach through the overlying tissues is the easiest route. In the face, however, as the scar would be readily visible, approaches are designed to hide this. Surgical access to...
Dental implant rehabilitation in fibula free flaps
The fibula free flap was first described in 1975 and since then has gone on to become the gold standard technique for reconstruction of longer spans in the mandible or maxilla. It is a reliable flap that affords good quality...
The hot nose
Capsaicin nasal spray can offer moderate to significant symptomatic relief to 70-80% of patients with idiopathic rhinitis (IR). Efficacy was also shown in lab studies. Nasal hyper reactivity (NHR), absence of allergy / infective rhinosinusitis, age limits (18-60), no anatomical...
How to talk about hearing aid costs?
Money is always a controversial topic if discussed in reference to healthcare. This study raises the interesting topic of difficulties when it comes to discussing the costs of hearing aids with customers. Sixty-two audiological appointments were recorded and discussions concerning...
Intraoperative MRI use during pituitary tumour resection
This article provides an overview of intraoperative MRI (iMRI) use in transphenoidal surgery (TSS) for pituitary tumours. Traditionally imaging of the surgical field during surgery involves intraoperative fluoroscopic imaging or neuronavigation which help to avoid injury to critical structures but...
Allergen immunotherapy and allergic rhinitis – EAACI guideline 2017
Allergic rhinitis (AR) is a common chronic childhood disease with considerable social burden and impact on quality of life, frequently necessitating treatment with various combinations of antihistamines and corticosteroids. The allergen immunotherapy (AIT), sometimes known as desensitisation therapy, can modify...
Long term morbidity of extended medial maxillectomy for inverted papilloma
This Italian review paper looks at five-year morbidity after extended endoscopic medial maxillectomy in 59 patients in a university teaching hospital setting. All patients underwent an extended approach medial maxillectomy for inverting papilloma, this included removal of the entire medial...
Complication rates for grommet insertion in H&N cancer patients
Otitis Media (OM) can be the direct result of H&N malignancy itself or secondary to treatment of malignancy. Both surgery and radiotherapy can cause lasting changes to the physiologic function of the ET, middle ear, tympanic membrane and ear canal....
Posturography in persistent postural-perceptual dizziness (PPPD)
Those in neuro-otology practice will be familiar with PPPD now appearing in the forthcoming beta edition of ICD-11. This condition combines the symptoms of phobic postural vertigo and chronic subjective dizziness in which anxiety plays a part. The underlying hypothesis...
