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Facial paralysis risk factors in benign parotid surgery
The literature shows that the risk of facial paralysis following benign parotid surgery can be as high as 57% for temporary weakness and 7% for permanent facial nerve damage. It is generally thought that the factors involved may be related...
How to manage the cheek in gender affirming surgery
This publication discusses cheek augmentation surgery related to gender-affirming facial surgery. The publication describes the difference between the common male cheek anatomy and the desired ideal feminine appearance and how to achieve it. In the author’s experience, gender-affirming surgery patients...
CI outcome measures and different languages
Outcome measures for hearing rehabilitation strategies in children are the subject of endless debate. The underlying problem with measuring outcomes in this population is delineating the extent to which development (which is in itself variable) and hearing ability (usually the...
Patient positioning for transnasal flexible laryngoscopy
The position of a patient’s head during flexible nasendoscopy to visualise the larynx does not usually require much consideration – adequate views are almost always obtained with a patient sitting in a neutral position. Occasionally however, there will be patients...
Is canal wall down with obliteration a useful compromise between canal wall up procedure and open mastoid cavities?
Controversy has raged for many years between open mastoid cavity procedures and canal wall up techniques in terms of postoperative recidivism and ear discharge. It is generally believed that canal wall up procedures can miss hidden cholesteatoma but preserve useful...
Are elective neck dissections needed during salvage laryngectomy?
There has recently been a move away from elective neck dissections in the setting of salvage laryngectomy. This has mainly resulted from an appreciation of the increase in morbidity, in particular pharyngocutaneous fistula formation, and an improvement in cross-sectional imaging...
Tramadol soaked nasal packs for post-septoplasty analgesia
Having had a septoplasty a number of years ago for the potential treatment of snoring, I was intrigued by this paper which compared the analgesic effect of tramadol-soaked and lignocaine-soaked nasal packs following septoplasty. In my practice, I have always...
Bone grafting in orthognathic surgery
In this systematic review of 48 articles the authors reviewed the complication, stability, aesthetics and healing of Le Fort I, sagittal split, chin and zygomatic osteotomies. They concluded that there was strong evidence that bone grafting promotes healing of a...
Novel method for determining BCC margins
This correspondence describes a new technique for determining basal cell carcinoma (BCC) borders, to aid in obtaining clear peripheral resection margins. Whilst this can be straightforward in small well-defined nodular BCCs, some BCC subtypes are ill-defined or morphoeic, and resection...
Perioperative management of the head and neck cancer patient
The perioperative care of patients with head and neck cancer is complex and requires significant preoperative planning and patient education. The issues include analgesia, antibiotics, stoma and wound care, general and chest physiotherapy, thromboprophylaxis and nutrition. This article provides a...
Cinch suture: Does it work?
Flaring of the nostrils is a common side-effect of a maxillary osteotomy. At times flaring is minimal or of no significance. In some instances, it can be a significant postoperative concern to the patient, even to the extent of declining...
