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Harvesting the flexor hallucis longus: what is the increased morbidity?
The free fibula flap is now widely used in clinical applications for microvascular reconstruction and occasionally, to add bulk, the flexor hallucis longus (FHL) muscle is harvested along with the fibula. The post-operative morbidity is usually described as mild and...
3D ultrasonography for evaluation of muscles following facial palsy
Reconstructive surgery for facial nerve palsies is not recommended beyond two to three years after a degenerative facial nerve lesion. Since the time course of muscle atrophy is variable, this timeline is a rough guideline. The only assessment method currently...
Sinonasal undifferentiated carcinoma – slowly getting there
The rarest of the rare, sinonasal tumours form only a small part of the total number of head and neck tumours and undifferentiated carcinoma (SNUC) is one of the rarest of this group. There is some data (and some expert...
What is the right balance to strike in the management of anaplastic thyroid cancer?
This is a pragmatic article on a difficult and much debated subject. Management of anaplastic thyroid cancer (ATC) can feel like making decisions between a rock and a hard place, and this article suggests one path to help navigate some...
The septum and breathing
The authors compared the improvement in nasal obstructive symptoms in two groups of patients. One group underwent septoplasty alone and the other septoplasty accompanied with compensatory turbinoplasty. They used the Nasal Obstruction Symptom Evaluation (NOSE) [12] and visual analog scale...
One airway, one disease - not for everyone!
While 85% of asthmatic patients have rhinitis, only 20-30% with rhinitis have asthma. Together with atopic dermatitis (AD), rhinitis and asthma form a triad that tend to co-exist in patients (multimorbidity). This co-existence raises the possibility of genetic mechanism. Authors...
Is endoscopic approach more precise in addressing failed ventilation system in chronic mucosal ear disease?
Chronic mucosal disease, as opposed to cholesteatoma, is more directly related to failure of the ventilation system involving three channels. Isthmus anticus and isthmus posticus are channels in front and behind the long process of the incus and there is...
A comparison between trainee and trainer outcomes in mastoid surgery
In this era where training faces restrictions due to theatre time, fewer sessions available to trainees and requirements of consultant-led and consultant-delivered services, one unit confirmed that myringoplasties given to trainees reduced from 34.2% to 16%. This study compares outcomes...
Motor learning: better knowing how, not how well
Motor learning is described as the ability to perform a motor skill due to practice and/or experience. Research on interventions to enhance limb motor skills can be influenced through the amount, distribution, variability and schedule of practice as well as...
How common is oropharyngeal dysphagia amongst the adult population?
It is well known that oropharyngeal dysphagia (OD) is a symptom arising from many different aetiologies or disease conditions and that it is a significant morbidity affecting people’s quality of life. Establishing the prevalence of OD is complicated by the...
Safety factors in use of balloon tuboplasty
Various medications used to restore eustachian tube function have unpredictable results and these are often disappointing. Balloon dilatation of eustachian tube came around 2010 but has not really gained momentum, mainly due to apprehended complications. In this review article, the...
