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Risk factors for pharyngocutaneous fistula after laryngectomy

Pharyngocutaneous or salivary fistula is a feared complication following laryngectomy, causing significant morbidity, prolonged hospital inpatient stay / cost and mortality. Previous radiotherapy / chemoradiotherapy is a well recognised risk factor and leads many surgeons to recommend onlay pectoralis major...

Multiple free flaps for head and neck cancer

Most patients with advanced head and neck cancers now undergo microvascular free flap reconstruction. This is mainly as flaps facilitate complete tumour and margin removal by providing reliable wound coverage and better restoration of form and function. However despite this,...

Surgical management of refractory osteoradionecrosis

This is a French single-centre, 10-year experience of 55 surgical resection and reconstruction procedures. They claim an overall effectiveness rate of 92.3%. A total of 36 segmental and 19 marginal mandibulectomies were performed. A variety of free flaps were used,...

More than words: looking at all the evidence

Evidence based practice (EBP) is a three-pillared approach whereby information on the research evidence, factors relating to the patient and clinical experience are all considered to inform a care decision. Unfortunately, there is frequently very little research evidence to inform...

Audiometric outcomes following endoscopic stapes surgery

Adding to the evidence base for endoscopic stapes surgery, this systematic review and analysis of outcomes sought to establish the efficacy and safety of this approach. This review included 14 studies with a pooled sample of 314 adult patients. The...

Serum biomarkers for CRSwNP

This cross-sectional comparative study looked at 50 patients with nasal polyps who, at the time of diagnosis, also had a blood test evaluating serum total IgE, IL-17 and Pentraxin-3. The study assesses whether these blood markers are useful in the...

Should we leave a reconstructed auricle exposed?

Microtia results in psychological and functional morbidity and total auricle reconstruction offers the affected individual a more cosmetically pleasing ear. The art of dressing postoperatively can be heterogenous between surgeons. This single-centre retrospective study based in China compared complication rate...

Dirty Work

Gabriel Weston’s new novel chronicles four traumatic weeks in the life of its narrator, Dr Nancy Mullion. Nancy is a young trainee in obstetrics and gynaecology, the subject of a General Medical Council (GMC) investigation into her clinical performance following...

ENT leadership

Challenges The first challenge is to agree what we mean by the term leadership because there are many different ways in which the term is used. What is, however, a consensus is that the key distinction between leadership and management...

Facing changes after surgery through portraiture

‘Facing Out: Life After Treatment for Facial Cancer’ was a two-year arts-for-health project funded by Arts Council England and The National Lottery which culminated in an exhibition at The Whitworth Art Gallery, Manchester, in February 2019. Here, artist and project...

The role of artificial intelligence and applications in ENT surgery

AI is progressing apace. If you’re wondering how it might affect our working lives in ENT, read on for insights and a pilot study that show us what may be possible. The recent launch of ChatGPT, an open access artificial...

In conversation with David Baguley

A reflective discussion with a scientist-practitioner in tinnitus David Baguley has worked in audiology at Addenbrooke’s Hospital since 1985, becoming the Consultant Clinical Scientist in 1989. In 2006, David received an International Award in Hearing from the American Academy of...