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First signs of late nodal metastases

This is a retrospective review of 65 patients who had late metastases during follow-up after initial curative treatment. They analyse the detection methods of palpation, ultrasound, CT and subjective symptoms. Palpation detected the nodes in 31 patients, ultrasound in 17,...

The many uses of human amnion

Human amnion has historically been the focus of much myth and superstition. To be born with the ‘caul’ intact was considered lucky and the caul was often manufactured into clothing. In 1910 foetal membranes were first used in skin transplantation...

Review of surgical treatments of intractable Meniere’s disease

This is a nice summary of the evidence available for the surgical treatments for intractable Meniere’s disease. To summarise, in five-10 years, over 90% of vestibular neurectomy cases, more than 80% of intratympanic gentamycin treatment, and 70-80% of endolymphatic sac...

Nuclear heads – and necks

Imaging of the extra-cranial head and neck is challenging due to the anatomic complexity of the region. CT, MRI and ultrasonography (US) are amongst the most frequently utilised radiological modalities in head and neck imaging but do not always provide...

Reducing the risk of Frey’s syndrome after parotidectomy – which methods are best?

Gustatory sweating or Frey’s syndrome is a well-recognised complication of parotid surgery. The reported incidence is highly variable, from 4% to 96%, with around 30% of patients reporting symptoms. A number of intraoperative techniques can be used to reduce the...

Food impaction in children is associated with eosinophilic oesophagitis

There is an increasing amount of evidence to suggest that chronic oesophageal inflammation and motility disorders play a more significant role in oesophageal food impaction (EFI) in children compared to structural defects. The authors conducted a retrospective study of children...

To drain or not to drain

These two separate papers neatly tie together the same ideas. The first, a retrospective study of 107 patients and 116 procedures over a 10-year period who underwent a CSF leak repair, 82.2% without a lumbar drain and 17.8% with. The...

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...

Treatment algorithm for olfactory disorders

The purpose of this paper is to review the current evidence in diagnosing olfactory disorders and suggest an algorithmic approach to patients with relevant complaints. Age-associated olfactory loss is often multifactorial and requires a careful history and physical exam. A...

ENT Expert Opinion

The creator of ENT Expert Opinion, Dr Niall Jefferson, was in the midst of his surgical training in Ear, Nose and Throat Surgery in Australia in 2012. In contemplating his upcoming Fellowship exams, he began to seek out resources that...

Present and future in myringoplasty

Tympanic membrane perforations are a common finding in ENT practice. Whilst watchful waiting or formal tympanoplasty are standard options – wouldn’t it be amazing if there was a low cost, safe, in-clinic option to immediately help patients (I hear you...