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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...

One anastomosis or two

This is a cumulative meta-analysis from Hong Kong reviewing 27 articles and a total of 7,389 flaps. The authors, at the outset, acknowledge that the number of anastomoses is not the only factor of venous compromise and flap failure. Nonetheless...

Risk factors in free flap failure

This is a retrospective analysis from China of 881 free flaps over nearly four years, 49 of which were ‘taken back’, 26 of which were lost, giving a 97% success rate. The commonest cause of flap failure was venous thrombosis....

Revising pinna embryology and anatomy

This forms an introductory article for a group of papers discussing the reconstruction of the pinna. It is a succinct yet adequately detailed article that all of us, at whatever stage of our careers should endeavour to read, as it...

Which is the best graft for myringoplasty?

This is a systematic review and meta-analysis of retrospective studies for type 1 tympanoplasty (myringoplasty) surgery comparing temporalis fascia and cartilage autograft materials for reconstruction. Inclusion criteria was patients with more than 50% perforated tympanic membrane with intact ossicular chain....

REARRANGED: An Opera Singer’s Facial Cancer And Life Transposed

Rearranged is a wonderfully positive memoir telling of Kathleen Watt’s ordeal through maxillary osteosarcoma. As an early career opera singer in the New York Metropolitan Opera’s chorus, her dreams are derailed and life transformed when this most rare diagnosis hits....

Septal surgery made easy?

The injecting of the greater palatine canal has been documented for some time. The authors in this paper expand this to the more common procedure of the septoplasty. They summarise the pros and cons published regarding the technique in sinus...

Nasal decongestants don’t improve Eustachian tube function

Prescribing nasal steroids and decongestants. It’s something most of us do routinely, in an effort to reduce chronic middle ear effusion in an adult by trying to improve eustachian tube (ET) patency. This study used clever devices (tube manometry and...

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,...