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Endoscopic middle ear surgery for cholesteatoma treatment

A critical question when any new technique is proposed is ‘does it work?’ In this article Daniele Marchioni and Davide Soloperto discuss the success rates of endoscopic ear surgery for cholesteatoma. Introduction Surgical management of cholesteatoma is still a controversial...

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...

A novel way to reduce postoperative nausea and vomiting

This is an interesting RCT which evaluates the prophylactic effect of bilateral endoscopic injection of local anaesthetic in the sphenopalatine ganglion (SPG) on postoperative nausea and vomiting (PONV). It has a robust design, and is sufficiently powered and blinded, with...

Delirium post-op

This is a retrospective study from Japan analysing 102 patients who underwent oral cancer resection and free flap reconstruction. Postoperative delirium occurred in a third of these patients. An increased risk was identified in those with high preoperative albumin, postoperative...

Do nasal septal deviation and septoplasy affect Eustachian tube function?

The authors suggest that nasal septal deviation (NSD) or septoplasty possibly affect Eustachian tube (ET) function. They conclude this from their prospective study on 25 patients who underwent septoplasty for NSD. These patients aged above 14 years had no other...

Reduce medical errors by improving communication: supporting vulnerable people

This article starts by emphasising that communication failures are a fairly common cause of medical errors. They highlight that people with dysarthria can experience significant communication difficulties and are at particular risk of this type of breakdown in care. People...

Comparison of outcomes after septoplasty

For this prospective study, the authors assessed the quality of life (QoL) with the rhinosinusitis SNOT-20 (Sino-Nasal Outcome Test-20) questionnaire and the symptoms on a visual analogue scale (VAS) in all patients undergoing nasal septal surgery. The patients reported the...

A move away from bony free flaps in reconstruction

Techniques for facial reconstruction have come on in leaps and bounds since the world wars. The use of titanium implants is more recent and the technology for manipulating the metal and how we use it is rapidly developing. Here the...

Middle ear pressures with different anaesthetic agents

The use of appropriate anaesthetic agents is essential to avoid complications during middle ear surgery. This Turkish study attempted to identify whether intravenous (IV) anaesthetics (propofol) or inhalational agents (sevoflurane) cause more variations in middle ear pressures. The authors performed...

Shoulder function in patients undergoing neck dissection: its effects on work and leisure activities

Shoulder dysfunction is common after neck dissection and includes shoulder pain, limited abduction and scapular winging. Modifications of the radical neck dissection were designed to limit morbidity, however, even with accessory nerve-sparing neck dissections, shoulder dysfunction can be seen. Shoulder...

Intermediate risk factors SCC tongue

This retrospective review from Japan assessed 89 patients who underwent surgery for squamous cell carcinoma of the tongue, specifically they reviewed the evidence of perineural and vascular invasion (27.0% and 23.6%). Their results suggest, not unsurprisingly, that perineural and vascular...

Canal wall down with obliteration of cavity for paediatric cholesteatoma

The authors present evidence that canal wall down (CWD) surgery with primary obliteration is an effective way to treat paediatric cholesteatoma. Fifty-eight ears were operated on and follow-up was for five years on average. Residual cholesteatoma rate was 9.9% with...