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Preservation rhinoplasty
Hump reduction and osteotomies to close the open roof, or lowering the whole nasal dorsum? Charles East explains how preservation techniques can improve outcomes by maintaining the integral structures of the nose. What is preservation rhinoplasty? The origins of reduction...Use of a diode laser for the removal of a frontal sinus osteoma
In this How I Do It, Professor Sergei Karpischenko introduces a gentle method of reduction of mobilised frontal sinus osteoma which has been successfully used in five patients in his university clinic using a diode laser in contact mode. Osteoma...
Factors affecting the occurrence of salivary fistula after total laryngectomy
It is generally believed that patients should be fed by nasogastric tube for 7-10 days after undergoing total laryngectomy or laryngopharyngectomy to avoid the occurrence of post-operative salivary fistula. This study challenges this belief and looks into various factors that...
Vascularised tissue in salvage total laryngectomy
Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...
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...
Parapharyngeal space tumours – is the transoral approach effective?
Several approaches are described to the parapharyngeal space to permit resection of tumours in this region, with the most commonly employed approach being the transcervical route. The transoral approach remains somewhat controversial as it is felt that this approach can...
Cerebrospinal fluid leaks after vestibular schwannoma surgery
This study analyses 30-day readmission data after vestibular schwannoma surgery using a multicentre longitudinal State of California dataset. The authors studied risk factors, and timing of readmission in 6820 patients over 15 years. Of these, 490 readmissions were reported for...
Treating middle ear conditions in developing countries
This month’s journal issue discussed global health in otolaryngology with this paper focusing on the management of chronic middle ear disease in the developing world. Chronic suppurative otitis media (CSOM) is more common in developing countries. The reason for this...
Measuring the ‘impact’ of preoperative immunonutrition
Using preoperative nutritional supplements as part of ‘enhanced recovery’ in surgical patients is not a new concept. This interesting paper looks at the latest development in optimising patients undergoing head and neck oncological surgery. Immunonutrition (Nestle’s ‘Oral Impact’ in this...
Is medical therapy without surgical treatment sufficient in treating peritonsillar abscess?
Standard treatment of peritonsillar abscess (PTA) has typically involved both medical therapy and surgical drainage either in the form of needle aspiration, or incision and drainage. However, is medical without surgical treatment sufficient? The authors suggest that medical therapy without...
Pediatric Endoscopic Endonasal Skull Base Surgery
Published in 2020, this book, edited by professors of neurosurgery and otolaryngology, approaches the narrow field of paediatric endoscopic skull base surgery with a wealth of knowledge and expertise that the authors have achieved practising in adult and paediatric joint...
