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Microvascular free flap failures – looking beyond surgical technique
Microvascular free flaps are commonly used in reconstruction for head and neck defects. Failures of these flaps, however, are associated with a significant morbidity and mortality. Flap failures within the first 72 hours are commonly attributed to technical failure of...
Do parents sleep better after paediatric adenotonsillectomy?
Paediatric adenotonsillectomy for sleep disordered breathing (SDB) is amongst the commonest surgical procedures performed in ENT. In the outpatient clinic, parents routinely express their concern about their child’s breathing but the impact of sleep disordered breathing on the parent is...
Visual distraction helps patients tolerate flexible laryngoscopy
With the arrival of flexible fibreoptic laryngoscope some 35 years ago, the examination of the laryngopharynx has become remarkably easier and saves immense time and costs since the days of mirror examination when this examination was not truly satisfactory in...
Postinfectious olfactory disorders
Recovery of olfactory function following URTI is frequent, even many years after the infectious insult. Upper respiratory tract infection is the commonest cause of olfactory loss. Many treatment options exist including topical steroids, vitamin B, acupuncture, and zinc, which can...
How does temporomandibular dysfunction affect voice-related quality of life?
Temporomandibular dysfunction (TMD) is a group of neuromuscular or musculoskeletal problems that affect the muscles and fascia related to chewing and jaw opening. Patients are often seen in ENT clinics because of symptoms such as trismus, pain and muscle tension,...
Which da Vinci surgical system? Novel flexible, single-port versus current multiport, rigid-arm robotic surgical system
The da Vinci robotic surgical system has transformed how oropharyngeal head and neck surgery can be delivered. The existing da Vinci Si model has challenges: the dimensions of this are larger than would be ideal for head and neck surgery...
How best to manage single-sided deafness?
Nowadays there is a plethora of options for patients with single-sided deafness (SSD) including: Bluetooth contralateral routing of signal (CROS) aids; in-the-ear bone conduction hearing aids (TransEar); intra-oral bone conduction aids (SoundBite) and bone-anchored technologies (BAHA). Unilateral cochlear implantation is...
We should all use ultrasound-guided core needle biopsy when investigating salivary gland lesions
Ultrasound core needle biopsy of salivary glands is an excellent diagnostic tool in terms of accuracy (both sensitivity and specificity), technical performance, and safety profile. This paper provided an update of the previous meta-analysis of the same question, which found...
What is balloon eustachian tuboplasty (BET)?
Eustachian tube dysfunction (ETD) is the result of a combination of factors that interfere with the mucosal functional or cartilaginous structures. Failure to open the eustachian tubes can cause aural pain, pressure in the ears, muffled hearing, crackling/popping sounds in...
Should we do oesophagoscopy during panendoscopy?
Panendoscopy entails a complete evaluation of the upper aerodigestive tract, and consists of oral inspection, direct laryngoscopy, bronchoscopy, oesophagoscopy, or some combination of these procedures. Despite many advances in imaging over the years, a skilled surgeon’s eyes remain superior in...
Pre-habilitation in head and neck cancer – a literature review to guide best practice
Curative treatment of head and neck cancer (HNC) often requires surgery; however, outcomes are impacted by the complexity of the surgery and the patient population. Increasingly ‘Enhanced Recovery After Surgery’ (ERAS) protocols are being used to maximise patient outcomes and...
