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To monitor the nerves or not?

Whilst intraoperative nerve monitoring has become the standard of care for mastoid and parotid surgery, its benefit in thyroid surgery remains unclear. In the UK NICE was agnostic on the subject in 2008, stating that it was potentially helpful and...

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...

What are the non-inflammatory causes of a conductive loss?

This retrospective study looked at patients with an intact tympanic membrane with non-inflammatory causes – i.e. otitis media and cholesteotoma. They document their findings based on exploratory tympanotomy. They operated depending on the findings with either a stapedectomy or a...

Robot controlled mastoid surgery!

This is a fascinating piece of work by a Korean team developing a human-robot collaborative control. Their model uses image guidance surgery to locate the drill tip’s position. Important structures can be highlighted – in this case the facial nerve....

Risk factors for post laryngectomy fistula

This is a meta-analysis looking at the postoperative pharyngocutaneous fistula rates following total laryngectomy. The authors ended up with 34 studies with about 2500 patients. The most striking finding was that preoperative radiotherapy was a significant risk factor as well...

What’s the risk of regrowth with partial (intracapsular) tonsillectomy

Partial (intracapsular) tonsillectomy is enjoying somewhat of a revival offering the potential for less postoperative pain and bleeding whilst relieving the obstructive element. The authors look at 303 patients, 82 of whom had partial tonsillectomy using coblation. They measured pre...