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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...
Do adhesions actually cause nasal blockage?
All of us who perform nasal surgery are familiar with the disappointing presence of nasal adhesions (NA) or synechiae in our postop patients. These can often lead to patients deriving less perceived benefit from their surgery than that which they...
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...
When to treat a fractured mandible?
This is a prospective study from Brisbane of 215 patients with a total of 359 fractures of the mandible. Nine outcome variables were analysed with a further 19 included to adjust for potential confounding. Treatment delay was found not to...
Merocel vs Cutanplast Anal packing
This study compared two different nasal dressings after septoplasty. Seventy-six patients acted as their own controls by having one nostril packed with Merocel and one nostril somewhat improbably with Cutanplast Anal (gelatin sponge). It seems that the gelatin sponge was...
Systematic review comparing transoral laser surgery versus open partial laryngeal surgery for advanced laryngeal cancer
The aim of this Italian systematic review was to establish outcomes (local control and survival) of conservative laryngeal surgery for advanced T stage laryngeal cancers. Articles published from 1980 onwards, had at least 10 patients that underwent partial laryngeal surgery...
Deep space neck infections and their management
This article explores the approach to managing patients with deep space neck infections. Clearly, an understanding of the fascial planes within the neck is required which then provides an understanding of the route of spread in these cases. The authors...
Close monitoring of patients for delayed hyponatremia post-transsphenoidal surgery
he incidence of delayed hyponatremia is 16-28% and usually accounts for unplanned readmission of the patient within 30 days after transsphenoidal surgery. One of the surrogate measures of quality of care adopted by the government and regulatory agencies is 30-day...
Precision medicine in allergic rhinitis and chronic rhinosinusitis
Precision medicine (PM) with its ‘four Ps’ (personalised, predictive, preventive and participatory) is about appreciating differences between individuals when offering management options for health problems. Multiple groups interested in rhinology such as EPOS and ARIA supported a review of the...
Importance of face-to-face communication in clinical practice
Breakdowns in communication with patients who have difficulty in understanding, speaking or hearing may occur during a consultation. The authors of this paper studied the hearing-related breakdowns in communication especially amongst older adults with hearing impairment (HI) using conversational analysis...
Dutch pharyngeal pouch surgery experience
A decade’s experience of pharyngeal pouch surgery was reported in this paper from Rotterdam. A total of 94 patients were analysed. The majority (80%) underwent an endoscopic approach, either with stapling or CO2 laser-assisted. Interestingly, 13 of 75 (14%) procedures...
