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Elasticated retraction in head and neck surgery – a trainee’s perspective

The effectiveness of surgical technique and satisfactory outcome is greatly dependent on good surgical exposure. Retraction requires adequate traction and counter-traction of tissues in order to expose the tissue or organ under scrutiny for the surgeon. This is a universal...

Use of Elasticated Hooks in Open Rhinoplasty

Introduction Good exposure is an essential requisite in open rhinoplasty and often requires appropriate assistance to aid surgery. Frequently, surgeons lack adequate assistance in theatre and often have to depend on the scrub nurse for retraction. A self-retaining retractor is...

Middle ear reconstruction in children: why, when and how

Every ear in every child is different. Rob Nash discusses the rationale behind reconstructive ear surgery in children and his philosophy on timing and techniques of reconstruction. It is rare for middle ear pathologies to be life threatening. Indeed, it...

Allergy – what’s in a name?

Allergy is defined as an “abnormal immune reaction to an ordinarily harmless substance” [1], however the meaning of the word has taken many forms since its introduction in 1906 by Austrian Paediatrician and Immunologist, Clemens von Pirquet [2]. Combining his...

In conversation with John Carlisle: the silent hero shaping medical publication integrity

Have you ever been curious as to what your anaesthetist is getting up to on their laptop during long cases? Me neither, but I always generally assumed they were trading Bitcoin, solving the Riemann hypothesis and buffing their Tinder profile....

In conversation with John Carlisle: the silent hero shaping medical publication integrity

Have you ever been curious as to what your anaesthetist is getting up to on their laptop during long cases? Me neither, but I always generally assumed they were trading Bitcoin, solving the Riemann hypothesis and buffing their Tinder profile....

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...

Diagnostic performance of non-echo-planar diffusion weighted MRI in detection of suspected cholesteatoma

Even though a ‘second look’ remains a gold standard for detection of residual cholesteatoma after intact canal wall techniques, non-echo-planar diffusion weighted MRI is considered a reasonable alternative to avoid further surgery. However, to establish or exclude a cholesteatoma de...

Stimulation for a good night’s sleep

This article was an interesting read. It is an update from the authors’ original paper printed in the NEJM in 2014 regarding the results of an implantable pulse generator (IPG) for stimulating the hypoglossal nerve in response to respiration. This...

Linking tooth extraction and snoring

One of the more contemporaneous theories about OSA is that extraction of teeth or other orthodontic treatment during the development of the facial skeleton leads to alteration of bony growth and therefore alteration of the final result. There is evidence...

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...

Middle ear muscle disorders: presentation, diagnosis and management

Patients often report symptoms relating to disorders of the middle ear muscles. Prof Bance gives us an overview of the anatomy and function, as well as guides our diagnosis and management. The middle ear muscles (MEMs) are a mystery, both...