The OtorhinolaryngologistThe Otorhinolaryngologist has been accredited by ENT-UK for the purposes of providing ENT specialists with online eLearning Continuing Professional development.The content of the publication covers a range of CPD related topics including "Clinical reviews", "Operative techniques", "Case reports" and a "Trainees section". The articles are all peer-reviewed.

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Satisfactory completion of the CPD assessment related to any SINGLE article, that is attaining a minimum threshold of 70% correct responses, will permit the participant to download a certificate of CPD completion, with an indication of 1 hour CPD activity. Clinicians should only claim credit commensurate with the extent of their participation in the activity.

Latest Articles

  • Ultrasonography to manage a unique presentation of chronic otorrhoea
    Ultrasonography to manage a unique presentation of chronic otorrhoea

    A 42-year-old builder presented to clinic with an isolated symptom of chronic, unilateral otorrhoea. The discharge had proven refractory to topical antibiotic drops. He reported being assaulted with a plank of wood, nine months earlier. On examination the tympanic membrane and ear canal were unremarkable. A traumatic scar was identified in the post auricular area. With mastoid pressure the discharge could be induced. On microscopy, pus was seen extruding from the posterior ear canal wall. A pure tone audiogram with tympanometry was within normal limits. A computer tomography (CT) scan of the temporal bones showed a radiolucent object superior, lateral to the bony external acoustic meatus.

    Read 20660 times
  • Surgical management of neck trauma with parotid haematoma in a patient with vascular Ehlers-Danlos syndrome
    Surgical management of neck trauma with parotid haematoma in a patient with vascular Ehlers-Danlos syndrome

    Patients with vascular Ehlers-Danlos syndrome (vEDS) and other connective tissue disorders pose a challenge surgically due to vessel fragility, tissue friability and poor wound healing. We describe the presentation and successful surgical management of a patient with vEDS who developed a large parotid haematoma acutely after blunt trauma to zone III of the neck and parotid gland. Key steps in management included liason with the vascular surgery team, limiting the neck exploration and use of a suction drain. The patient made a full recovery. To our knowledge, this type of injury in a patient with this condition has not been described in the literature before. We describe similar cases and surgical challenges of vEDS in the discussion.

    Read 9870 times
  • First branchial cleft anomaly: An accessory ear canal
    First branchial cleft anomaly: An accessory ear canal

    Branchial cleft anomalies are rare malformations caused by disruption to the normal choreography of the embryological precursors of the face, neck and pharynx. Rarer still are anomalies of specifically the first branchial cleft, affecting fewer than 1 in a million. Clinically, these congenital anomalies may present as cysts, sinus tracts, fistulae. Here we present a case of a Work Type II first branchial cleft anomaly manifesting as a duplicated external auditory canal. The patient has an uncomplicated lesion with normal hearing and no pressing desire to undergo excision. The classification system implemented has no bearing on either the decision to operate nor the operative approach that would be employed. The complicated process of formation followed by obliteration of the first branchial cleft leads to uniquely heterogenous lesions that require individualised surgical planning with pre-operative imaging.

    Read 10541 times
  • The complications with use of hair bearing skin for reconstruction of the internal nasal lining: a case report
    The complications with use of hair bearing skin for reconstruction of the internal nasal lining: a case report

    SCC is the second most common cancer in white Europeans, commonly affecting sun exposed areas including the nose. Management involves excision of the lesion and reconstruction if required. A paramedian flap is well suited to the reconstruction of large nasal defects. We report a complication of paramedian flap use for reconstruction of nasal cutaneous SCC when hair bearing skin was used on the internal surface of the nasal cavity and grew inside the nasal cavity, extending into the oropharynx. We review the literature and discuss options for avoiding the use of hair bearing skin in reconstruction of the internal nasal lining.

    Read 9813 times
  • Intraoperative ultrasound to detect impalpable cervical metastases from recurrent papillary thyroid cancer: A case report and review of the literature
    Intraoperative ultrasound to detect impalpable cervical metastases from recurrent papillary thyroid cancer: A case report and review of the literature

    Selective neck dissection has an important role in the management of cervical metastases from differentiated thyroid cancer both in primary management and in cases of recurrence in the neck. We describe a case of deep level IV and V cervical recurrence of papillary cancer in a patient who had undergone previous thyroidectomy, left selective neck dissection (levels II, III, IV and VI) and radioactive iodine where the use of intraoperative ultrasound (IOUS) was employed to locate the metastatic disease for excision. This case highlights an unusual location for a metastatic lymph node and the benefit of IOUS in this case of difficult to locate, impalpable disease in the open neck.

    Read 11036 times

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