Conservative treatment of chondrodermatitis nodularis chronica helicis using a doughnut pillow is very cost effective.

Background Myringoplasty success rate is estimated to be between 60 and 90 per cent. Factors predicting success include the choice of graft and use of auditory canal packing. This study aimed to determine the intra-operative factors associated with endoscopic myringoplasty success. Methods A retrospective review of all endoscopic myringoplasty cases between January 2017 and January 2020 was undertaken. Data were collected on: patient demographics, tympanic membrane perforation size, intra-operative details, audiology and post-operative outcomes. Results There was no significant difference in graft success rates between cases using bismuth iodoform paraffin paste and Spongostan packing (86.7 per cent vs 84.9 per cent, respectively). Conchal cartilage graft had a higher success rate (100.0 per cent) compared with Biodesign grafting biomaterial (66.7 per cent), but was not superior to tragal cartilage (84.6 per cent) or temporalis fat or fascia (80.0 per cent). Conclusion Spongostan packing is equivalent to bismuth iodoform paraffin paste in terms of endoscopic myringoplasty success rate. Although conchal cartilage graft had higher success rates, it was not statistically significantly different from tragal cartilage.

Functional endoscopic sinus surgery (FESS) is a widely practiced technique in the UK. This procedure has variable complication rates and can have some serious consequences. We present a case of surgical emphysema of the neck, face and the pre-vertebral space following FESS. Emphysema of the face and neck has been previously reported. However, to our knowledge, emphysema of the pre-vertebral space following FESS has not been documented. Pre-vertebral emphysema following FESS is an unusual and potentially serious complication.

Introduction Numerous technological advances have been made during the COVID‐19 pandemic. There has been a growing body of evidence highlighting the value of virtual consultations as an adjunct to physical appointments. This study presents the virtual clinic experiences of one ENT department in the UK. Methods Retrospective review of all virtual consultations undertaken at a single ENT department during the COVID‐19 pandemic. Results A total of 556 virtual consultations took place during the study period across all ENT sub‐specialties. Of which 27% of patients were converted to face‐to‐face follow‐up and over 30% were discharged following a virtual consultation. Out of 333 video consultation, 31% were converted to telephone due to patient preference or technological difficulties. Conclusion This study highlights the benefits and lessons learnt from implementing a virtual clinic system in ENT. The authors recommend the introduction of video consultation as a useful adjunct to face‐to‐face appointments during the COVID‐19 pandemic and beyond. Level of Evidence 4.

Background Three-dimensional endoscopes provide a stereoscopic view of the operating field, facilitating depth perception compared to two-dimensional systems, but are not yet widely accepted. Existing research addresses performance and preference, but there are no studies that quantify anatomical orientation in endoscopic ear surgery. Methods Participants (n = 70) were randomised in starting with either the two-dimensional or three-dimensional endoscope system to perform one of two tasks: anatomical orientation using a labelled three-dimensional printed silicone model of the middle ear, or simulated endoscopic skills. Scores and time to task completion were recorded, as well as self-reported difficulty, confidence and preference. Results Novice surgeons scored significantly higher in a test of anatomical orientation using three-dimensional compared to two-dimensional endoscopy (p < 0.001), with no significant difference in the speed of simulated endoscopic skills task completion. For both tasks, there was lower self-reported difficulty and increased confidence when using the three-dimensional endoscope. Participants preferred three-dimensional over two-dimensional endoscopy for both tasks. Conclusion The findings demonstrate the superiority of three-dimensional endoscopy in anatomical orientation, specific to endoscopic ear surgery, with statistically indistinguishable performance in a skills task using a simulated trainer.