The collective myringoplasty success rate was 80.8 per cent (105/130); for successful patients, the mean air conduction audiometric gain was -6.8 dB (t = 5.29, p < 0.0001). Neither perforation size nor any other assessed variable was a statistically significant determinant factor for successful myringoplasty. Air conduction audiometric gains following successful myringoplasty were directly correlated with pre-operative perforation size (-4.0 dB for 0-20 per cent perforations, -5.0 dB for 21-40 per cent, -9.1 dB for 41-60 per cent, -10.8 dB for 61-80 per cent and -13.3 dB for 81-100 per cent).

Ann R Coll Surg Engl 2010; 92: 40-43 40Indications for parotidectomy include benign and malignant tumours as well as inflammatory conditions of the parotid gland.1 Traditionally, the cervicomastoidfacial incision (alternatively known as the modified Blair incision) is used for surgery of the parotid gland which offers excellent surgical access to the parotid gland, but leaves a visible scar in the neck. Alternatively, for suspected benign tumours, a more cosmetic modified facelift (rhytidectomy) incision can be considered which leaves no visible neck scar.2 At the Luton & Dunstable Hospital, parotidectomy is performed by ear nose and throat (ENT) and maxillofacial surgeons. We retrospectively analysed parotidectomies performed by both departments over a 2-year period. The aim of this study was to establish the frequency of each surgical approach used and to identify any difference in complication and patient satisfaction of the operative scar between the two incisions. Patients and MethodsA retrospective analysis of case notes for patients who underwent parotidectomy by both ENT and maxillofacial departments between January 2006 and February 2008 was undertaken. All operations were either performed or supervised by a consultant. Only benign indications for parotidectomy were considered for this study; thus, histologically confirmed cases of malignancy were excluded. The numbers of patients who underwent parotidectomy via a cervicomastoidfacial and modified facelift incision were counted. For each incision, details regarding immediate postoperative facial nerve weakness and wound haematoma were obtained from the notes. A patient-outcome evaluation questionnaire was posted to all included patients at least 6 months following their parotid surgery. Information regarding facial paraesthesia and gustatory sweating was sought, The rhytidectomy or modified facelift (MF) incision allows an alternative approach which leaves no visible neck scar. The objective of this study was to establish the frequency of each surgical approach used and identify any difference in complication and patient satisfaction between the two incisions for benign conditions of the parotid gland. PATIENTS AND METHODS A retrospective analysis of 101 case notes for patients who underwent parotidectomy by both ENT and maxillofacial departments between January 2006 and February 2008 was undertaken. All histologically confirmed cases of malignancy were excluded. For each incision, immediate postoperative complications were obtained from the notes. A postal patient outcome evaluation questionnaire sought information regarding persistent and late complications as well as a visual analogue scar satisfaction score for both incisions. RESULTS Overall, 79 parotidectomies were included (59 CMF incisions, 20 MF incisions). Of CMF incisions, 34% suffered facial weakness immediately postoperatively versus 20% of MF incisions. Of CMF incisions, 4% suffered postoperative haematomas versus none following MF incisions. In the study cohort, 47 (60%) responded to the ...

This course represents an effective method of teaching ENT emergency management to junior doctors. ENT induction programmes benefit from the incorporation of a simulation component.

3b. Laryngoscope, 128:2139-2144, 2018.

Wilhelm Frederick von Ludwig first described in 1836 a potentially fatal, rapidly spreading soft tissue infection of the neck and floor of the mouth. The condition was later named 'Ludwig's angina', a term which persists in medicine to this day. A gold medallist at 19 and professor at 25, Ludwig also served as president of the Württemberg Medical Association and chief physician to the royal family. His outstanding contribution to medicine was rewarded with the title Excellence upon retiring in 1855. Ludwig died at the age of 75, ironically, days after developing an inflammation of the neck. Could it be that Ludwig died of his own condition? This article combines a biography of Wilhelm Frederick von Ludwig with an overview of his eponymous condition and its management.