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Extracutaneous Merkel cell carcinoma or metastatic Merkel cell carcinoma with an occult primary?

Merkel cell carcinoma (MCC) is a rare and aggressive malignancy arising from dermal neuroendocrine cells, first described by Toker in 1972 [1]. It is predominately seen in the head and neck region of older, white males and risk factors include...

Transnasal endoscopic choanal atresia surgery

Surgery is currently the only definitive treatment for congenital choanal atresia (CCA). There are various surgical approaches including transnasal, transeptal or transpalatal. The authors propose that the preferred option is transnasal endoscopic choanal atresia surgery (TECAS) and set out to...

Assessment of septal deviation in septorhinoplasty

A variety of methods exist to assess the nasal septum, often dependent of the healthcare resources available, and whether there is a specific pathology affecting the function of the nose. The authors present a small series of patients presenting with...

Cosmetic Injection Techniques: A Text and Video Guide to Neurotoxins and Fillers

This is a very well-written, concise guide to aesthetic injecting with plenty of useful, high-quality illustrations throughout. Six chapters take you from your initial consultation through to advanced injection techniques covering neurotoxins, fillers and fat-dissolving injections. The consultation chapter is...

Repeated orbital decompression surgery

This is a retrospective review of nine redo orbital decompressions in six patients. All operations were performed for dysthyroid optic neuropathy, both initially and when repeated. The interval between first and redo decompressions varied from one to 15 years and...

Hair Loss and Restoration

Shapiro and Otbeg elegantly address the causes of hair loss, both idiopathic and pathological, and explain the treatments currently and the evidence behind them Our understanding of the pathophysiology of hair loss has evolved greatly in recent years. Before the...

Part four: Aye, Aye. AI?

“Formal clinical guidelines would provide a structured, evidence-based approach to managing patients who have undergone melanoma treatment and are considering elective surgery. This would enhance patient safety, standardise care, and support informed decision-making. Given the increasing prevalence of melanoma and...

The origin of the Children’s Burns Club

Burn injuries can affect any of us or our families at any time. A momentary lapse in attention can lead to a lifetime of scarring. Whilst any individual member of a family group can be physically scarred, all the family...

How I Do It - Non-surgical approach to facial palsy – a preliminary case report

In October 2013, a female patient presented for an initial consultation. She had a past medical history of left lower seventh (facial) nerve palsy following excision of left benign parotid adenoma in 2002. This had been treated over the years,...

Botulinum toxin type A for the treatment of allergic & idiopathic rhinitis: The Aller-Tox™ method

Hay fever provides a significant burden on the NHS, according to NHS data, approximately 20% of UK residents are hay fever sufferers. Around one fifth of these patients with allergies struggle with the fear of a possible asthma attack [1]....

Lacrimal gland carcinoma outcomes

This is retrospective review of outcomes of lacrimal gland epithelial tumours treated between 1972 and 2014 at Moorfields Eye Hospital. Seventy-nine patients were reported, comprising 53 adenoid cystic carcinomas, 15 primary adenocarcinomas and 11 carcinomas ex-pleomorphic adenoma. The authors compare...

Gross negligence manslaughter in healthcare: The medico-legal dilemma

Three years ago, I concluded a multi-part blog series looking at a case of gross negligence manslaughter in Hong Kong. The specific case related to a doctor who had operated on a patient who tragically died some 40 minutes after...