The review found an extensive range of surgical treatment techniques, but reported results were rarely statistically significant. It is difficult to be categorical about the effectiveness of a surgical treatment method; nonetheless, each technique has its own advantages and drawbacks.

Tympanoplasty using cartilage with or without perichondrium has better morphological outcome than tympanoplasty using temporalis fascia. However, there was no statistically significant difference in hearing outcomes between the 2 grafts.

The primary and secondary posttonsillectomy hemorrhage rates were 0.3 and 9.2%, respectively. Tonsillectomy using bipolar diathermy has a statistically significant higher secondary hemorrhage rate than using cold dissection (12.5% vs. 5.5%, P < 0.05).

Objectives.  To critically evaluate the surgical treatment strategies for nasal valve collapse and their outcomes. Method.  A systematic review of studies for surgically treated nasal valve collapse from 1970 to 2006 including an analysis of techniques and their outcomes. Database search of EBM reviews, (Cochrane, DARE, CCTR & ACP Journal club), Medline and EMBASE’ including a hand search of bibliographies in identified papers. The outcomes used are success of techniques at relieving symptoms and cosmesis. The inclusion criteria was a minimum of 10 patients in each study with a defined minimum 6‐month period of follow‐up. Results.  No randomised trials exist; 31 studies met the minimal inclusion criteria. Seventeen addressed the internal nasal valve, seven the external nasal valve and seven both. A variety of techniques have been used including spreader grafts, alar batten grafts, splay grafts, butterfly grafts, and lateral expansion sutures. All techniques have high success rates with no single technique appearing more successful than others. Studies had similar inclusion criteria and a mean follow up >12 months. The level of evidence is III. Few studies provided objective measures of nasal airflow in the form of rhinomanometry, but when presented results were significantly improved. Conclusions.  A variety of surgical techniques are available to deal with nasal valve collapse. The specific pathological problem causing obstruction at the nasal valve must be identified and the surgical solution tailored to the individual. There is no ‘one size fits all’ procedure.

This survey investigates the attitudes of medical and nursing staff towards the daily otolaryngology ward rounds in a teaching hospital. Initial, open-ended questionnaires generated themes from which a structured questionnaire was constructed. Respondents indicated on a Likert scale the extent to which they agreed or disagreed with statements concerning their attitudes towards the ward round. Thirty-five members of staff were surveyed. The overall response rate was 74.3 per cent (n = 26). The majority of staff agreed that the ward round was a constructive use of their time and served to promote team spirit. It allowed for adequate communication between medical and nursing staff but there was uncertainty about the provision of adequate patient communication. The nursing staff agreed that the ward round provided a valuable learning experience. There was uncertainty about this among the medical staff. There was agreement in both groups that patients find the ward round to be reassuring. A significant majority of staff expressed concerns over maintenance of patient confidentiality. These findings could be used to inform changes in the departmental ward round structure. Specific attention should be directed to discussing sensitive issues in a more private setting and maximizing educational opportunities for junior medical staff.