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Traditionally, large, symptomatic, parotid stones that were refractory to conservative treatment were usually managed by parotidectomy, with the attendant risk to the facial nerve. Microendoscopes have transformed the management of such stones. For large stones that are not amenable to retrieval with a basket the endoscope provides a new dimension to operative surgery. It can guide the surgeon on to the duct and stone without the need to remove the parotid gland. In 2005-2014, 111 consecutive patients underwent endoscopically-assisted operations for the removal of 132 parotid stones at Guy's Hospital. Removal was successful in all but three cases. Long-term follow up (mean (SD) 44 (30) months) was obtained by postal or online survey and telephone, and 92 patients (83%) said that they had no symptoms. Further endoscope-assisted surgery was required in four cases, with preservation of the gland in all patients. Sialocoeles developed postoperatively in 15% (n=17). Transient facial nerve weakness occurred in 4 cases (4%), and there was no case of permanent deficit. Endoscopically-assisted retrieval of parotid stones is a technique to preserve the gland that adds to the current minimally-invasive options for management of parotid calculi.

This course, run by the Pulvertaft Hand Centre at the Royal Derby Hospital, is highly recommended for surgeons wishing to use the mini C-arm in theatres or with outpatients. At the time of writing, it was the only course available that fulfils the criteria for the Ionising Radiation (Medical Exposure) Regulations 2000. The course is aimed mainly at plastic and orthopaedic surgeons who wish to use the mini C-arm for imaging extremities. However, there were many colleagues from allied specialties, including rheumatology and radiology, who wanted a safe grounding in the theoretical use of the …