’I Don’t Have a Crystal Ball’ – Why Do Doctors Tend to Avoid Prognostication?

Uncertainty, fear to harm the patient, discomfort handling the discussion and lack of time are the most cited barriers to prognostic disclosure. Physicians can be reassured that patients desire the truth about prognosis and can manage the discussion without harm, including the uncertainty of the information, if approached in a sensitive manner. Conversational guides could provide support in preparing such difficult conversations. Communicating ’with realism and hope’ is possible, and anxiety is normal for both patients and clinicians during prognostic disclosure. As a clinician pointed out: ’I had asked a mentor once if it ever got easier. – No. But you get better at it.’

Mastoid Dressing in Ear Surgery: Is it Still Relevant?

Introduction Mastoid dressings are conventionally used in patients who undergo Tympanoplasty using post auricular approach. The rationale behind using a mastoid dressing is that the said dressing prevents haematoma formation and acts as a protective covering during the post-operative period. This study aims to understand the significance of mastoid dressing in patients undergoing Cortical Mastoidectomy and Tympanoplasty and its role in preventing post-operative wound complications and patient comfort. Materials and Methods A total of 77 patients were enrolled in the study over a one year period and were randomised into dressing and no dressing groups with the aim of deciphering any advantage of the mastoid dressing over a smaller dressing. Results Our data revealed no added advantage of conventional mastoid dressing over a small gauze piece dressing in terms of haematoma/seroma formation, contusion and wound dehiscence. However, there was significantly reduced patient discomfort and sleeping difficulties post-operatively in the no dressing group. Conclusion We conclude that smaller dressing is more favourable than the bulkier conventional mastoid dressings.