Tonsillectomy in or out?

Although tonsillectomy is the most common surgical act performed in ENT practice, there is still some concern about the safety of outpatient or day surgery scheduling, especially in adults. Although this has been common practice in many departments for some...

Core or fine needle assessment in lymphadenopathy and salivary gland tumours

This paper from the Republic of Korea analyses 278 patients retrospectively, 112 of which underwent fine need aspiration and 166 core needle biopsies. Eleven patients had indeterminate fine needle aspiration cytology, six of whom had an additional core biopsy. The...

Pedicle calcification – an uncommon problem

This paper from Germany describes an uncommon phenomenon of pedicle calcification in three cases. In patients from two centres that had fibula free flap reconstruction from January 2010 to January 2016, 68 cases had pedicle calcification and three cases were...

Peripheral nerve reconstruction using cell-enhanced acellular nerve grafts

Autologous nerve grafts are the current gold standard for peripheral nerve reconstruction. This systematic review analyses the role of cell-enhanced acellular nerve (ANA) grafts on the regeneration of peripheral nerve injuries. Several studies have been published to examine alternatives to...

Perioperative management of the head and neck cancer patient

The perioperative care of patients with head and neck cancer is complex and requires significant preoperative planning and patient education. The issues include analgesia, antibiotics, stoma and wound care, general and chest physiotherapy, thromboprophylaxis and nutrition. This article provides a...

Investigation of the role of KPNA2 biomarker in oral SCC invasiveness

This edition of Head and Neck has a strong focus on studies using immunohistochemistry (IHC) to elucidate potential roles of various cell-signalling molecules in both HNSCC and thyroid cancer. The ‘cellular-protein heavy’ title of this article may be off-putting to...

Using evidence and international consensus to guide treatment of thyroid nodules

The authors of this practical review paper highlight a growing issue within thyroid surgery, where high-quality ultrasound has increased the detection of subclinical nodules: what do we do with the patient presenting with an ‘incidental’ thyroid nodule? This has both...

Risk of second primary cancer among patients with head and neck cancers

Patients with head and neck squamous cell carcinoma (HNSCC) have an elevated risk of developing a second primary malignant neoplasm (SPMN). These are of increasing concern because the number of survivors of HNSCC has been growing owing to early detection...

When to treat a fractured mandible?

This is a prospective study from Brisbane of 215 patients with a total of 359 fractures of the mandible. Nine outcome variables were analysed with a further 19 included to adjust for potential confounding. Treatment delay was found not to...

Delirium post-op

This is a retrospective study from Japan analysing 102 patients who underwent oral cancer resection and free flap reconstruction. Postoperative delirium occurred in a third of these patients. An increased risk was identified in those with high preoperative albumin, postoperative...

Modified subciliary approach to the orbital floor

Fractures involving the lateral midface and orbital floor are routinely treated by maxillofacial surgeons. The surgical management requires access to the facial skeleton to reposition and free the soft tissues. There are three main approaches to the orbital floor: infraorbital;...

Is a chest x-ray necessary in making urgent referrals for suspected head and neck cancer?

The article presents an audit on urgent referrals for suspected head and neck cancer in 2144 patients. Only 8.6% of cases proved positive for head and neck cancer. The Scottish Referral Guidelines were adhered only in 55.1% of cases. Interestingly,...