Traditional incision and drainage of a quinsy may be more efficacious than aspiration

Peritonsillar abscess drainage has always been one of the first procedures an ENT junior doctor performs. Traditionally incision and drainage (I&D) was the mainstay of treatment. In recent years, needle aspiration of the abscess has become much more commonplace, perhaps...

Active smoking predicts poor outcome in HPV positive oropharyngeal squamous cell carcinoma

Tobacco smoking is a well-known risk factor in human papilloma virus (HPV)-negative head and neck squamous cell cancer. Its effects include increased risk of treatment failure, distant metastases and reduced overall survival. HPV has been increasingly implicated as a causative...

Clinical histopathology of 250 parotidectomy patients

Clinical histopathology of 250 parotidectomy patients This is a retrospective study of 250 consecutive parotidectomy patients at units in Belgium and the Netherlands. The sensitivity and specificity of FNAC was 64% and 99% respectively, the sensitivity being slightly lower than...

Extracapsular dissection versus parotidectomy

This is a literature review of 16 papers using the PRISMA protocol. In comparing the two techniques, not surprisingly, they found that extracapsular dissection was associated with a reduced incidence of facial nerve paralysis and Frey’s syndrome and a shorter...

Microvascular free flap failures – looking beyond surgical technique

Microvascular free flaps are commonly used in reconstruction for head and neck defects. Failures of these flaps, however, are associated with a significant morbidity and mortality. Flap failures within the first 72 hours are commonly attributed to technical failure of...

Intraoperative identification of primary tumours in unknown primary head and neck cancer using transoral laser microsurgery with frozen sections

The aim of the study was to compare the sensitivity and specificity of intraoperative identification of primary tumours in patients with unknown primary head and neck squamous cell carcinoma (UP HNSCC) using transoral laser microsurgery (TLM) with frozen sections, with...

Can we predict risk of adverse events preoperatively in patients undergoing head and neck cancer surgery?

Ed’s Choice reviews a paper aiming to create a reliable index to predict postoperative outcomes in head and neck cancer patients. This interesting study identifies variables that may assist in risk assessing prospective surgical candidates. There have been a few...

Voice and unilateral vocal fold paralysis

Voice outcomes are the main comparators when managing unilateral vocal fold paralysis (UVP). In a review of the literature, 11 voice indicators are included in 80% of all articles. However, when surgeons were surveyed on their clinical preferences and their...

Percutaneous tracheostomy in anticoagulated patients

This Belgian study looked at the risks and complications of bedside percutaneous tracheostomy in patients who received anticoagulant therapy. The 231 tracheostomies included in the study were performed over an eight-year period by two otolaryngologists using bronchoscopic guidance. The mean...

Narrow band imaging in laryngopharyngeal reflux

Narrow band imaging (NBI) is a tool on the Olympus endoscopic systems that uses blue and green wavelengths to enhance visualisation of mucosal vasculature. It has been used to aid in the early diagnosis of upper aerodigestive tract cancers. A...

Surgical management of refractory osteoradionecrosis

This is a French single-centre, 10-year experience of 55 surgical resection and reconstruction procedures. They claim an overall effectiveness rate of 92.3%. A total of 36 segmental and 19 marginal mandibulectomies were performed. A variety of free flaps were used,...

Hierarchy of orthognathic surgical stability

This study was designed as “an overview” of secondary studies and analysed 15 articles. Two procedures were considered highly unstable: a bilateral sagittal split osteotomy for clockwise rotation of the mandible with bi-cortical screw rigid internal fixation, and posterior maxillary...