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Importance of the time interval between surgery and postoperative radiation therapy in head and neck cancer

The ideal time to start postoperative radiation therapy (PORT) in head and neck cancer patients has been an issue of debate. In the USA, the National Comprehensive Cancer Network (NCCN) recommends initiating radiotherapy within six weeks from surgery. The six-week...

Patient reported outcomes following total laryngectomy using the Swallowing Outcomes After Laryngectomy (SOAL) questionnaire

Following a total laryngectomy, alterations in the pharyngeal musculature and changes in the pharyngo-oesophageal segment due to reconstruction, results in altered bolus transit. Swallowing dysfunction after total laryngectomy for head and neck squamous cell carcinoma can vary from 10%-90%. There...

Adjuvant radiotherapy for T4N0 laryngeal cancers treated with laryngectomy

A total laryngectomy remains the gold standard for the initial treatment of advanced (T4) squamous cell carcinomas of the larynx without evidence of distant disease. Adjuvant radiotherapy (RT) is also recommended for such cancers. In the absence of other adverse...

Outcomes of reirradiation for recurrent head and neck SCC

Recurrent squamous cell carcinoma of the head and neck is often a challenge to manage when radiotherapy has previously been administered as a component of the initial treatment. Salvage surgery is usually the preferred modality of treatment, but for unresectable...

Changing perceptions in head and neck cancer management caused by quality of life issues

Sir Felix Semon was an outstanding clinician and exceptional laryngologist. The money raised by donations from his colleagues on his retirement in 1909 was used to establish the London University’s Semon Lecture. Semon’s Obituary in the BMJ, reads: “In Semon's...

Allergen immunotherapy and allergic rhinitis – EAACI guideline 2017

Allergic rhinitis (AR) is a common chronic childhood disease with considerable social burden and impact on quality of life, frequently necessitating treatment with various combinations of antihistamines and corticosteroids. The allergen immunotherapy (AIT), sometimes known as desensitisation therapy, can modify...

Advances in diagnosis and management of allergic rhinitis

This article reviews advances in the diagnosis and management of allergic rhinitis. Recent advances in the diagnosis of allergic rhinitis include testing of local immunoglobulin E (IgE), urinary test to diagnose aspirin hypersensitivity and optical rhinometry to assess degree of...

How to tackle the problem of ciprofloxacin-resistant ear infections?

The growing issue of ciprofloxacin-resistant ear organisms is certainly a pertinent one. The situation here in the UK, where ototoxic topical drops are frequently given initially in the presence of pus and a perforation, differs markedly from elsewhere where fluoroquinolones...

To montelukast or not to montelukast

Both histamine and cysteinyl leukotrienes play an important role in both seasonal allergic rhinoconjunctivitis (SARC) and asthma. A combination therapy against both was shown to give benefit both in vitro and in vivo. Authors wanted to test the efficacy of...

Combination PPI and intralesional steroid treatment for recurrent laryngeal granuloma

The existence of a wide range of treatments for recurrent laryngeal granulomas (repeat surgery, high-dose proton pump inhibitor (PPIs), surgery with botulinum toxin injection, botulinum toxin injection alone, etc) is a testament to the refractory nature of this condition, with...

Are there benefits of prophylactic swallowing exercises for patients with head and neck cancer?

This randomised controlled trial aimed to establish the impact of prophylactic swallowing exercises in patients undergoing chemoradiation therapy for head and neck cancer. The primary outcome was the functional oral intake scale (FOIS), although secondary measures for feeding tube use,...

In conversation with Professor Paul J Donald

Prof Paul J Donald has recently stepped down as Chairman of the ORL-HN Department at UC Davis in Sacramento and is winding down to retirement. In this interview with Prof Pat Bradley, Prof Donald explains some of the highlights of...