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Observations and ruminations - a week of collaboration and learning in Ghana

A week of surgical exchange in Ghana reveals the power of collaboration, resilience and mutual learning in advancing global ENT care. Isabelle JM Williams. Isabelle’s perspective It was a Saturday lunchtime at Heathrow airport, terminal 3. Professor David Howard, Miss...

Are elective facelifts a good idea after head and neck cancer radiotherapy?

The aim of this study was to assess the safety of elective cervicofacial rhytidectomy following radiotherapy for head and neck squamous cell carcinomas (HNSCC). A greater proportion of HNSCC patients are infected with certain strains of the human papillomavirus, which...

Which da Vinci surgical system? Novel flexible, single-port versus current multiport, rigid-arm robotic surgical system

The da Vinci robotic surgical system has transformed how oropharyngeal head and neck surgery can be delivered. The existing da Vinci Si model has challenges: the dimensions of this are larger than would be ideal for head and neck surgery...

Assessing post-extubation dysphagia on the intensive care unit

The incidence of post-extubation dysphagia (PED) is reported to be about 12% in the general ICU population and around 18% in patients admitted to ICU as emergencies. PED was found to be an independent predictor of 28-day and 90-day mortality....

Preventing major postoperative haemorrhage following TORS

Transoral robotic surgery (TORS) has become an increasingly utilised treatment modality in the management of oropharyngeal squamous cell carcinoma (OPSCC). Postoperative haemorrhage, although uncommon, is a significant complication. To ameliorate this risk, transcervical ligation of branches of the external carotid...

IIb nodes in a node-negative neck

This is an 11-year retrospective study of 389 patients who underwent 527 supraomohyoid neck dissections in a clinically node-negative (cN0) neck between November 2012 and November 2023. Oropharyngeal, maxillary, gingival and maxillary sinus tumours, along with those with a location...

Scary Cases in Otolaryngology

When I was first presented with the Halloween-like graphic that is displayed on the cover of this 230-page book, I wondered what scary stories may lie ahead. To my delight, by the time I’d turned over the first few pages,...

Laryngeal cleft in a 66-year-old man!

This is a fascinating case report of a 66-year-old man who presented with a carcinoma of the piriform sinus. During chemoradiotherapy, he developed dyspnoea, dysphagia and aspiration pneumonia. His chemoradiotherapy was stopped and he underwent a pharygnolaryngectomy. When the surgical...

ENT Training: a Singapore perspective

I recently had the opportunity to participate in a week’s observation with Associate Prof Thomas Loh, a head and neck surgeon with a special interest in nasopharyngeal carcinoma at the National University Hospital of Singapore (NUHS). What was striking from...

A histological test for LPR?

Laryngopharyngeal reflux (LPR) is often considered to be a contributory factor to the development of a spectrum of laryngeal abnormalities including vocal cord leukoplakia and dysplasia. This is especially the case when traditional risk factors, such as tobacco smoking, are...

Surgical management of sleep disordered breathing

Snoring and sleep-disordered breathing are often described as multi-level problems, and different surgical procedures are required to treat the various sites of airway narrowing and/or collapse. Jonathan Hobson gives us an eloquent run-through the various options available to the ENT...

Radiology of referred otalgia

Otalgia is a common presenting complaint to Ear Nose and Throat Departments. Otalgia is either primary or secondary (referred) [1]. Referred otalgia is a ‘red flag’ symptom and can be a diagnostic challenge for clinicians and radiologists as the pathology...