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SPECT-CT imaging improves surgical efficiency in sentinel lymph node biopsy in melanoma

Sentinel lymph node biopsy is used in clinically lymph node negative, primary cutaneous melanoma. A combination of planer lymposcintigraphy using a radiolabelled colloid detected intra-op by gamma probe, and cutaneous injection of blue dye is used. However, with lymphoscintigraphy spillage...

Parathyroid pearls

This article serves to deliver some pearls of wisdom in parathyroid surgery for the ‘low volume parathyroid surgeon’. They have been divided into those relating to the preoperative diagnosis, imaging and localisation techniques and surgical difficulties. Recognised sources of error...

Deep space neck infections – salivary gland as source is commoner in elderly patients

Whilst deep space neck infections (DNI) can originate from many sources, dental and salivary glands are commonly the culprit. This paper details 44 patients treated for deep space neck infections originating from salivary gland and compares them to a previously...

Retained surgical cottonoids in the nose

his is an interesting group of case reports essentially documenting the presence and characteristics of retained surgical packing (non-resorbable) post sinus surgery. Paranasal gossypiboma refers to surgical foreign objects such as sponge or patties that are left in the nose;...

Expanding the role of FNA in thyroid nodule decision-making

Papillary thyroid cancer, the commonest histological type, has been extensively reported as having BRAF proto-oncogene mutations (most commonly the V600E mutation). There is great interest in BRAF as a molecular marker, particularly as a prognostic factor that may guide the...

Does pre-op intratympanic gentamicin improve balance control after vestibular schwannoma surgery?

This retrospective study was based on data from 44 patients selected from a cohort of 153 who had undergone surgical resection of vestibular schwannoma over a 10-year period. The aim was to evaluate the dynamics of the postural control system...

The laryngeal microdebrider – a useful adjunct in the surgical treatment of Reinke’s oedema?

The surgical treatment of Reinke’s oedema traditionally involves a cold steel incision placed in the lateral aspect of the vocal fold with aspiration of the characteristic gelatinous contents. In this paper, the authors compare voice outcomes in patients treated with...

Factors affecting the occurrence of salivary fistula after total laryngectomy

It is generally believed that patients should be fed by nasogastric tube for 7-10 days after undergoing total laryngectomy or laryngopharyngectomy to avoid the occurrence of post-operative salivary fistula. This study challenges this belief and looks into various factors that...

Superstructure-preserving stapes surgery in otosclerosis

Stapedectomy is a well-established procedure for otosclerosis but it has a small risk of a non-hearing ear, which can be devastating for patients. The development of a procedure which is safer and with a less steep learning curve for junior...

Can and should vestibular schwannoma surgery be carried out via the endoscopic transcanal approach?

The extent and scope of endoscopic ear surgery has rapidly progressed in recent years, and this paper, from one of the leading proponents of this technique, reports on the outcomes of a case series of patients who have had total...

A novel scale for the assessment of tracheoesophageal voice quality – the SToPS

There is currently no assessment tool in widespread use that permits a valid and reliable perceptual assessment of voice quality following laryngectomy. Such a scale is needed to investigate the functional outcomes of surgical voice restoration and rehabilitation regimes. Existing...

Risks of tracheostomy in head and neck cancer

Tracheostomy is associated with several complications, with rates quoted as high as 8-45%, including: bleeding; displacement; obstruction; surgical emphysema; pneumothorax; fistulae and failure to decannulate. There are now many studies that confirm the increased length of stay and complications of...