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Stereotactic radiosurgery for pituitary adenomas

Residual and recurrent functioning pituitary adenomas can be difficult to delineate on postoperative MRI scans, making them difficult targets for stereotactic radio surgery. In such cases radiation delivery to the entire sellar has been utilised as a radio surgical equivalent...

Preoperative tumour embolisation

This review article analyses the role of preoperative endovascular tumour embolisation in the treatment of a variety of hypervascular head and neck lesions including juvenile nasal angiofibroma, glomus tumour, carotid body tumours, and meningioma. Although the concept of tumour embolisation...

Resection margins in head and neck surgery

Although an increasing proportion of head and neck malignancies are treated with non-surgical modalities, when surgery is undertaken an incomplete clearance results in significantly worse prognosis. However, the intraoperative assessment of an adequate margin is difficult. The personal practice of...

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...

Acoustic schwannoma regression post-Gamma Knife treatment

In this retrospective study the authors studied the optimal interval following radiosurgery for differentiating between true growth of tumour versus pseudoprogression using serial volumetric data. A total of 118 patients with a median tumour volume of 0.74cm3 at Gamma Knife...

Paediatric versus adult pituitary adenomas

This retrospective study compares paediatric with adult patients undergoing pituitary adenoma surgery over a period of 26 years at a single institution. All surgeries were performed via a sublabial approach using the operating microscope. An endoscope was used occasionally for...

Rib grafts for mandibular reconstruction

Reconstruction of the mandible following ablation requires good bone stock to allow optimal function and the placement of dental implants. In the developed world, vascularised bony flaps are accepted as the gold standard but these may not be widely available...

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,...

What is the right balance to strike in the management of anaplastic thyroid cancer?

This is a pragmatic article on a difficult and much debated subject. Management of anaplastic thyroid cancer (ATC) can feel like making decisions between a rock and a hard place, and this article suggests one path to help navigate some...

Vestibular schwannoma surgery and inner ear injuries

Iatrogenic inner ear injury during vestibular schwannoma (VS) surgery ranges between 20% and 30% in the literature. However, there is no up-to-date quantification of such injuries, hence this study. The authors conducted a US-multicentre database search looking for patients who...