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Intraoperative nerve monitoring: 2017

Having written the definitive text on laryngeal nerves, Gregory Randolph and Dipti Kamani describe the benefits of intraoperative neural monitoring and, importantly, how to proceed if the nerve is pathologically involved or there is loss of signal. Over the years,...

Head and Neck: Dissection and Reconstruction Manual

The ‘Head and Neck Dissection and Reconstruction Manual’ is compiled by the Chinese University of Hong Kong (CUHK) Head and Neck Course faculty and edited by Professor A Van Hasselt and E Wong. The Manual is specifically aimed at ENT...

Middle ear muscle disorders: presentation, diagnosis and management

Patients often report symptoms relating to disorders of the middle ear muscles. Prof Bance gives us an overview of the anatomy and function, as well as guides our diagnosis and management. The middle ear muscles (MEMs) are a mystery, both...

Predicting which oropharyngeal SCC HPV-positive patients should avoid de-escalated treatment

This study is timely for many reasons and raises very important questions in the management of the current rise in HPV-positive patients with oropharyngeal cancer (OPC). The uniqueness of this group within head and neck cancer in terms of favourable...

Less pain more gain: impact of prophylactic gabapentin on swallowing outcomes in head and neck cancer patients undergoing radiation treatment

Patients planned for chemoradiation to the head and neck are usually advised to expect some pain and soreness during their treatment and that pain relief will be offered as and when it is required. Uncontrolled pain and mucositis affect oral...

Contemporary UK experience of oropharyngeal transoral laser microsurgery

It is well recognised that the current emergence of HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) as a distinct disease entity requires a fresh look at standard treatment modalities that are based on chemoradiotherapy for stage III/IVa OPSCC. The Newcastle experience...

Difficult consultations with HPV-positive oropharnyeal cancer patients

The aetiological role of human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OPSCC) is well established, and its incidence has massively increased over the last decade, whilst the incidence of HPV-negative OPSCC is declining. Although we know that HPV-positive OPSCC...

Impact of the updated cancer staging system on HPV-positive disease

The AJCC cancer staging manual was updated in 2017 (8th edition). It is used in the MDT setting for planning treatment and assessing prognosis for individual patients, and is also widely used internationally in clinical trials. Unlike previous iterations of...

ENT in Ethiopia: Aksum-Barts Partnership

In keeping with many other countries in sub-Saharan Africa, Ethiopia has a chronic lack of hospitals and doctors. Nadia Ashraf and Tim Crocker-Buqué tell us about a project which aims to improve training in ENT, in a hospital that has...

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...

Destination unknown

We as doctors do not always know the answer. Associate Professor Jacqueline Allen guides us through the importance of acceptance of this uncertainty and its complex mental journey. She highlights that, as clinicians, we must embrace the unknown and be...