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5-cm incision for neck dissection and free flap reconstruction

Patients with oral cavity squamous cell carcinoma (SCC) will commonly require neck dissection as it is associated with a higher rate of overall and disease free survival. Free flap reconstruction of the defect following surgical resection is considered the gold...

Low risk options following failure of intratympanic gentamicin for Meniere’s

This article is a useful summary of the options available when intratympanic gentamicin (ITG) fails to adequately control vertigo episodes in Meniere’s patients. The authors describe the anatomical reasons that may impede drug delivery to the round window with the...

Incidental thyroid nodules: should we observe or operate?

Thyroid nodules are extraordinarily prevalent, detected by physical examination in 7% and by imaging studies in 67% of the population. Although most of these nodules are benign, up to 20% are found to be malignant on excision. It’s a very...

Voice therapy is an effective treatment for presbyphonia

The quality of an individual’s voice often declines with age. This deterioration occurs firstly as a result of vocal fold atrophy secondary to histologic alteration of the vocal fold mucosa as well as atrophy of the laryngeal musculature. Phonatory efficiency...

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...

Darn it! It’s going to take longer to get good at stapes surgery!

Traditionally, it has been said the learning curve for a particular operation lies between 20 and 30 cases. In stapedotomy, a surgeon is deemed successful and perhaps competent if closure of the air-bone gap (ABG) is reached to within 10dB...

Sialendoscopy assisted excision of parotid stones

This is a retrospective paper from China that looks to assess the efficacy and safety of sialendoscopy with a combined transoral or transcutaneous approach for the removal of parotid stones. Sialolithiasis is known to be a cause for obstructive parotid...

CSF leak – endoscopic or open repair?

Cerebrospinal fluid (CSF) rhinorrhoea is well known to the ENT surgeon. It commonly occurs secondary to a predisposing event such as accidental or iatrogenic trauma. When it occurs spontaneously, it can be associated with benign intracranial hypertension. The commonest CSF...

Early ENT involvement can improve long-term quality of life after temporal bone fractures

Sports injuries and road traffic accidents are common causes of head injuries, with 18-40% of skull base fractures involving the temporal bone. Often these patients have other more life threatening injuries so ENT intervention is delayed or absent. Facial palsy,...

Scalp reconstruction a new algorithm

Reconstruction of the scalp after acquired defects remains a common challenge for the reconstructive surgeon, especially in light of a history of radiation to the area. Wound healing by secondary intention or with a wound vacuum assisted closure are viable...

Depth of invasion of oral cancer should be incorporated in new AJCC staging system

Since 1977, when the first edition of the Manual for Staging of Cancer was published by the American Joint Committee on Cancer (AJCC), the primary tumour staging for oral squamous cell carcinoma (SCC) has remained unchanged. In the last four...

Measuring the ‘impact’ of preoperative immunonutrition

Using preoperative nutritional supplements as part of ‘enhanced recovery’ in surgical patients is not a new concept. This interesting paper looks at the latest development in optimising patients undergoing head and neck oncological surgery. Immunonutrition (Nestle’s ‘Oral Impact’ in this...