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Prognostic value of neutrophil-to-lymphocyte ratio in HPV-positive oropharyngeal cancer

The authors propose that high neutrophil-to-lymphocyte ratio (NLR) is associated with poor disease-free survival (DFS) in patients with human papillomavirus positive (HPV+) oropharyngeal cancer (OPC). This is a retrospective study that compared the outcomes of 43 patients treated for HPV+...

Imaging in hyperparathyroidism

Following their caudal migration at eight weeks of development, the parathyroid glands normally locate posterolaterally to the upper pole of the thyroid gland at the level of the cricoid cartilage (superior parathyroid glands arising from the fourth branchial pouch and...

HPV and ENT; should we vaccinate boys?

David Black and Charlie Hall reiterate Vin Paleri’s pleas for a common sense evidence-based approach by those who allocate healthcare resources to the now urgent issue of HPV-related disease. They discuss the merits of different vaccines and the need for...

An update on laryngeal reinnervation

Laryngeal paralysis remains very difficult to treat, but reinnervation offers many attractions. Laryngeal paralysis presents a unique and varied problem that requires a patient centred approach and a range of treatment options depending on laryngeal and patient factors. There is...

ENT leadership

Challenges The first challenge is to agree what we mean by the term leadership because there are many different ways in which the term is used. What is, however, a consensus is that the key distinction between leadership and management...

Gardasil vaccination as an adjuvant treatment for established recurrent laryngeal papillomatosis in male adults - does it stimulate an immune response?

Recurrent respiratory papillomatosis (RRP) is well known to be caused by infection with the human papilloma virus (types 6 and 11). Recurrence after surgical removal is common and potentially frequent and severe. Previous research has established that many patients with...

Oropharyngeal malignancies

The authors retrospectively reviewed 44 patients who underwent a combined transoral and transcervical treatment without mandibulectomy for oropharyngeal malignancy. The combined approach was performed first by a neck dissection followed by transoral excision of the lesion and reconstruction by a...

Clinical assessment in OSA

This paper divides the assessment up into anatomical (nasal and oropharyngeal), endoscopic and imaging. It points out the salient features to look out for in OSA patients with regards the nasal valve and also oropharyngeal anatomy, with tonsil hypertrophy grading...

Postoperative radiation in early stage oropharyngeal squamous cell cancer (OPSCC)

There is significant variation in treatment strategies for OPSCC between units. This is largely due to unanswered questions which continue to exist beyond the published literature. We know that human papilloma virus status has a significant influence on prognosis but...

Active smoking predicts poor outcome in HPV positive oropharyngeal squamous cell carcinoma

Tobacco smoking is a well-known risk factor in human papilloma virus (HPV)-negative head and neck squamous cell cancer. Its effects include increased risk of treatment failure, distant metastases and reduced overall survival. HPV has been increasingly implicated as a causative...

Long-term effectiveness of sleep surgery for obstructive sleep apnoea

n this study, 39 patients from Turkey with obstructive sleep apnoea (of varying severity) underwent an expansion sphincter pharyngoplasty. This operation was devised by Prof Kenny Pang in Singapore and involves using the palatopharyngeus muscle and partly relocating it laterally...

No soup for you…! Early identification of postoperative perforation increases the success of conservative management

Iatrogenic perforation of the hypopharynx or cervical oesophagus is a well-recognised life-threatening complication. Previous studies have demonstrated that conservative management with broad-spectrum antibiotics and withholding oral feeding may avoid morbidity associated with surgical repair. This study addresses when conservative management...