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Concussion and vestibular processing deficits

It is well known that patients with mild traumatic brain injury (mTBI), also referred to as concussion, display longstanding vestibular symptoms but often clinical signs and objective vestibular function test abnormalities are lacking. The aim of the study was to...

Robotic surgery for ventral skull base malignancy

The use of transoral robotic surgery (TORS) in the head and neck area has been shown to be a safe and effective technique, achieving good oncological clearance of the oropharynx, hypopharynx, supraglottis and glottic area. However, robotic surgery for the...

Sentinel nodes and UADT tumours

This is the review of a multicentre study to set practical guidelines for sentinel node techniques (SLN) in upper aerodigestive tract (UADT) squamous cell carcinomas including classical and extended indications. SLN biopsies are strictly indicated in patients with clinically and...

To drain or not to drain

These two separate papers neatly tie together the same ideas. The first, a retrospective study of 107 patients and 116 procedures over a 10-year period who underwent a CSF leak repair, 82.2% without a lumbar drain and 17.8% with. The...

Results of hypoglossal-facial nerve anastamosis techniques for facial palsy

Preserving facial nerve function is of prime importance in acoustic neuroma surgery. A comprehensive knowledge of anatomy, experience and surgical precautions can reduce the incidence significantly. Important considerations are when and how to repair if injury occurs. Several options include:...

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...

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...

What is the evidence for contralateral tonsillectomy in TORS for known unilateral tonsil malignancy?

The concept of field changes by carcinogens within the upper aerodigestive tract is well established with reported rates of synchronous tumours of 4% and second primaries of 36%. The tonsil in particular has the highest rate of synchronous tumours, postulated...

Radiation-induced dysphagia in head and neck cancer

This is a helpful reference paper that provides an overview of the biomolecular effects of radiation on the tissues of the upper aero-digestive tract. The authors explain that radiation injuries occur in a repetitive and accruing manner over the duration...

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...

A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth

It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...