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McIsaac scores in tonsillitis

Acute tonsillitis is usually caused by a viral infection, however often antibiotics are prescribed without a confirmed diagnosis of a bacterial infection. The Modified Centor (McIsaac) criteria, which include fever (>38°c), tonsillar exudate, no cough, anterior cervical lymphadenitis and age,...

An algorithm to distinguish between distant metastases and metachronous lung primary in patients with HPV-related oropharyngeal cancer

Distinguishing between distant metastases of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) and metachronous primary lung squamous cell carcinoma (SCC) is important as it has implications for treatment, prognosis counselling, and registry data. Although p16 immunohistochemistry (p16 IHC) is widely accepted...

CT chest surveillance for oral cancer patients

Computed tomography (CT) imaging of the chest is performed as part of the assessment of patients with oral cancer to exclude pulmonary metastasis or synchronous cancer. This process is integral to staging of the disease. In some cases, non-specific pulmonary...

Awareness of alternative techniques in cochlear implantation

The use of alternative techniques for cochlear implantation is indicated in unusual cases where the standard procedure would not be suitable. The authors of this study highlight the various reasons as to why an alternative technique might be sought, and...

Trends in the incidence of oropharyngeal cancer

The recent rise in HPV-related oropharyngeal squamous cell carcinoma is well described. There has been a significant shift from tobacco-driven to virus-driven cancers at this anatomical site. This retrospective study analysed US tumour registry data over a long period (1973–2009)...

Blindness after orthognathic surgery

This is a case report and review of the literature of this rare, but well recognised alarming complication. The authors discuss the possible mechanisms, suggesting that it does not arise from a direct injury to the optic nerve and is...

Deep space neck infections and their management

This article explores the approach to managing patients with deep space neck infections. Clearly, an understanding of the fascial planes within the neck is required which then provides an understanding of the route of spread in these cases. The authors...

Learning curve for sialendoscopy

Sialendoscopy represents a minimally invasive technique that permits direct salivary tree visualisation and treatment using endoscopic techniques. Previous studies have shown that it is an efficacious, safe and potentially gland preserving method to treat major salivary gland disease. However, it...

Carotid artery involvement with head and neck metastases

This is a retrospective review of 27 patients radiologically diagnosed as having metastases involving the common or internal carotid arteries. All patients underwent a salvage neck dissection with surgical carotid peeling. Thirteen of the 27 achieved loco-regional control, five developed...

Does a labyrinthine fistula in cholesteatoma surgery lead to hearing loss?

Thirty-five patients with labyrinthine fistula related to cholesteatoma were studied retrospectively. All patients underwent CT scans and preoperative hearing tests 1-2 weeks prior to surgery (averaged at 0.5, 1, 2, 3, 4, 8 kHz). All 35 patients underwent mastoid surgery,...

Velopharyngeal insufficiency after adenotonsillectomy

The authors retrospectively reviewed the clinical records of 320 paediatric patients who underwent either tonsillectomy, adenoidectomy or adenotonsillectomy, under a single paediatric ENT surgeon. Patients with pre-existing velopharyngeal insufficiency (VPI) were excluded, as assessed by preoperative testing for nasal air...

Allergen specific subcutaneous immunotherapy helps in prolonged control of allergic rhinitis

One of the commonest allergens involved in perennial allergic rhinitis is house dust mite. A good proportion of these cases prove intractable to treatment with oral and intranasal antihistamines and intranasal steroid sprays. Immunotherapy is considered a useful alternative and...