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How are swallowing and voice affected following anterior cervical discectomy and fusion (ACDF)?

Anterior cervical discectomy and fusion (ACDF) requires an anterior transcervical approach (ACA) to allow decompression of the cervical spine and nerve roots. This approach is also occasionally used for corpectomy and osteophyte removal. Key neurovascular structures related to swallowing and...

Diagnosis and management of acute sensorineural hearing loss: a Japanese perspective

In this paper, the authors set out the clinical guidelines to standardise diagnosis and treatment of acute sensorineural hearing loss in Japan. They categorised acute sensorineural hearing loss into five disorders: idiopathic sudden sensorineural hearing loss (iSSNHL), acute low-tone sensorineural...

Intra orbital treatment to save the eye!

Invasive fungal sinusitis can be a devastating condition, and accepted management is surgical debridement of infected tissue, systemic antifungal treatment and reversal of immunosuppression. Orbital involvement is common, affecting up to 75% of cases, and in advanced disease orbital exenteration...

Outcomes of reirradiation for recurrent head and neck SCC

Recurrent squamous cell carcinoma of the head and neck is often a challenge to manage when radiotherapy has previously been administered as a component of the initial treatment. Salvage surgery is usually the preferred modality of treatment, but for unresectable...

Management of patulous eustachian tube dysfunction

Idiopathic sudden sensorineural hearing loss (iSSNHL) is defined as a hearing loss of 30 dB or more at three contiguous frequencies within 72 hours, with acute low-tone hearing loss (ALHL) excluded from this category. Despite standard treatment, outcomes vary: one-third...

The ACS-NSQIP study – predictive risk factors and outcomes in primary malignant parotid tumour surgery

Malignant parotid gland tumours occupy a good proportion of the ENT surgeon’s operative caseload. Large standardised datasets for malignant parotid tumour surgery are limited. This international multi-institutional study is based on the pooled American College of Surgeons National Surgical Quality...

Dysplasia at the margins of laryngeal cancer specimens following laser resection – is conservative management appropriate?

Transoral laser microsurgery (TOLM) remains the cornerstone of treatment for early laryngeal squamous cell carcinomas. Whilst the hope is always to achieve a complete surgical excision with clear margins, it is sometimes the case that on histological analysis, disease is...

Dysphagia in complex laryngology – maintaining the balance

These authors from the speech and language therapy department at Imperial College Healthcare NHS Trust, describe their view of a patient-centred approach to managing dysphagia in complex laryngology. Careful consideration of the balance of airway, voice and swallow, which is...

30 Years Experience with Pettigrew Temporal Bones

The Glasgow Temporal Bone Course was started in 1976, by Mr Alastair Pettigrew using cadaver bones. However, because of changes in the law in the UK, these became unavailable in the middle 90s and the course had to use the...

American Thyroid Association Thyroid Cancer Management Guidelines: utilising risk stratification to optimise patient care

The steep rise in thyroid surgery around the globe, has led to the development of risk stratification to define the indications for surgery and the extent of surgery as well as adjuvant therapies for papillary carcinoma, to avoid over treatment....

Posterior TM perforations carry greater hearing loss: practical pointers for clinic

This single-centre prospective study of 100 adults with central pars tensa perforations examined how perforation size and quadrant relate to hearing loss. Using video-otoscopy to estimate perforation area and pure tone audiometry for thresholds, the authors found hearing loss in...

The use of THRIVE in laryngology and phonosurgery

The team in Lewisham has been using THRIVE for our phonosurgical cases for about a year. Here, we discuss the pros, cons and potential pitfalls of setting up and using THRIVE as ventilation during anaesthesia rather than using an ML...