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Tricky post-laryngectomy swallows

Despite improvements in chemoradiation therapy and the adoption of organ preservation for some head and neck cancers, total laryngectomy remains the treatment often providing best survival chances for advanced laryngeal cancer. This article reviews the causes of dysphagia post-laryngectomy and...

Thyroid cancer: to dissect the neck or not?

This is a good review of the much-debated management of the neck in thyroid cancer. It discusses oncological goals that must be achieved whilst maintaining voice, swallowing and parathyroid function. A clear description is made of the common nodal basins...

Harvesting the flexor hallucis longus: what is the increased morbidity?

The free fibula flap is now widely used in clinical applications for microvascular reconstruction and occasionally, to add bulk, the flexor hallucis longus (FHL) muscle is harvested along with the fibula. The post-operative morbidity is usually described as mild and...

Should we be utilising the pre-lacrimal approach for maxillary sinus inverted papilloma?

For some time now, gold standard management of the maxillary sinus inverted papilloma has been endoscopic medial maxillectomy (EMM). Recently the endoscopic prelacrimal recess approach (EPLRA) has been reported to provide good access whilst preserving the nasolacrimal duct and inferior...

Early vs late activation of cochlear implant device

Device activation after cochlear implant surgery was typically performed after wound healing, and varies anytime from three to four weeks after surgery. Nowadays, activation is performed as early as two to three days after surgery. The authors evaluated the effect...

Thyroidectomy - a pictorial walk through the surgical steps

We as ENT surgeons work closely with the endocrinologist to provide MDT care for patients with a variety of pathologic conditions of the thyroid gland, including benign, malignant and hormonal disease processes. Surgery plays a central role for a variety...

Endolymphatic sac surgery (ESS) revisited

Ever since the destructive articles by Toss and coworkers, ESS was considered a taboo. However more and more centres are reviving it and report favourable results in properly selected patients. In this article the authors conducted a retrospective, single-centre observational...

A funny thing happened on the way to a conference – and other stories

This series of stories is dedicated to those of you with whom some of these moments were shared (or endured) and, above all, to my amazing and long-suffering husband, David Howard. Most of you know him as an exceptional head...

CAD/CAM assisted mandibular reconstruction or freestyle?

The gold standard for the reconstruction of the mandible is a free bone flap and the fibula is commonly used. The fibula is a straight bone and presents considerations and difficulties in the formation of a U-shaped neo-mandible. Computer aided...

Does albumin have an effect on nasal polyposis?

Sometimes a short paper catches your eye! What causes chronic rhinosinusitis? What causes polyps? Fungi? Biofilms? Allergy? Maybe the lack of albumin? The two authors of this short paper present data that may suggest that the lack of albumin can...

Risk factors for pharyngocutaneous fistula after laryngectomy

Pharyngocutaneous or salivary fistula is a feared complication following laryngectomy, causing significant morbidity, prolonged hospital inpatient stay / cost and mortality. Previous radiotherapy / chemoradiotherapy is a well recognised risk factor and leads many surgeons to recommend onlay pectoralis major...

Coupler microvascular anastomoses: how good?

This paper is written by a group of reconstructive surgeons and a school of computing. The study used computational fluid dynamics to model blood flow through idealised sutured and coupled vessels, to investigate if differing anastomotic techniques affect intravascular blood...