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Outcomes for transoral vestibule approach thyroid surgery
Ed’s choice explores a systematic review examining one of the recent innovations in head and neck surgery. It may come as a surprise to some that within a few years of the first published cases of transoral vestibule thyroidectomy, an...Anaesthesia for sleep nasendoscopy and snoring / obstructive sleep apnoea surgery
Surgery for sleep disordered breathing inevitably requires surgeon and anaesthetist to share the airway. Here, Edward Bick gives us the anaesthetic viewpoint, reiterating that communication is the key. A specific note is made of the anaesthetic technique for sleep nasendoscopy,...The drive for success: from the hockey pitch to the surgical field
A hockey ball is rock hard and can travel at 100 mph. Stopping it with your most vulnerable body parts seems an excellent metaphor for higher surgical training... Four years on from the 2012 Olympics presents an ideal time to...
Predicting the nature of swallowing deficits caused by surgical resection of the tongue?
Patients treated surgically for cancer of the tongue are expected to have difficulty in eating, drinking and swallowing. The authors of this paper report on a cohort of 106 patients in their practice who had surgical resection as primary treatment....
Grading dysphagia as a toxicity in treating head and neck cancer
Common Terminology Criteria for Adverse Events (CTCAE) is a system used by clinicians to grade the toxicity of oncology treatments in a standardised manner. Dysphagia is perhaps the most common long-term toxicity of head and neck cancer treatment. Currently, a...
How well do different assessments of swallowing correlate with one another?
Swallowing (dys)function may be assessed by three key measures: 1. instrumental swallowing techniques such as the modified barium swallow (MBS) or videofluoroscopy; 2. functional measures of diet texture that patients can eat comfortably (usually rated by the clinician); and 3....
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...
Are there benefits of prophylactic swallowing exercises for patients with head and neck cancer?
This randomised controlled trial aimed to establish the impact of prophylactic swallowing exercises in patients undergoing chemoradiation therapy for head and neck cancer. The primary outcome was the functional oral intake scale (FOIS), although secondary measures for feeding tube use,...
Less pain more gain: impact of prophylactic gabapentin on swallowing outcomes in head and neck cancer patients undergoing radiation treatment
Patients planned for chemoradiation to the head and neck are usually advised to expect some pain and soreness during their treatment and that pain relief will be offered as and when it is required. Uncontrolled pain and mucositis affect oral...
Can prediction models help identify dysphagia in ventilated patients?
Dysphagia commonly affects patients in intensive care units (ICU), particularly those on mechanical ventilation, and is associated with high risk of mortality. This systematic review and meta-analysis aimed to identify predictors for dysphagia in ventilated ICU patients by summarising existing...
Swallowing the risk: managing dysphagia in aged care
The risk of dysphagia increases with age and the prevalence of dysphagia in aged care facilities is 41–52%. Dysphagia increases the risk of aspiration, asphyxiation, malnutrition, pneumonia and ultimately death. Modifying food and fluids, by providing mashed or pureed foods...
