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Microsurgical trainees to avoid strenuous exercises?

It is commonly believed among microsurgeons that over-exertion can impair microsurgical performance. The authors aimed to investigate if they could prove this theory and compared the performance of medical students, postgraduate trainees and expert controls who were microsurgery tutors. A...

Nuclear heads – and necks

Imaging of the extra-cranial head and neck is challenging due to the anatomic complexity of the region. CT, MRI and ultrasonography (US) are amongst the most frequently utilised radiological modalities in head and neck imaging but do not always provide...

TORS for patients with sleep-disordered breathing

Transoral robotic surgery is now a well-accepted technique in malignant tumours of the tongue base. Here the team from St Mary’s and the Royal National Throat Nose & Ear Hospital in London describe its use in carefully selected patients with...

Juvenile Nasopharyngeal Angiofibroma

This book was first published in 2017 in India and PJ Wormald is one of the Associate Editors. It consists of 16 chapters with exceptional surgical photographs, as well as scans of different imaging modalities and illustrations. It is a...

Rhinology and 3D printing

3D printing has increasing applications in rhinology, for instance to create patient-specific preoperative models for procedure planning, including designing a template for reconstruction planning following tumour resection, patient consultation and customised prostheses. The authors focused their review on the role...

Should we reconsider induction chemotherapy in advanced stage laryngeal cancer?

Use of chemo-radiotherapy for advanced laryngeal cancer led to a major shift in treatment as an alternative to total laryngectomy. Despite widespread adoption of chemoradiotherapy, survival rates have not improved and the original premise of matching neoadjuvant chemotherapy tumour response...

Previous radiotherapy does not cause worse outcomes in patients with differentiated thyroid cancer

Radiation exposure from nuclear incidents, especially in childhood, is known to increase the risk of thyroid cancer. This large retrospective study from the Memorial Sloan Kettering Cancer Centre sought to determine if thyroid cancers in patients with prior exposure to...

Sellar surgery – when to prepare for repair

Endoscopic sellar surgery, especially for adenomas, is a relatively safe, straightforward surgery with (mostly) reproducible results and few complications. One of the commonest complications is the creation of a CSF leak with the subsequent need for repair (there is usually...

Modern surgical treatment for obstructive sleep apnoea indicate suppression of inflammatory cytokines

This study comprises 57 patients, 29 of which were treated by anterior palatoplasty procedure, expansion sphincter pharyngoplasty and submucosal minimal invasive lingual excision techniques and 27 by CPAP therapy. Parameters to determine success were AHI, VAS score, ESS score, mean...

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...

Risk factors for post laryngectomy fistula

This is a meta-analysis looking at the postoperative pharyngocutaneous fistula rates following total laryngectomy. The authors ended up with 34 studies with about 2500 patients. The most striking finding was that preoperative radiotherapy was a significant risk factor as well...

Margin control using optical techniques in head and neck surgery

Emerging optical techniques such as high-resolution microendoscopy (HRME) are currently being examined for their reliability in discriminating benign from neoplastic epithelium. These techniques may offer the potential to detect the margin of an upper aerodigestive tract tumour in a non-invasive...