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Chemo-radiation in elderly patients with head and neck cancers
Chemo-radiotherapy is the standard of care for organ preservation in stage three and four oropharyngeal cancer, prospective data on patients over 65 has not been available as they are usually excluded from randomised trials. This paper reviews the experience of...
Pomegranate juice as an otoprotective agent
Chemotherapeutic agents such as cisplatin, given alongside irradiation, offer a survival advantage in head and neck cancer. Some patients often complain bitterly about side-effects of their treatment, one of which is ototoxicity. In this paper, the authors propose the use...
X-ray vs. intraoperative testing for determining cochlear implant placement
Most cochlear implant centres confirm electrode position after surgery using X-rays to ensure optimal electrode placement. As well as transorbital view X-rays, this team check placement using impedance measures and neural response telemetry (NRT) performed intraoperatively. The former indicates whether...
Cochlear implantation following radiotherapy treatment of vestibular schwannomas
The authors presented a case report and systematic review assessing the outcomes of patients from cochlear implantation (CI) following radiotherapy treatment for vestibular schwannoma (VS). Outcomes of cochlear implantation in these patients are uncertain due to the combination of both...
Is Gamma Knife Surgery effective for intracanalicular vestibular schwannomas?
Vestibular schwannomas (VSs) are rare, occurring in approximately five per 100,000 adults a year. In circa 8% of cases, the VS is contained within the internal auditory canal, i.e. intracanalicular (iVS). Although radiosurgery is a recognised treatment modality for VSs,...
Adjuvant radiotherapy for T4N0 laryngeal cancers treated with laryngectomy
A total laryngectomy remains the gold standard for the initial treatment of advanced (T4) squamous cell carcinomas of the larynx without evidence of distant disease. Adjuvant radiotherapy (RT) is also recommended for such cancers. In the absence of other adverse...
Options for the endoscope and acquired cholesteatoma
This was a thought-provoking article examining the reasons why the authors believe that the endoscope is enabling an improved understanding of acquired cholesteatoma and its management. They describe in depth the ventilation pathways of the middle ear, and how they...
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...
The theory of everything (tonsil)?
Tonsil sepsis can manifest as acute tonsillitis, a peritonsillar abscess (PTA) or rarely as an intra-tonsillar (ITA) abscess. Whilst the management of these conditions is familiar to ENT surgeons from early in training, perhaps little attention has been paid to...
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...
