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Partial reconstruction of the pinna

Reconstruction of the pinna is one of the most challenging procedures in facial plastic surgery. Although there has been significant progress since one of the earliest recorded descriptions by Sushruta in 600 BC, the complex three-dimensional structure of the pinna...

BAHA stability measurement in children

This useful paper reports the experience of using resonance frequency analysis for single stage bone-conduction implants in a paediatric population. A smartpegTM is attached to the abutment and vibrated by a close quarters magnetic field. The amount of vibration is...

Physician health and wellness amidst a global pandemic

Dr Westerberg attended a workshop on Physician Wellness hosted by Dr Osler a few years ago at our Canadian Society of Otolaryngology-Head and Neck Surgery meeting. The list of symptoms of stress and burnout resonated as typical of almost a...

The barber-surgeon of Avebury

On a stroll through Neolithic Britain, Seville oranges on a quay in Dundee, marmalade and 14th century coins, Chris Potter unravels the story of a man (a surgeon?) seemingly crushed by a falling 13-tonne stone. But things are not quite...

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...

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...

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....

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....

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...