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Lymph node ratio is a significant predictor for loco-regional recurrence after neck dissection in patients with papillary thyroid cancer

Lymph node metastases are common in papillary thyroid cancer (PTC), yet the impact of nodal metastases on survival remains unclear. Lymph node density (LND) is the ratio between the number of positive lymph nodes excised and the total number of...

Are elective neck dissections needed during salvage laryngectomy?

There has recently been a move away from elective neck dissections in the setting of salvage laryngectomy. This has mainly resulted from an appreciation of the increase in morbidity, in particular pharyngocutaneous fistula formation, and an improvement in cross-sectional imaging...

Current practice in cochlear implantation

From candidacy to surgery and rehabilitation, cochlear implant practice is evolving, with new technologies shaping outcomes for patients worldwide. Image courtesy of MED-EL. Cochlear implants restore a sense of hearing in the profoundly deaf, representing the most successful neuroprostheses available,...

Upper airway endoscopy: achieving a balanced service whilst minimising the conflict of sustainability

Nasal endoscopes present a unique challenge in balancing sustainability and practicality. Both disposable and reusable scopes may have distinct roles in modern practice. Flexible endoscopy of the upper aerodigestive tract is an essential technique that facilitates detailed assessment of the...

The Recurrent and Superior Laryngeal Nerves, 1st edition

Exactly 60 years after Dr William Rustad’s 47 page publication on the recurrent laryngeal nerve and thyroid surgery, Prof Gregory Randolph from Boston has edited a unique state-of–the-art review of the recurrent and laryngeal nerves for thyroid and parathyroid surgeons....

Global health missions – not just for consultants. A guide for trainees.

Lulu Ritchie is a courageous and driven trainee in London, inspired by humanitarian missions but conscious of the usual requests for consultant level doctors. Lulu didn’t let that hold her back. She found a way and has kindly summarised her...

Medicine in the Mountains

This is an easy-to-read paperback with interesting accompanying photographs. Its focus is one of the UK-based teams who have done considerable healthcare work in Nepal. Written by David Hawker, a British anaesthetist, we see the story unfold through his eyes....

Reconstructing post-resective auricular defects

The auricle is split into six specific anatomic subunits that vary in skin thickness, contour, structural integrity and the availability of healthy surrounding tissues. It is important to reconstruct an aesthetically pleasing auricle as slight deformities may be prominent. The...

Do intratympanic injections require local anaesthesia?

Intratympanic injections are becoming increasingly acceptable in the management of Meniere’s disease, tinnitus and sudden hearing loss. This is because they avoid the need for hospitalisation and can be performed as low-cost outpatient procedures. It is traditional to freeze the...

IL-25 and nasal polyps, another target

Immune response in chronic rhinosinusitis with nasal polyps (CRSwNP) is mainly via type 2 T-helper (Th2) cells while Th1 cells characterise chronic rhinosinusitis without nasal polyps (CRSsNP) immune response. CRSwNP is heterogeneous on a cytological level causing a varied response...

A conservative approach to treat ameloblastoma

Ameloblastoma is an odontogenic tumour that is benign but locally aggressive and is associated with local recurrence. They are rare, accounting for 1% of oral tumours, and occur almost exclusively in the jaws. It is more common in the mandible...

Thyroidectomy and hypnosis

This is a retrospective study comparing thyroidectomy under conventional general anaesthesia and surgery under hypnosis. Patients are interviewed and evaluated before the surgery and the process explained. During the surgery, they are induced into a hypnotic trance in a controlled...