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Reconstructive Plastic Surgery of the Head and Neck: Current Techniques and Flap Atlas

Head and neck reconstruction continues to provide a challenge to surgeons, driving innovative approaches in free-flap surgery and a need to embrace developing technologies. This excellent text, written primarily by authors from the renowned MD Anderson Cancer Center in Texas,...

Augmented reality – a quick overview of potential technology

Is that the optic nerve? Where is the carotid? Both questions you would prefer to know the answer to upfront. This article discusses if augmented reality can help us with surgical navigation around the skull base. Although endoscopic skull base...

Lawrence Werth (19 October 1956 – 19 August 2014)

In August the audiology community was saddened to learn that Lawrence Werth (57), Chairman of PC Werth Ltd, London had passed away after a brave battle with skin cancer. A prolific contributor to this magazine over the years, he is...

Luddism and ENT

If the press and the tech world are to be believed, AI is going to take over many of our jobs. Chris Potter has his doubts. As regular readers will no doubt be aware, I pride myself on inhabiting the...

‘Close’ surgical margin in oral tongue redefined, 2.3mm is as good as 5mm

Gold standard treatment of squamous cell carcinoma (SCC) of the oral tongue remains surgical resection of the primary tumour with negative margins. The primary goal is the complete excision of the tumour with no residual cancer cells left behind. A...

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...

What should be considered a ‘close’ margin in oral cavity squamous cell carcinoma?

Achieving clear margins during surgical resection in oral cavity squamous cell carcinoma (OCSCC) is thought to reduce local recurrence (LR) and improve prognosis; however, what constitutes a clear, close, or involved margin is inconsistent in the literature and in practice....

Best timing for post-treatment PET-CT scans in head and neck cancer

Unfortunately we know that the recurrence rate for head and neck cancer can be high, up to 30-50% in some series. These recurrences tend to occur within the first two years following treatment. Optimal surveillance strategies to detect recurrences early...

Carotid artery involvement with head and neck metastases

This is a retrospective review of 27 patients radiologically diagnosed as having metastases involving the common or internal carotid arteries. All patients underwent a salvage neck dissection with surgical carotid peeling. Thirteen of the 27 achieved loco-regional control, five developed...

Synchronous bilateral tonsil cancer

There is a long-standing debate regarding either unilateral or bilateral tonsillectomy for histological confirmation of tonsil cancer. Bilateral tonsillectomy is the standard of care in Denmark for proven or suspected tonsil carcinoma, and in the diagnostic work-up of the unknown...

Useful algorithm to manage adults with branchial cysts

Managing a solitary cystic lateral neck mass, specifically differentiating between a simple second branchial cyst and a metastatic cyst poses a challenge. Often the diagnosis only becomes apparent on the final histology. This paper analysed 28 adults that presented to...

Extent of central neck dissection in the patients with thyroid carcinoma

The first level of lymphatic spread in well-differentiated thyroid carcinoma is to the central compartment of the neck, namely, the paratracheal, prelaryngeal and pretracheal lymph nodes. Central neck dissection may carry an increased morbidity, namely, hypoparathyroidism and recurrent laryngeal nerve...