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Managing high flow head and neck arteriovenous malformations (AVM)
Vascular malformations are lesions where the traditional network of capillaries linking arteries and veins are lacking. Patients usually present with bleeding, pain, disfigurement and tissue expansion and destruction. High flow lesions can be challenging to manage in the head and...
Treating keloid scarring with pressure clips following excision: does it work?
Keloid scars can pose a difficult management problem. Whilst not harmful in themselves they can be cosmetically unappealing and lead to social embarrassment and resulting isolation, and following surgical excision they often reoccur. Mechanical pressure is an adjuvant to surgical...
Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture
Placement of voice prosthesis at the time of trachea-oesophageal puncture is well described using 20-French prostheses. There is debate about the optimal size of the prosthesis with work in the 1980s and 1990s supporting larger prostheses. The rationale was that...
When should that child’s wet ear be operated on?
The team from Birmingham have provided a meta-analysis to answer the question of when to perform a type 1 tympanoplasty on chronic paediatric perforations (under 18 year olds). Forty-five studies were included which resulted in 2609 cases. Closure rate at...
Importance of the time interval between surgery and postoperative radiation therapy in head and neck cancer
The ideal time to start postoperative radiation therapy (PORT) in head and neck cancer patients has been an issue of debate. In the USA, the National Comprehensive Cancer Network (NCCN) recommends initiating radiotherapy within six weeks from surgery. The six-week...
CT and intraoperative nerve monitoring to identify non-recurrent laryngeal nerve during thyroid surgery
A non-recurrent laryngeal nerve (NRLN) is a rare (incidence 0.3% to 1.3%) anatomical variant that results in a higher rate of vocal cord palsy following thyroid surgery. This team from China examined the utility of preoperative CT and intraoperative nerve...
Sound localisation after bilateral cochlear implantation
Limited information is known about the localisation skills of paediatric cochlear implant patients who were good hearing aid users before their hearing deteriorated. As localisation is a skill often associated with good natural hearing, there is a worry that implants...
Investigation of the role of KPNA2 biomarker in oral SCC invasiveness
This edition of Head and Neck has a strong focus on studies using immunohistochemistry (IHC) to elucidate potential roles of various cell-signalling molecules in both HNSCC and thyroid cancer. The ‘cellular-protein heavy’ title of this article may be off-putting to...
Superstructure-preserving stapes surgery in otosclerosis
Stapedectomy is a well-established procedure for otosclerosis but it has a small risk of a non-hearing ear, which can be devastating for patients. The development of a procedure which is safer and with a less steep learning curve for junior...
Inter-aural hearing preservation in cochlear implantation
Hearing preservation during cochlear implantation is becoming increasingly important, although results can be unpredictable. NICE are in the process of updating their guidance in the UK and it is possible that those with better hearing than the current candidates will...
Valsalva manoeuvre treatment of otitis media with effusion in adults
Otitis media with effusion (OME) is common in children but has a low prevalence in adults. There is some evidence to advocate middle ear inflation as a successful treatment for children with OME. This form of treatment is also recommended...
