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2982 results found

Thyroid ultrasound elastography: does nodule stiffness predict malignancy?

Approximately 50% of the general population has a thyroid nodule while 5-15% of these are malignant [1]. A major challenge, therefore, is how to detect the malignant nodules for appropriate, timely treatment and avoid unnecessary, costly investigations for the remainder....

Noise monitoring on a smartphone

“The smartphone has more computing power than was used to put the first man on the moon.” Robert Eikelboom discusses the potential of the smartphone as an effective noise monitoring device. Noise exposure and public health Excessive exposure to noise...

Commentary: dementia, hearing loss, and the danger of professional rabbit holes

The Lancet, a world-leading general medical journal, has a global impact. Its commissioned report into dementia prevention, intervention and care has been cited over 6000 times and has further been reviewed and updated in 2020 and now 2024. Here, Profs...

Surgical challenges in advanced or recurrent thyroid malignancy

The management of thyroid malignancy and extent of surgery is controversial, especially considering the limitations of preoperative diagnosis. Neil Tolley provides guidance and reminds us of our responsibility not to over-treat. In the UK, 16% of thyroidectomies are performed for...

Exciting advances in facial reanimation

Despite several techniques for reanimation after facial paralysis, the management of these patients continues to challenge us. This paper reviews advances in facial reanimation surgery, provides updates on the timing of intervention, modifications to the traditional gracilis muscle transfer, other...

Managing the thyroglossal duct cyst

Although the operation to remove thyroglossal cysts and their tracts is commonly performed, a full understanding of the possible anatomical locations of the tracts may be less appreciated. This article helps the reader understand the possible variations available which should...

Inferior alveolar nerve recovery after ORIF fractured mandible

Mandibular fractures are quite common facial injuries, but aetiology varies with country and age. Common treatment options are open reduction and internal fixation via an intra-oral or extra-oral incision. Nerve injury or dysfunction is often seen preoperatively and may also...

Minimal or not so minimal?

Parathyroidectomy is usually a straightforward technique when the target gland has been accurately determined. Surgical excision is usually through a small midline incision. With the advent of video assisted surgery, trials have been made to use this technique in parathyroidectomy....

Pharyngocutaneous fistula after total laryngectomy

Pharyngocutaneous fistula (PCF) after total laryngectomy is a serious complication post-surgery, and can lead to prolonged hospitalisation, adding delays in postoperative chemoradiotherapy. This Turkish retrospective study looked at 166 patients who underwent total laryngectomy for laryngeal cancer, although it is...

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...

The perils of poor postop blood pressure control

This retrospective case control study reviews 621 patients undergoing thyroid surgery over a 10-year period from 2002-2012 looking at postoperative haemorrhage rates. This potentially catastrophic complication warrants close analysis in order to best discern how it can be minimised. The...

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...