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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...
A histological test for LPR?
Laryngopharyngeal reflux (LPR) is often considered to be a contributory factor to the development of a spectrum of laryngeal abnormalities including vocal cord leukoplakia and dysplasia. This is especially the case when traditional risk factors, such as tobacco smoking, are...
Management of infantile haemagiomas of the airway
This paper reviews the diagnosis and management of infantile haemagiomas (IH) affecting the airway. Approximately half of infants with this condition would also have cutaneous haemagiomas which are usually in the beard distribution. IH could affect any parts of the...
What is the prognostic value of lymph node yield and density in head and neck cancer?
Neck dissection in addition to surgery of the primary site is commonly recommended in head and neck cancer treatment. However, there has been no consensus on the number of nodes that need to be removed to constitute a sufficient neck...
Seeking medical attention with tonsillectomy complications depends on who you are. Lessons from the USA
In the current UK model, NHS care is free at point of access so there are no perceived economic barriers to seeking attention with postoperative complications. This study from the US examines surgical and emergency room databases from across California,...
Treatment algorithm for olfactory disorders
The purpose of this paper is to review the current evidence in diagnosing olfactory disorders and suggest an algorithmic approach to patients with relevant complaints. Age-associated olfactory loss is often multifactorial and requires a careful history and physical exam. A...
Full Vs tapered dose of oral prednisolone for sudden sensorineural hearing loss
I was drawn in by the title of this article, in the expectation that it might be a randomised controlled trial, but it was not. Sudden sensorineural hearing loss is an uncommon condition, which has a potentially disastrous outcome, so...
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...
Who finds it hard to swallow?
Early identification of dysphagia in inpatients on acute stroke wards has been recommended as best practice guidelines in many countries. However, several institutions fail to use formal dysphagia screening protocols and rely on informal detection by nurses and doctors. This...
Management of patients with advanced otosclerosis
This paper discusses the management options of advanced otosclerosis. There are several definitions for advanced otosclerosis in the literature but, more recently, the diagnosis of advanced otoscletosis has been reserved for patients who have less than 30% aided speech discrimination...
Vascularised tissue in salvage total laryngectomy
Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...
