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National analysis of outcome of head and neck cancer surger

Patient outcomes continue to become ever more visible in the NHS with ongoing drives to demonstrate transparency in our delivery of healthcare. This article reviews unit-level data publication using Hospital Episode Statistics data in all units undertaking head and neck...

Management of metastatic neck disease

This article publishes the findings of a recent expert-led evidence based management symposium in the UK with recommendations according to the SIGN level of evidence and grading. The article neatly summarises the key points, and its clarity despite the complexity...

Cost effectiveness and vestibular schwannoma surgery

This is the first cost effectiveness modelling study looking at the three main treatment options for small to medium sized vestibular schwannomas. This study uses the widely accepted cost per quality adjusted life year (QALY) outcome measure to evaluate three...

Sham controlled trial: BPPV

I was drawn to this study and it proved an enlightening read; it also is a good example of where recommendations of a Cochrane review for long-term evidence of benefit have been acted upon! The study looked at the efficiency...

Sublingual immunotherapy

This paper reviews the recent European studies on sublingual immunotherapy (SLIT). SLIT is currently widely used in Europe and is gaining popularity in the United States. It is known that longer treatment is needed with SLIT compared with subcutaneous immunotherapy...

Extranodal natural killer / T-cell lymphoma in the head and neck

The authors present a retrospective single institution review of patients with a very rare variant of non-Hodgkin lymphomas (NHL). They report on the occurrence, clinical course and outcomes of their patients with natural killer / T-cell lymphoma (NKTCL) nasal type....

Steroids for vocal cord mucus retention cysts

This is an interesting paper that describes the use of intralesional steroid injections to treat vocal cord mucus retention cysts. The gold standard is microlaryngoscopy and excision of the lesion. In patients who may be unable to undergo surgery, this...

Avoiding the sweaty cheek

Frey’s syndrome is a common (10-40%) and important complication following parotid surgery. Gustatory sweating during oral stimulation can be embarrassing as it is accompanied by flushing and a sensation of heat. This is as a direct result of regenerated parasympathetic...

Nasal dermoids

This article goes through the fairly specific and unique condition of paediatric midline nasal dermoids. It goes through the epidemiology and then the embryology, reminding the reader that a protrusion of dura extends from the anterior cranial fossa through the...

Radiological diagnosis of mastoiditis in patients screened for acoustic neuroma

Magnetic resonance imaging is the ‘gold standard’ for screening patients suspected to have acoustic neuroma. Various abnormalities are picked up through this investigation, one of which, not uncommonly reported, is mastoiditis. This requires referral to otolaryngology and further evaluation. In...

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...

Is the greater auricular nerve important in parotid surgery?

The greater auricular nerve (GAN) is often partially or totally sacrificed during parotidectomy procedures. This was a retrospective study comparing auricular sensation and quality of life in patients that either had their GAN preserved or sacrificed. In the shortterm, patients...