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Head and neck high dependency unit - an alternative to ITU?

Close observation of the airway is a primary requirement for patients undergoing major head and neck surgery. It is also necessary for patients with upper airway infection and trauma. Wound care, drains, feeding and analgesia also require specific attention. Whilst...

Pre-habilitation in head and neck cancer – a literature review to guide best practice

Curative treatment of head and neck cancer (HNC) often requires surgery; however, outcomes are impacted by the complexity of the surgery and the patient population. Increasingly ‘Enhanced Recovery After Surgery’ (ERAS) protocols are being used to maximise patient outcomes and...

Steroids pre-FESS

This meta-analysis and systematic review from the Netherlands and the UK aims to answer the question of whether corticosteroids inhaled and / or taken orally are beneficial to patients with chronic rhinosinusitis undergoing functional endoscopic sinus surgery. Refreshingly 18 RCTs...

Do spreader grafts improve nasal airflow?

This Portuguese study looks at pre- and postoperative peak nasal inspiratory flow (PNIF) in 72 consecutive patients undergoing septorhinoplasty surgery. The aim was to demonstrate the functional value of spreader graft insertion, the aesthetic value having already been confirmed. In...

Risk factors for post laryngectomy fistula

This is a meta-analysis looking at the postoperative pharyngocutaneous fistula rates following total laryngectomy. The authors ended up with 34 studies with about 2500 patients. The most striking finding was that preoperative radiotherapy was a significant risk factor as well...

Predictors of complications in patients undergoing oral cavity cancer surgery

Surgical management of oral cavity cancers is complex, frequently involving extensive resections and complicated reconstructions. Quantification of risk in an individual patient may allow surgeons to more effectively identify patients at higher risk of complications and develop strategies for prevention,...

Ultrasound assessment of metastatic disease

This Japanese study of 10 patients over 15 years, assesses the role of ultrasonography in assessing metastatic disease to the thyroid gland, specifically renal clear cell carcinoma (RCCC). Whilst uncommon, the authors state that there is a favourable prognosis when...

Hyperbaric oxygen therapy and flap reconstruction: does it help?

This is a multicentresite retrospective review from four clinics in the USA on patients who received radical debridement and free flap reconstruction for osteoradionecrosis (ORN) between 1 Jan 1995 and 30 June 2011. Patients were stratified divided based on having...

Use of tranexamic acid in ENT surgery

Postoperative bleeding in otolaryngologic procedures causes delayed discharge, requires re-admission and adds considerably to the cost of patient care. Whether the anti-fibrinolytic activity of tranexamic acid should be used routinely to prevent haemorrhagic complications after ENT operations is speculation but...

Lipofilling for scar improvement

Since Coleman et al. in 1991 reported on lipofilling, numerous applications have been reported; these include but are not limited to contour restoration, lip augmentation, and wrinkle therapy. There has also been some one off reported improvements in scars following...