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How do you solve a problem like Dysphagia?
When a patient is referred to a speech and language therapist for the management of swallowing difficulties, multiple options are available to address these issues. The choice is based on a detailed assessment of the patient’s swallowing physiology and function....
Associated findings in MRI used for detecting acoustic neuroma
Presently, gadolinium enhanced magnetic resonance imaging is the ‘gold standard’ for investigating acoustic neuroma. There are often ‘incidental’ findings that may or may not be significant. In this study of 109 scans, the authors noted an uptake of 0.9% for...
Smoking causes cancer – so what’s new?
You may well ask what is the novel value of a paper looking at smoking habits in patients with confirmed head and neck squamous cell carcinoma (HNSCC), but this paper highlights some pertinent points for clinical practice in the current...
Role of sentinel lymph node biopsy in managing papillary thyroid cancer
Although studies have shown that the presence of lymph nodes metastases in papillary thyroid carcinoma does not alter survival, other studies have shown that it increases morbidity and mortality and that the presence of cervical lymph node metastasis at diagnosis...
Deep space neck infections – salivary gland as source is commoner in elderly patients
Whilst deep space neck infections (DNI) can originate from many sources, dental and salivary glands are commonly the culprit. This paper details 44 patients treated for deep space neck infections originating from salivary gland and compares them to a previously...
Incidental thyroid nodules: should we observe or operate?
Thyroid nodules are extraordinarily prevalent, detected by physical examination in 7% and by imaging studies in 67% of the population. Although most of these nodules are benign, up to 20% are found to be malignant on excision. It’s a very...
What is the evidence for contralateral tonsillectomy in TORS for known unilateral tonsil malignancy?
The concept of field changes by carcinogens within the upper aerodigestive tract is well established with reported rates of synchronous tumours of 4% and second primaries of 36%. The tonsil in particular has the highest rate of synchronous tumours, postulated...
Prostaglandin versus leukotriene receptor-antagonists in treatment of seasonal allergic rhinitis RCT phase II
Seasonal allergic rhinitis is very common. Failure to control the disease with mono-therapy leads to dual therapy treatment with less compliance and reduced quality of life. A prostaglandin receptor antagonist (ONO-4053) showed some efficacy in controlling allergic rhinitis in animal...
Intraoperative MRI use during pituitary tumour resection
This article provides an overview of intraoperative MRI (iMRI) use in transphenoidal surgery (TSS) for pituitary tumours. Traditionally imaging of the surgical field during surgery involves intraoperative fluoroscopic imaging or neuronavigation which help to avoid injury to critical structures but...
Advances in surgical innovation for head and neck cancer
This article reviews current advances in surgical treatment of head and neck cancers such as sentinel node biopsy, stereolithic modelling, transoral robotic surgery and intra-operative imaging of tumour margins. Sentinel node biopsy has been found to be especially useful for...
Long term morbidity of extended medial maxillectomy for inverted papilloma
This Italian review paper looks at five-year morbidity after extended endoscopic medial maxillectomy in 59 patients in a university teaching hospital setting. All patients underwent an extended approach medial maxillectomy for inverting papilloma, this included removal of the entire medial...
