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Plunging new depths for the treatment of ranulas
Within our scope of practice, we encounter a number of salivary gland pathologies, including the sublingual gland. Clinical signs are often subtle, and even with meticulous surgical management, morbidity can easily occur. Textbooks advocate excision of the gland as the...
Red flag head and neck cancer symptoms
This was a prospective study of 1589 patients that were enrolled in the Scottish Audit of Head and Neck Cancer between 1999 and 2001. It recorded their presenting symptoms and assessed their long-term survival with respect to symptoms and subsites...
To monitor or not to monitor
This is a report on an e-mail based survey of 1249 otologic surgeons on their practice regarding facial nerve monitoring during ear surgery. The response rate was very low (6.6%). The majority of responders (92%) stated that they did not...
Incidental findings in paranasal sinus Magnetic Resonance Imaging (MRI) studies
Incidental findings in the paranasal sinuses of mucosal thickening and polyps in MRI studies may cause concerns for clinicians and patients. The authors studied MRIs of 982 participants with a mean age of 58.5 years who randomly and independent of...
The stubborn polyp cases are ‘different’
The widely different behaviour of nasal polyp disease between patients is a major feature of rhinology practice and makes counselling of patients difficult when approaching their first operative intervention. Setting aside aspirin sensitivity (Samter’s triad), which is known to be...
ENT emergencies
This Belgian paper reports the epidemiology of 1296 patients attending the emergency department with ENT problems over a five-year period. As expected the most common presentation was epistaxis, but interestingly vertigo seemed to be the second most common presentation to...
Comparing patient and surgeon concerns in sinus surgery
This prospective observational study had a total of 180 patients undergoing endoscopic sinus surgery for chronic rhinosinusitis with or without polyposis. Data was analysed using descriptive statistics and analysis of variance. Subjects felt the greatest level of concern regarding potential...
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...
Risk factors for post tonsillectomy bleeds
This paper reviews post-tonsillectomy bleeding in 692 patients and attempts to tease out risk factors. The overall bleed rate of 11.6% seems very high. The return to theatre rate was 2.6%. The paper identifies male patients and adult patients as...
Resection margins in head and neck surgery
Although an increasing proportion of head and neck malignancies are treated with non-surgical modalities, when surgery is undertaken an incomplete clearance results in significantly worse prognosis. However, the intraoperative assessment of an adequate margin is difficult. The personal practice of...
The sentinel lymph nodes revisited
The concept of sentinel lymph node sampling has been around for some time. However, its acceptability in routine head and neck practice has yet to be established. This article presents the authors’ experience in 10 patients with Merkel cell carcinoma...
