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Management of stage IV pharyngolaryngeal lesions

This is a retrospective study of 63 patients presenting with stage four laryngeal and/or hypopharyngeal squamous cell carcinoma. The aim was to define the factors influencing the oncological and functional outcomes of the patients. All patients had T4 lesions with...

Does trainee participation in cochlear implant surgery affect operative times?

The role of surgical education is a very sensitive issue in spite of the obvious need and the obligation of doctors to pass on their knowledge and experience to the next generation. This study is very interesting as it assesses...

Submental island flap to reconstruct the lower lip

The lips are necessary for oral competence, cosmesis, speech and feeding. Non-melanoma cancers can affect the lips, and the lower lips are about 80% more likely to be affected. A large number of these cancers are squamous cell carcinomas. Treatment...

Changes in airway dimensions after orthognathic surgery

This is a systematic review of meta-analysis evaluating the effect of different types of orthognathic surgery on the cross sectional area and volume of the upper airway as assessed using CT or MRI. They found 28 articles of which only...

Delayed facial palsy post vestibular schwannoma resection

This article presents findings of a retrospective evaluation of 489 patients who underwent vestibular schwannoma surgery and developed delayed facial palsy. The authors define delayed facial palsy as deterioration of at least two HB grades between postoperative days five and...

Risk factors for pharyngocutaneous fistula after laryngectomy

Pharyngocutaneous or salivary fistula is a feared complication following laryngectomy, causing significant morbidity, prolonged hospital inpatient stay / cost and mortality. Previous radiotherapy / chemoradiotherapy is a well recognised risk factor and leads many surgeons to recommend onlay pectoralis major...

Multiple free flaps for head and neck cancer

Most patients with advanced head and neck cancers now undergo microvascular free flap reconstruction. This is mainly as flaps facilitate complete tumour and margin removal by providing reliable wound coverage and better restoration of form and function. However despite this,...

A novel way to reduce postoperative nausea and vomiting

This is an interesting RCT which evaluates the prophylactic effect of bilateral endoscopic injection of local anaesthetic in the sphenopalatine ganglion (SPG) on postoperative nausea and vomiting (PONV). It has a robust design, and is sufficiently powered and blinded, with...

Surgical management of refractory osteoradionecrosis

This is a French single-centre, 10-year experience of 55 surgical resection and reconstruction procedures. They claim an overall effectiveness rate of 92.3%. A total of 36 segmental and 19 marginal mandibulectomies were performed. A variety of free flaps were used,...

More than words: looking at all the evidence

Evidence based practice (EBP) is a three-pillared approach whereby information on the research evidence, factors relating to the patient and clinical experience are all considered to inform a care decision. Unfortunately, there is frequently very little research evidence to inform...