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Absorbing the hurt
In this article, taken from his blog, ENT surgeon John McGarva reminds us that while we can’t fix everything, we may still be able to help. It was a long time ago. I was a scarily young Houseman, barely 22,...Paediatric auditory brainstem implant: overview and outcomes
Auditory brainstem implants were first used in adults with NF2. They have more recently become a technology option for children but what is the evidence to support this choice? This article discusses the evidence so far. Auditory brainstem implant is...
Salivary Gland Neoplasms
Salivary Gland Neoplasms is another useful addition to the Advances in Otolaryngology series. This issue (Vol 78) sees Prof Patrick Bradley (Nottingham) and David Eisele (Baltimore) co-edit a 206-page edition, nicely divided into 23 chapters, covering basics like molecular pathology,...
What should be considered a ‘close’ margin in oral cavity squamous cell carcinoma?
Achieving clear margins during surgical resection in oral cavity squamous cell carcinoma (OCSCC) is thought to reduce local recurrence (LR) and improve prognosis; however, what constitutes a clear, close, or involved margin is inconsistent in the literature and in practice....
Adjuvant intratympanic steroid therapy in sudden sensorineural hearing loss
Sudden sensorineural hearing loss (SNHL) means abrupt hearing loss by 30dB affecting three consecutive frequencies within 72 hours. This is treated by high tapering doses of systemic steroids, the role of which is controversial and fraught with possible complications in...
Endoscopic findings and prediction of outcome in unilateral vocal cord paralysis
Unilateral vocal cord paralysis which is not due to irreversible causes such as malignancy, systemic disease or trauma varies considerably in terms of full recovery and restoration of voice. Usually electromyography is used to make possible predictions, but this facility...
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...
The stigma of HPV in oral cancer
The increase of oropharyngeal carcinoma (OPC) in the developed world seems to be largely caused by infection with the human papillomavirus (HPV). HPV is a group of 150 DNA viruses that are common and most people will be infected at...
The unknown primary again
In this retrospective study of 35 patients, the authors followed a systematic protocol for the detection and management of malignant cervical lymph nodes without an apparent primary lesion. Although their one, three and five year survival results are consistent with...
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...
Sinonasal undifferentiated carcinoma – slowly getting there
The rarest of the rare, sinonasal tumours form only a small part of the total number of head and neck tumours and undifferentiated carcinoma (SNUC) is one of the rarest of this group. There is some data (and some expert...
