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Pre-hospital care
For those of us that work within the acute hospital system, the sound of the trauma pager going off warning of an incoming casualty with as yet unknown injuries is often the sound of uncertainty and anxiety. When it becomes...
Prolactinomas: when to operate
Prolactinomas are the most common functional pituitary adenomas, comprising 40% of all pituitary adenomas. There are consensus guidelines and several common management pathways. This article discusses the role of surgery for these patients. Following diagnosis, the goals of treatment are...The role of the maxillo-facial surgeon in the management of skull base malignancy
Whilst ablative surgery remains the principal treatment option for head and neck malignancy, the skull base is the last frontier. The complex anatomy, supreme functionality of the brain, and varied pathology provokes many a detailed discussion in the multidisciplinary team...Robotic assisted orbital surgery (RAOS) – a novel approach to orbital malignancy surgery
Robotic technology in ENT surgery has been used in certain areas of head and neck cancer care but, in this article, we hear of an exciting development from the team at Guy’s & St Thomas’. Advances in surgical robotic technology...
Reactive lesions of the contralateral vocal cord – excise or leave?
It is well recognised that benign lesions of one vocal cord can give rise to reactive lesions of the contralateral vocal cord directly opposite to the primary lesion. These contralateral reactive lesions (CRLs) are thought to arise due to impact...
Bones, stones and surgical moans: rethinking PTH dynamics in parathyroid surgery
Intraoperative parathyroid hormone (IOPTH) testing has revolutionised minimally invasive unilateral parathyroidectomy (MIP) as the gold standard treatment for primary hyperparathyroidism, replacing old-timey four-gland exploration. IOPTH testing ensures reliable excision of all hypersecreting glands, including those pesky hard-to-find ones, without relying...
Alcohol and hearing
Alcohol is a well-known central nervous system depressant. Individual reactions to alcohol might vary, but the connection between alcohol consumption and tolerance to loud noise or difficulties in communication in noisy environments are well-observed phenomena; for example, at evening parties....American Thyroid Association Thyroid Cancer Management Guidelines: utilising risk stratification to optimise patient care
The steep rise in thyroid surgery around the globe, has led to the development of risk stratification to define the indications for surgery and the extent of surgery as well as adjuvant therapies for papillary carcinoma, to avoid over treatment....Anaesthesia for free-flap surgery
Adel Hutchinson is one of those calm and controlled anaesthetists for whom nothing seems too difficult. In this article, she describes the key perioperative factors for one of the highest complexity operations in ENT; free-flap surgery. It makes good reading...
