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How effective are our two-week-wait guidelines in picking up head and neck cancer?
With a 30% increase in the incidence of head and neck cancer since 1999 in the UK, it is important that the two-week wait referral guidelines safely encompass all risk factors but also render these urgent referrals based on signs...
Learning from reimplantation
The Irish implant centre in Dublin undertook a retrospective study of their reimplantation cases to look at what lessons could be learnt. Device failures fall into two classes: hard and soft failures. Hard failures are implant malfunction or altered performance....
Hierarchy of orthognathic surgical stability
This study was designed as “an overview” of secondary studies and analysed 15 articles. Two procedures were considered highly unstable: a bilateral sagittal split osteotomy for clockwise rotation of the mandible with bi-cortical screw rigid internal fixation, and posterior maxillary...
Endoscopic stapes surgery
This retrospective Turkish study looked at the audiological and surgical outcomes of 40 patients who underwent endoscopic stapes surgery over a three-year period. To assess the learning curve, the patients were divided into two groups based on the date of...
What is the right balance to strike in the management of anaplastic thyroid cancer?
This is a pragmatic article on a difficult and much debated subject. Management of anaplastic thyroid cancer (ATC) can feel like making decisions between a rock and a hard place, and this article suggests one path to help navigate some...
Evidence-based clinical education
All healthcare professionals participate in education of students in both their own and other disciplines. It is part of our role and we are often used to squeezing it in and around our clinical responsibilities. In fact, the events during...
Does minimally invasive surgery under local anaesthesia have a role in the management of chronic rhinusinusitis?
A formal FESS procedure usually done under local anaesthesia is considered as gold standard in the management of chronic rhinusinusitis. However, success is hampered by a significant recurrence rate of polyps requiring revision surgery, long waiting lists, reluctance of elderly...
Stepwise approach to manage palatal myoclonus successfully
Palatal myoclonic tinnitus (PMT) is a rare condition caused by rhythmic voluntary or involuntary movements of the soft palate, mainly the tensor veli palatini and levator veli palatine muscles. Patients usually present with a ‘clicky’ noise in the ear. Oral...
The right to choose: stories from the rare dementias
People with primary progressive aphasia (PPA) experience an insidious onset and gradual decline in language on a background of lesser or no cognitive impairment, hence a language-led dementia. There are three different PPA variants that correspond with three different clinical...
Predictors of diabetes insipidus post-hypophysectomy
Transient diabetes insipidus (DI) after pituitary surgery is not uncommon and its diagnosis fairly obvious. Permanent DI is rare and often depends on the neurosurgeon’s experience. This retrospective study describes a large series of patients with majority undergoing endoscopic transsphenoidal...
COVID-19 tracheostomies
This is a review of tracheostomies completed by an OMFS Unit in London from 10 March to 18 May 2020. A total of 176 COVID-19 patients were admitted to intensive care, 72 of which required tracheostomy due to prolonged respiratory...
