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Middle ear muscle disorders: presentation, diagnosis and management

Patients often report symptoms relating to disorders of the middle ear muscles. Prof Bance gives us an overview of the anatomy and function, as well as guides our diagnosis and management. The middle ear muscles (MEMs) are a mystery, both...

Can we predict risk of adverse events preoperatively in patients undergoing head and neck cancer surgery?

Ed’s Choice reviews a paper aiming to create a reliable index to predict postoperative outcomes in head and neck cancer patients. This interesting study identifies variables that may assist in risk assessing prospective surgical candidates. There have been a few...

The fatal illness of Frederick the Noble

Sir Morell Mackenzie is acknowledged as the ‘Father of British Otolaryngology’. He was the leading throat specialist of his time and one of the founders of the Journal of Laryngology and Otology in 1887. He studied in Paris, Vienna and...

The newest robot from da Vinci – what can it offer for hypopharyngeal cancer surgery?

The standard existing da Vinci surgical robot (the Si model) has been much maligned for not being optimally designed for transoral access and endoscopic manoeuvrability in head and neck surgery. This preclinical work from Holsinger and his team looks at...

In-office KTP laser excision of a vocal process granuloma

The KTP laser is increasingly being used in an outpatient setting – particularly in North America – to treat various laryngeal pathologies including papillomas, leukoplakia, dysplasia and vascular lesions. This article reports the use of the KTP laser in the...

Surgical voice restoration after laryngopharyngectomy

Voice restoration is one of the key rehabilitative steps after laryngectomy or total laryngopharyngectomy (TLP). Patients who undergo TLP require reconstruction – increasingly commonly with microvascular free flaps. Despite their advantages in terms of fistula rates and swallowing outcomes, these...

KTP laser ablation for early glottic cancer

TLM for glottic carcinoma has historically been performed with a carbon dioxide (CO2) laser. A much smaller literature base has examined the use of potassium titanyl phosphate (KTP) laser in this context. This retrospective chart review aims to fill that...

Postoperative radiation in early stage oropharyngeal squamous cell cancer (OPSCC)

There is significant variation in treatment strategies for OPSCC between units. This is largely due to unanswered questions which continue to exist beyond the published literature. We know that human papilloma virus status has a significant influence on prognosis but...

Vascularised tissue in salvage total laryngectomy

Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...

Iatrogenic vocal fold paralysis – the time to recovery

Iatrogenic vocal fold paralysis can result from stretching, compression or complete transection of recurrent laryngeal or vagus nerves. These injuries are a significant source of concern for patients and clinicians alike. The question is how long should we wait for...

Does Tranexamic acid reduce intraoperative bleeding during FESS?

Intraoperative bleeding during FESS can reduce visibility and obscure important landmarks. This can result in longer operative times, increase risks of complications and even lead to incomplete surgery. Tranexamic acid is a drug which prevents fibrinolysis and stabilises blood clots....

Is flexible nasendoscopy really aerosol generating?

Amid the COVID-19 pandemic, the safety of office-based laryngoscopy has been a source of considerable concern, speculation and debate. Flexible nasendoscopy is a key diagnostic tool in the assessment of the ENT patient, however most healthcare providers consider this to...