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Surgery for drooling

This paper looks at the surgical options for sialorrhoea once the first two options of behavioural and physiotherapy interventions and pharmacotherapy have been exhausted. The social impact of sialorrhoea on patients and their families is significant and often lifelong therefore...

When ears go bad

Whilst rare, squamous cell carcinoma is the commonest primary malignancy of the temporal bone and is discussed in this review article. This tumour frequently presents with otalgia, ottorhoea and hearing loss; less commonly, with facial palsy or parotid mass. Investigations...

Ethanol ablation for benign cystic neck lesions

Benign cystic head and neck lesions have traditionally been managed conservatively or with surgical excision. Ethanol ablation (EA) has now established a role in the management of benign thyroid cysts, and its use has also been expanded to non-thyroid cysts....

Is there a limitation for excising parapharyngeal tumours transorally?

The parapharyngeal space is a complex anatomical space bounded medially by the oropharynx and laterally by the mandible. It is conceptualised as an inverted pyramid extending from base of skull above to the hyoid bone below. The space is divided...

Clinical histopathology of 250 parotidectomy patients

Clinical histopathology of 250 parotidectomy patients This is a retrospective study of 250 consecutive parotidectomy patients at units in Belgium and the Netherlands. The sensitivity and specificity of FNAC was 64% and 99% respectively, the sensitivity being slightly lower than...

Is the greater auricular nerve important in parotid surgery?

The greater auricular nerve (GAN) is often partially or totally sacrificed during parotidectomy procedures. This was a retrospective study comparing auricular sensation and quality of life in patients that either had their GAN preserved or sacrificed. In the shortterm, patients...

To monitor the nerves or not?

Whilst intraoperative nerve monitoring has become the standard of care for mastoid and parotid surgery, its benefit in thyroid surgery remains unclear. In the UK NICE was agnostic on the subject in 2008, stating that it was potentially helpful and...

Radiology and paediatric neck lumps

This is a comprehensive article examining the modalities available for children presenting with suspected congenital neck lumps. Each modality is explained in turn, with pros and cons highlighted, but also in the context of the emergency patient and the elective....

Neck dissection in adenoid cystic carcinoma is a risk worth taking?

This paper from Stanford University presents impressive figures to guide the debate on the extent of surgical management in adenoid cystic disease. Adenoid cystic carcinomas present a particular problem in that they can recur even after 20 years. They have...

Direct intratemporal facial nerve to hypoglossal nerve coaptation for facial reanimation

The hypoglossal nerve is a common axonal source for dynamic facial nerve rehabilitation. In its regular and modified forms of splitting the nerve it is associated with tongue hemiatrophy, speech and swallow dysfunction, facial movement and hyper contracture. This case...