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Perioperative management of the head and neck cancer patient

The perioperative care of patients with head and neck cancer is complex and requires significant preoperative planning and patient education. The issues include analgesia, antibiotics, stoma and wound care, general and chest physiotherapy, thromboprophylaxis and nutrition. This article provides a...

A global view of thyroid surgery practices

The incidence of thyroid cancer continues to increase, and both surgery for benign and malignant disease carries an important and persistent incidence of perioperative complications. This paper reports the results of an electronic survey sent to members of seven surgical...

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...

Can comorbidities predict complications after total laryngectomy? Utility of the Modified Frailty Index (mFI) score

Decision making regarding appropriate treatment for laryngeal cancer is complex. Patients undergoing total laryngectomy experience significant changes in anatomy and physiology and are at risk for significant postoperative complications. These patients represent a group with significant comorbidities. In addition, patients...

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....

Effects of nasal sprays on ciliary function

What do topical nasal sprays do to the nasal mucosa in the long term? This study reports the effect of corticosteroids, antihistamines and common preservatives in nasal sprays, benzalkonium chloride (BKC) and potassium sorbate (PS), on an in-vitro model of...

CT and intraoperative nerve monitoring to identify non-recurrent laryngeal nerve during thyroid surgery

A non-recurrent laryngeal nerve (NRLN) is a rare (incidence 0.3% to 1.3%) anatomical variant that results in a higher rate of vocal cord palsy following thyroid surgery. This team from China examined the utility of preoperative CT and intraoperative nerve...

Marginal gains

Many consider facial nerve monitoring compulsory in parotid surgery yet few do the same for the marginal mandibular nerve in a submandibular approach, even though the nerve is finer and more difficult to identify. Here a group map the nerve...

Voice outcomes following extended laser resections for laryngeal cancer

It is now widely accepted that the oncological and voice outcomes following transoral laser microsurgery for early T1a glottic cancers are equivalent to, if not superior to, traditional radiotherapy. Voice outcomes following more extensive resections have not been as frequently...

Which patients are more likely to have postoperative pulmonary complications after major head and neck?

Postoperative pulmonary complications (PPC) following major head and neck surgery are frequently encountered. Indeed, surgery in the head and neck area itself has been identified as a risk factor for these complications. Microvascular reconstruction is a widely accepted and proven...

Curettage adenoidectomy impairs eustachian tube function

Adenoidectomy is a common procedure undertaken for obstructive sleep apnoea and nasal obstruction. Curettage is the most common technique but is associated with complications (mucosal trauma, bleeding) that may cause eustachian tube dysfunction (ETD). This study analysed changes in middle...

Cartilage interposition versus PORP ossiculoplasty

In this Egyptian study, the authors looked at the hearing outcomes in patients who underwent ossiculoplasty with cartilage interposition versus those with partial ossicular replacement prosthesis (PORP). They looked at a total of 47 ears from 45 consecutive patients with...