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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...

Thyroidectomy - a pictorial walk through the surgical steps

We as ENT surgeons work closely with the endocrinologist to provide MDT care for patients with a variety of pathologic conditions of the thyroid gland, including benign, malignant and hormonal disease processes. Surgery plays a central role for a variety...

The benefits of early voice therapy for unilateral vocal cord paralysis

This retrospective review of voice outcomes following a diagnosis of unilateral vocal fold paralysis divided patients into three groups according to the time of initiation of voice therapy following the onset of paralysis. The ‘early’ group started voice therapy within...

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...

Advances in surgical innovation for head and neck cancer

This article reviews current advances in surgical treatment of head and neck cancers such as sentinel node biopsy, stereolithic modelling, transoral robotic surgery and intra-operative imaging of tumour margins. Sentinel node biopsy has been found to be especially useful for...

Outpatient closure of CSF leaks: a good idea or a step too far?

After day-case septoplasty, day case thyroidectomy, now day case CSF leak repair – has the pendulum moved too far? The authors put forward a convincing case for what, only 10 years ago, would have sounded like a provocation. They quote...

Expanding the role of FNA in thyroid nodule decision-making

Papillary thyroid cancer, the commonest histological type, has been extensively reported as having BRAF proto-oncogene mutations (most commonly the V600E mutation). There is great interest in BRAF as a molecular marker, particularly as a prognostic factor that may guide the...

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....

Giacomo Puccini’s laryngeal cancer

Giacomo Puccini, one of the best known composers of all time, was diagnosed with laryngeal cancer and died from the disease in 1924. In this article, Rosario Marchese-Ragona and Alessandro Martini describe Puccini’s experience of the disease with quotes from...

Clinical Practice Guideline on Tympanostomy Tube in Children Update (AAO-HNS)

The American Academy of Otolaryngology–Head and Neck Surgery Foundation’s ‘Clinical Practice Guideline: Tympanostomy Tubes in Children (Update)’ has been recently published - an update of the original 2013 guideline. This article forms an executive summary to accompany the full guideline....

ICG in ENT surgery

The use of fluorescence imaging is well established in the medical sphere, forming an essential arm of medical diagnostics with liver function, ophthalmic angiography, and assessment in cell biology with fluorescence microscopy. Fluorescence imaging in surgery, however, is an evolving...

A soprano’s demise: a cautionary tale for the thyroid surgeon

Prior to the mid-19th century, thyroid surgery was considered excessively dangerous. The emergence of anaesthetic, antisepsis and improved instrumentation, however, increased its feasibility and frequency in Europe. The unhurried, judiciously antiseptic and haemostatic approach, advocated by Kocher, was popularised and...