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Sinonasal undifferentiated carcinoma – slowly getting there

The rarest of the rare, sinonasal tumours form only a small part of the total number of head and neck tumours and undifferentiated carcinoma (SNUC) is one of the rarest of this group. There is some data (and some expert...

Outcomes after facial nerve preservation surgery for large vestibular schwannomas

Large vestibular schwannomas (Koos grade three or four) are traditionally treated by surgical resection. Gross total resection of such large tumours often results in facial nerve dysfunction. Hence facial nerve preservation surgery was introduced in which maximal surgical resection is...

Facial paralysis risk factors in benign parotid surgery

The literature shows that the risk of facial paralysis following benign parotid surgery can be as high as 57% for temporary weakness and 7% for permanent facial nerve damage. It is generally thought that the factors involved may be related...

Outcomes of larger glottic cancer volumes treated with radiotherapy

T3 glottic cancer is characterised as vocal cord fixation and/or invasion into pre-epiglottic, post-cricoid, paraglottic spaces and/or within the inner cortex of thyroid cartilage. Traditionally, laryngectomy was considered the primary option to treat T3 laryngeal glottic cancers until other options...

Clival chordoma recurrence

Chordomas are generally slow growing and are histologically considered low grade tumours. Their high recurrence rate even after postoperative radiation renders them difficult to treat. This is particularly true for clival chordomas whose deep anatomic location and proximity to vital...

Does Koos classification predict facial nerve dysfunction?

The Koos classification is a grading system used often for preoperative evaluation of acoustic tumours on imaging studies. It indirectly correlates to the size of the tumour. Size of the vestibular schwannoma is often considered the main determinant for hearing...

Which factors affect the postoperative CSF leak following endoscopic skull base surgery?

Endoscopic skull base surgery is being increasingly performed worldwide for skull base tumours. Common indications include pituitary tumours, rathke cleft cysts, chordomas, craniopharyngiomas and olfactory neuroblastomas. The most common and important complication following endoscopic skull base surgery is postoperative CSF...

The lateral neck cystic mass – diagnostic dilemma. Can HPV status help?

Solitary cystic masses in the lateral neck can present a significant diagnostic dilemma as they can be metastases from tumours of the oro or nasopharynx. This retrospective paper detailed all patients presenting to a university hospital in Germany, from September...

Carnoy’s and the KOT

This is a retrospective review of 105 patients with keratocystic odontogenic tumours treated over a 23-year period with a mean follow up of 86 months. The recurrence rate was 11.4%. Permanent neuro-sensory deficit of the inferior alveolar nerve 16%. Younger...

How best to follow up a sinonasal cancer?

Sinonasal malignancies are rare tumours and, in the UK, are usually treated in tertiary treatment centres but may well be followed up long term in the patient’s local hospital, so advice on how best to manage these patients is invaluable....

Salvage surgery vs. repeat stereotactic radiosurgery for progressing vestibular schwannomas

This large multicentre case series of patients treated twice with stereotactic radiosurgery (SRS) for progressing vestibular schwannomas (VS) is reported by the International Gamma Knife Radiosurgery consortium. Progression of tumour growth after primary SRS is rare but does occur. Complications...

Transnasal oesophagoscopy in head and neck cancer: an update

The role of transnasal oesophagoscopy (TNE) in the management of head and neck cancer patients is evolving. Until 1990, oesphagoscopy required specialist endoscopists, general anaesthesia or sedation. This review succinctly summarises updates in the evidence for TNE in: i) Screening...