Intraoperative identification of primary tumours in unknown primary head and neck cancer using transoral laser microsurgery with frozen sections

The aim of the study was to compare the sensitivity and specificity of intraoperative identification of primary tumours in patients with unknown primary head and neck squamous cell carcinoma (UP HNSCC) using transoral laser microsurgery (TLM) with frozen sections, with...

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...

Voice and unilateral vocal fold paralysis

Voice outcomes are the main comparators when managing unilateral vocal fold paralysis (UVP). In a review of the literature, 11 voice indicators are included in 80% of all articles. However, when surgeons were surveyed on their clinical preferences and their...

Percutaneous tracheostomy in anticoagulated patients

This Belgian study looked at the risks and complications of bedside percutaneous tracheostomy in patients who received anticoagulant therapy. The 231 tracheostomies included in the study were performed over an eight-year period by two otolaryngologists using bronchoscopic guidance. The mean...

Narrow band imaging in laryngopharyngeal reflux

Narrow band imaging (NBI) is a tool on the Olympus endoscopic systems that uses blue and green wavelengths to enhance visualisation of mucosal vasculature. It has been used to aid in the early diagnosis of upper aerodigestive tract cancers. A...

Surgical management of refractory osteoradionecrosis

This is a French single-centre, 10-year experience of 55 surgical resection and reconstruction procedures. They claim an overall effectiveness rate of 92.3%. A total of 36 segmental and 19 marginal mandibulectomies were performed. A variety of free flaps were used,...

Hierarchy of orthognathic surgical stability

This study was designed as “an overview” of secondary studies and analysed 15 articles. Two procedures were considered highly unstable: a bilateral sagittal split osteotomy for clockwise rotation of the mandible with bi-cortical screw rigid internal fixation, and posterior maxillary...

Antibiotic prophylaxis in otolaryngologic surgery. Less is better!

Jan/Feb 2020 Editor’s Choice is a review of antibiotic prophylaxis in ENT and OMF surgery. It is not the first systematic review and meta-analysis published in the last two years. If anyone else has been offered a “potentially career-altering opportunity”...

Using autologous blood to reduce postoperative infections

The removal of impacted wisdom teeth is a common surgical procedure with possible complications including postoperative bleeding and wound infection and alveolar osteitis. Preventing osteitis is dependent on retaining the blood clot in the socket with no infection. There are...

Elevated prevalence of late-onset dysphagia among head and neck cancer survivors and identifying risk factors

Dysphagia is one of the most common problems affecting head and neck cancer (HNC) survivors. There are few studies investigating late-onset dysphagia post-treatment. The authors set out to investigate the prevalence of dysphagia-related diagnoses and procedures five years’ post-treatment, changes...

Should we be doing earlier MRIs in sudden sensorineural hearing loss?

There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....

Acute ENT activity in a teaching hospital

This Belgian prospective audit attempted to provide justification for the provision of a 24-hour emergency service at a large 1038-bed teaching hospital (with 31 ENT consultants). The authors looked at a one-month period during which 190 patients were admitted. They...