Journal Reviews
Suspect the unsuspecting in thyroid cancer
This article reminds readers of how often invasive thyroid disease can appear, as the symptomatology is minimal. Noticeable airway symptoms appear after 50% of the airway is involved and surgeons can often fall in the unsuspecting trap of discovering locally...
A mouth-rinse test that can screen for oral cancer?
This paper presents a promising screening tool for oral cancer – using a simple chlorhexidine mouth-rinse. The hypermethylated ZNF582 and PAX1 markers were chosen based on previous studies using oral scraping methods of collection and have been shown to be...
Paediatric nasopharyngeal carcinoma
Between 11 and 18% of nasopharyngeal carcinomas (NPC) occur in the paediatric age group but there are no specific management guidelines for this age group. Tunisia is a region with an intermediate incidence of NPC, the authors studied 40 cases...
The double-half bilobed flap or traditional bilobed flap: which is better?
Reconstruction of the nasal tip following ablative surgery can be taxing. The nasal tip is a very visible area with largely immovable skin and reconstruction needs an appreciation of the various subunits to achieve best results. The traditional superiorly based...
The newest robot from da Vinci – what can it offer for hypopharyngeal cancer surgery?
The standard existing da Vinci surgical robot (the Si model) has been much maligned for not being optimally designed for transoral access and endoscopic manoeuvrability in head and neck surgery. This preclinical work from Holsinger and his team looks at...
An algorithm to distinguish between distant metastases and metachronous lung primary in patients with HPV-related oropharyngeal cancer
Distinguishing between distant metastases of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) and metachronous primary lung squamous cell carcinoma (SCC) is important as it has implications for treatment, prognosis counselling, and registry data. Although p16 immunohistochemistry (p16 IHC) is widely accepted...
What is the evidence for contralateral tonsillectomy in TORS for known unilateral tonsil malignancy?
The concept of field changes by carcinogens within the upper aerodigestive tract is well established with reported rates of synchronous tumours of 4% and second primaries of 36%. The tonsil in particular has the highest rate of synchronous tumours, postulated...
Evidence for diagnostic role of narrow band imaging in the outpatient setting for head and neck squamous cell carcinoma
Narrow band imaging (NBI) uses light in the blue and green spectrum to differentiate areas of carcinoma from normal or inflammatory tissue. This tertiary referral head and neck unit in Spain used white light endoscopy as initial screening for all...
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...
First signs of late nodal metastases
This is a retrospective review of 65 patients who had late metastases during follow-up after initial curative treatment. They analyse the detection methods of palpation, ultrasound, CT and subjective symptoms. Palpation detected the nodes in 31 patients, ultrasound in 17,...
Predicting which oropharyngeal SCC HPV-positive patients should avoid de-escalated treatment
This study is timely for many reasons and raises very important questions in the management of the current rise in HPV-positive patients with oropharyngeal cancer (OPC). The uniqueness of this group within head and neck cancer in terms of favourable...
Previous radiotherapy does not cause worse outcomes in patients with differentiated thyroid cancer
Radiation exposure from nuclear incidents, especially in childhood, is known to increase the risk of thyroid cancer. This large retrospective study from the Memorial Sloan Kettering Cancer Centre sought to determine if thyroid cancers in patients with prior exposure to...
