Journal Reviews
Occurrence of cancer in asymmetrical tonsillar enlargement in adults
With significant increase in head and neck cancer in the last decade, attributed to HPV, fast-track referrals from primary care have markedly increased, adding further to the burden on the NHS. Whether or not unilateral tonsillar enlargement alone, without red...
Effects of coronavirus pandemic on presentation of head and neck cancer patients
The COVID-19 pandemic caused unprecedented disruption of NHS services. This was compounded by patients’ reluctance to attend hospitals at that time. How this affected the presentation of patients with head and neck cancer is the subject of this study. Head...
Ultrasound-guided core biopsy of neck lumps as first-line investigative modality supersedes fine needle aspiration cytology in the diagnosis of neck lumps
Ultrasound-guided fine needle aspiration cytology (USFNAC) when applied as initial investigation often proves non-diagnostic, the incidence being as high as 50% in a recent audit. In this study, the authors applied ultrasound-guided core biopsy (USCB) to neck lumps over 1cm...
Modifying two-week wait protocol for suspected head and neck cancer patients during COVID-19
As healthcare workers, we are committed to ensuring that our patients continue to receive the optimum care that we are set up to deliver. However, the last year has shown that we need to be mindful of balancing this with...
COVID-19 and medical practice
The pandemic has deeply affected all types of medical and surgical practice and even publications. In this issue, the lead article was on the French consensus on ENT practice during the pandemic. In ENT practice, both patients and health workers...
How effective are our two-week-wait guidelines in picking up head and neck cancer?
With a 30% increase in the incidence of head and neck cancer since 1999 in the UK, it is important that the two-week wait referral guidelines safely encompass all risk factors but also render these urgent referrals based on signs...
Is a chest x-ray necessary in making urgent referrals for suspected head and neck cancer?
The article presents an audit on urgent referrals for suspected head and neck cancer in 2144 patients. Only 8.6% of cases proved positive for head and neck cancer. The Scottish Referral Guidelines were adhered only in 55.1% of cases. Interestingly,...
Radiology and paediatric neck lumps
This is a comprehensive article examining the modalities available for children presenting with suspected congenital neck lumps. Each modality is explained in turn, with pros and cons highlighted, but also in the context of the emergency patient and the elective....
A comparison between ultrasonography-guided drainage with open surgical drainage of deep neck space abscesses
A comparison between ultrasonography-guided drainage with open surgical drainage of deep neck space abscesses Neck space abscesses are common; conventional drainage involves intra-oral or extra-oral approaches. The former can compromise the airway and the latter can cause neurovascular injuries, scarring...
5-cm incision for neck dissection and free flap reconstruction
Patients with oral cavity squamous cell carcinoma (SCC) will commonly require neck dissection as it is associated with a higher rate of overall and disease free survival. Free flap reconstruction of the defect following surgical resection is considered the gold...
Rationales to explore the neck in penetrating injuries
Penetrating neck injuries in the UK are more commonly associated with low velocity objects such as knives and blades as opposed to gunshots. To explore the neck requires careful consideration of the need to do so in line with Burgess...
Paediatric lymphadenopathy – helpful decision making
The authors present a very helpful algorithm to manage cervical lymphadenopathy in children. The goal of managing children with inflamed lymph glands is to identify the rare malignant case and not over-investigate the vast majority of benign reactive swellings –...