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Preventing major postoperative haemorrhage following TORS

Transoral robotic surgery (TORS) has become an increasingly utilised treatment modality in the management of oropharyngeal squamous cell carcinoma (OPSCC). Postoperative haemorrhage, although uncommon, is a significant complication. To ameliorate this risk, transcervical ligation of branches of the external carotid...

Assessing post-extubation dysphagia on the intensive care unit

The incidence of post-extubation dysphagia (PED) is reported to be about 12% in the general ICU population and around 18% in patients admitted to ICU as emergencies. PED was found to be an independent predictor of 28-day and 90-day mortality....

Which da Vinci surgical system? Novel flexible, single-port versus current multiport, rigid-arm robotic surgical system

The da Vinci robotic surgical system has transformed how oropharyngeal head and neck surgery can be delivered. The existing da Vinci Si model has challenges: the dimensions of this are larger than would be ideal for head and neck surgery...

Are elective facelifts a good idea after head and neck cancer radiotherapy?

The aim of this study was to assess the safety of elective cervicofacial rhytidectomy following radiotherapy for head and neck squamous cell carcinomas (HNSCC). A greater proportion of HNSCC patients are infected with certain strains of the human papillomavirus, which...

Laryngeal cleft in a 66-year-old man!

This is a fascinating case report of a 66-year-old man who presented with a carcinoma of the piriform sinus. During chemoradiotherapy, he developed dyspnoea, dysphagia and aspiration pneumonia. His chemoradiotherapy was stopped and he underwent a pharygnolaryngectomy. When the surgical...

Transoral Laser Microsurgery of Benign and Malignant Lesions

Published in 2016, this is a textbook that I have cited and recommended in a number of talks on transoral laser microsurgery (TLM). The content and layout is very similar to that of Steiner and Ambrosch’s Endoscopic Laser Surgery of...

ENT Training: a Singapore perspective

I recently had the opportunity to participate in a week’s observation with Associate Prof Thomas Loh, a head and neck surgeon with a special interest in nasopharyngeal carcinoma at the National University Hospital of Singapore (NUHS). What was striking from...

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...

Factors associated with laryngopharyngeal reflux

This Chinese cross-sectional survey across three hospitals and 320 patients looked at the effect of unhealthy lifestyles and eating habits, as well as psychological difficulties, on the development of laryngopharyngeal reflux (LPR). All the participants underwent gastroscopy, laryngoscopy and various...

In conversation with Professor Gao Zhiqiang

Prof Zhiqiang, President of the Chinese Society of Otorhinolaryngology, Head and Neck surgery takes us on a journey spanning over a hundred years of ENT in China: A story of an amazing achievement in a country with a population over...

Reflux – diagnostic tools and special considerations in singers

Depending on your point of view, laryngopharyngeal reflux (LPR) is either ubiquitous or is over-diagnosed. Are singers more prone to LPR? What are the best tests? Mark Watson and Jane Shaw tell us more. Laryngopharyngeal reflux (LPR: the backflow of...

Percutaneous fibre guided laser surgery of the endolarynx

Occasionally, getting access to the larynx for an intervention can be challenging. Markus Hess and Susanne Fleischer describe a novel way to perform laser treatment in such difficult instances. Fibre guided office-based endolaryngeal laser surgery has developed to be a...