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The unknown primary again

In this retrospective study of 35 patients, the authors followed a systematic protocol for the detection and management of malignant cervical lymph nodes without an apparent primary lesion. Although their one, three and five year survival results are consistent with...

The sentinel lymph nodes revisited

The concept of sentinel lymph node sampling has been around for some time. However, its acceptability in routine head and neck practice has yet to be established. This article presents the authors’ experience in 10 patients with Merkel cell carcinoma...

Differences between paediatric and adult cholesteatomas

An understanding of the differences between adult and paediatric cholesteatomas should be helpful in more effective management of the disease in children. In this study, the authors focused their comparison between paediatric and adult cholesteatomas to the operative findings, rates...

Algorithm for malignant otitis externa

Timely detection and effective management of this potentially fatal condition cannot be overemphasised. This study presents 16 cases over 12 months in a tertiary referral centre. Most patients had diabetes and others were immunocompromised due to radiotherapy, immunosuppressive medication or...

Can you hear the speech disorder?

Dysarthria is often the first or most pronounced feature of a Parkinson’s disease (PD) presentation, yet may be difficult to discern from normal ageing changes that impact voice and speech. Thus, it is important to be able to differentiate in...

Core biopsies are good enough for lymphomas

This paper, from the South of England, has reviewed ultrasound-guided core needle biopsies over a six-year period investigating the use of the detection of head and neck lymphomas. There were 367 samples included from 226 patients; 215 of the 226...

To scan or not to scan?

This comprehensive review article seeks to establish how useful is MRI in the evaluation of patients with a history of smell loss or distortion. Interestingly, while some studies found the imaging unhelpful, one paper described found a 25% rate of...

TIVA in FESS: a meta-analysis

This meta-analysis is from Rochester, New York, and aims to add more evidence for the use of TIVA in endoscopic sinus surgery (FESS) to arm rhinologists keen for a quick, bloodless FESS in the discussion with anaesthetists who prefer inhalation....

Variations in obstructive level with increasing depth of sedation in DISE

This study highlights some of the controversies surrounding DISE (Drug Induced Sedation Endoscopy, or otherwise known as sleep nasendoscopy in the UK). On one hand it provides some evidence that the BIS (BiSpectral Index), recordings of patients while they are...