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Active surveillance for papillary thyroid cancers – what is the risk of progression?

Papillary thyroid cancers (PTCs) are generally considered to be indolent malignancies with favourable outcomes. Active surveillance (AS) has consequently been trialled as a management option for small PTCs with no evidence of regional lymph node involvement, especially papillary thyroid microcarcinomas...

The decision-making process by parents of children with residual hearing who receive cochlear implants

It can be a difficult decision for parents whose children have residual hearing whether or not to undergo cochlear implantation. Their children may seem to be hearing with their hearing aids, and even in some cases can hear without aids....

Choosing instrumental assessments of swallowing for children

Swallowing disorders in children are increasingly common due to advances in medical care allowing them to survive prematurity or complex health conditions. Careful assessment of eating and drinking is necessary to ensure that children are managed both safely and with...

The initial electroneuronography result after temporal bone trauma related facial palsy may be misleading

It is taught that a complete facial nerve (FN) palsy after temporal bone (TB) trauma should be conservatively managed if electroneuronography (ENoG) shows a less than 90% degeneration of response compared to the contralateral side. This small study from the...

Less pain more gain: impact of prophylactic gabapentin on swallowing outcomes in head and neck cancer patients undergoing radiation treatment

Patients planned for chemoradiation to the head and neck are usually advised to expect some pain and soreness during their treatment and that pain relief will be offered as and when it is required. Uncontrolled pain and mucositis affect oral...

The sleep nasendoscopy learning curve

There seems to be no accepted way of surgically assessing patients with sleep disordered breathing (SDB). Because of this, clinicians fall roughly into three camps: those who just use one operation for all patients, those who have given up surgery...

Microsurgical trainees to avoid strenuous exercises?

It is commonly believed among microsurgeons that over-exertion can impair microsurgical performance. The authors aimed to investigate if they could prove this theory and compared the performance of medical students, postgraduate trainees and expert controls who were microsurgery tutors. A...

Associated findings in MRI used for detecting acoustic neuroma

Presently, gadolinium enhanced magnetic resonance imaging is the ‘gold standard’ for investigating acoustic neuroma. There are often ‘incidental’ findings that may or may not be significant. In this study of 109 scans, the authors noted an uptake of 0.9% for...

Adenoidal hypertrophy in children with allergic rhinitis

Nasal congestion in children with allergic rhinitis can be confounded by adenoidal hypertrophy. This retrospective Turkish study examines this association in more detail. The sample studied was 566 children (age 2-18) that were diagnosed (based on ARIA guidelines) and treated...

Smoking causes cancer – so what’s new?

You may well ask what is the novel value of a paper looking at smoking habits in patients with confirmed head and neck squamous cell carcinoma (HNSCC), but this paper highlights some pertinent points for clinical practice in the current...

Hilotherapy for facial surgery patients?

Hilotherapy involves administering regulated cold compression through a facemask. The principle of this treatment involves cyotherapy as a traditional treatment for reducing inflammation, pain and swelling following trauma. It is believed that using hilotherapy (Hilotherm®), which uses a mask to...

Outpatient closure of CSF leaks: a good idea or a step too far?

After day-case septoplasty, day case thyroidectomy, now day case CSF leak repair – has the pendulum moved too far? The authors put forward a convincing case for what, only 10 years ago, would have sounded like a provocation. They quote...