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The changing spectrum of cancer of the oropharynx: dilemmas and future directions

The association of HPV in oropharyngeal cancer has identified a ‘new disease’, with its unique biologic behaviour, and challenges for clinicians in selecting therapeutic combinations offering maximum efficacy and minimum morbidity or long-term sequela currently under study in clinical trials....

Outcomes of temporal bone-resurfacing for pulsatile tinnitus associated with vascular wall anomalies

This month’s Ed’s choice is an interesting systematic review into the management of pulsatile tinnitus. There are impressive results from resurfacing of symptomatic anatomical abnormalities of the temporal bone and I suspect that referrals for further imaging and otology clinic...

Selective upper airway stimulation

Obstructive sleep apnoea (OSA) is one of the most common diseases in industrialised countries and is characterised by an intermittent obstruction of the upper airway during sleep. The standard treatment for OSA is continuous positive airway pressure (CPAP) therapy, which...

Reconstructing post-resective auricular defects

The auricle is split into six specific anatomic subunits that vary in skin thickness, contour, structural integrity and the availability of healthy surrounding tissues. It is important to reconstruct an aesthetically pleasing auricle as slight deformities may be prominent. The...

Should we reconsider induction chemotherapy in advanced stage laryngeal cancer?

Use of chemo-radiotherapy for advanced laryngeal cancer led to a major shift in treatment as an alternative to total laryngectomy. Despite widespread adoption of chemoradiotherapy, survival rates have not improved and the original premise of matching neoadjuvant chemotherapy tumour response...

Do implants assist rehabilitation following mandibular reconstruction?

When undertaking mandibular reconstruction, optimal function and aesthetic rehabilitation is the goal. There is no doubt that patients consider chewing, swallowing and speech to be of paramount importance. Following surgery, suboptimal rehabilitation leads to a fall in quality of life...

The mark of the head and neck surgeon

Like Zorro, the head and neck surgeon leaves their mark. No more so than during parotid surgery. Various modifications have been put forward modifying the classic Blair incision. This latest modification camouflages the pre-tragal scar by running it on to...

Bone anchored implant stability predicted one week after implantation

Bone conduction (BC) devices can now be implanted as a single stage procedure with minimal soft tissue thinning to reduce the complications in the surrounding skin. The question of optimal loading time has to my mind not been answered. Here...

Benefit of prolonged voice rest following phonosurgery

The recommendation for voice rest following surgery is not agreed amongst surgeons, regarding either the type of voice rest (absolute or relative) or the optimal duration. In this ongoing study, 31 elective patients operated on for benign laryngeal lesions were...

Clinical evaluation of an image-guided cochlear implant programming strategy

This study ingeniously combines two current areas of active research in cochlear implantation (CI), the first is the use of imaging to assess intra-cochlear electrode position. The second, is the optimisation of a programming strategy to prevent current spread between...

Multiple free flaps for head and neck cancer

Most patients with advanced head and neck cancers now undergo microvascular free flap reconstruction. This is mainly as flaps facilitate complete tumour and margin removal by providing reliable wound coverage and better restoration of form and function. However despite this,...

Predictors of postoperative improvement after endoscopic sinus surgery in patients with chronic rhinosinusitis

Improvement after endoscopic sinus surgery in patients with chronic rhinosinusitis varies considerably. If elaborate preoperative and intraoperative data could be used to predict the postoperative course, management and length of the follow-up could be adjusted to provide optimal care. Two...