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An algorithm to distinguish between distant metastases and metachronous lung primary in patients with HPV-related oropharyngeal cancer
Distinguishing between distant metastases of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) and metachronous primary lung squamous cell carcinoma (SCC) is important as it has implications for treatment, prognosis counselling, and registry data. Although p16 immunohistochemistry (p16 IHC) is widely accepted...
Management of oral white patches with malignant potential
This paper focuses on a rare but aggressive form of leukoplakia with malignant potential and is an important reminder of the need for specialist management to those in allied specialties such as ENT that may initially be referred these oral...
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...
Objective testing for Eustachian tube dysfunction
Eustachian tube dysfunction (ETD) is typically diagnosed based on subjective symptoms and examination leading to wide variation in its diagnosis and management. The search for an objective test has looked at ways of measuring the passage of air through the...
‘Close’ surgical margin in oral tongue redefined, 2.3mm is as good as 5mm
Gold standard treatment of squamous cell carcinoma (SCC) of the oral tongue remains surgical resection of the primary tumour with negative margins. The primary goal is the complete excision of the tumour with no residual cancer cells left behind. A...
Supracricoid laryngectomy revisited
In this article, the authors report on the long-term (five- and 10-year) survival, local recurrence rate and cause of death in a cohort of 46 patients with T3M0N0 glottic carcinoma undergoing supracricoid laryngectomy. The five- and 10-year survival were 78%...
Does pregabalin help with post-tonsillectomy pain?
This is a small double-blind randomised controlled trial conducted on tonsillectomy and lateral pharyngoplasty operations. Both of these operations are terrifically painful, and I am sure most of us are looking for a way of reducing the suffering for our...
Cough no more?
The challenge of the ‘unexplained chronic cough’ that just will not go away is a challenge that frustrates many of us. Often patients have seen respiratory, upper GI and eventually they see you as the last resort! Is behavioural therapy...
Extrapolating lessons from vestibular schwannoma management
This paper presents a delightfully simple and sensible hypothesis for the management of benign schwannomas in the head and neck region. They have taken the approach used for the management of vestibular schwannomas and used the same principles to assess...
Performing a labyrinthectomy
This article takes the reader through the two main approaches for a labyrinthectomy for intractable Meniere’s disease. These are the traditional trans-mastoid and the less well known trans-canal. They state that according to the House clinic, the selection criteria for...
Reconstruction with scapular tip following hemimaxillectomy and rehabilitation with dental implants
Post ablative defects in the maxilla can be extremely complex, involve all three dimensions and may result in significant morbidity. Rehabilitation may be difficult with either an obturator or surgical reconstruction with a free fibula, Iliac crest or scapula. This...
