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Paediatric pain control post-tonsillectomy

The use of codeine in the paediatric population is widely debated since the American Food and Drug Administration (FDA) published warnings regarding overdose and death following the usage of codeine. Codeine is metabolised by the polymorphic cytochrome PY4502D6 (CYP2D6) in...

Core or fine needle assessment in lymphadenopathy and salivary gland tumours

This paper from the Republic of Korea analyses 278 patients retrospectively, 112 of which underwent fine need aspiration and 166 core needle biopsies. Eleven patients had indeterminate fine needle aspiration cytology, six of whom had an additional core biopsy. The...

Avoiding the sweaty cheek

Frey’s syndrome is a common (10-40%) and important complication following parotid surgery. Gustatory sweating during oral stimulation can be embarrassing as it is accompanied by flushing and a sensation of heat. This is as a direct result of regenerated parasympathetic...

Radiological diagnosis of mastoiditis in patients screened for acoustic neuroma

Magnetic resonance imaging is the ‘gold standard’ for screening patients suspected to have acoustic neuroma. Various abnormalities are picked up through this investigation, one of which, not uncommonly reported, is mastoiditis. This requires referral to otolaryngology and further evaluation. In...

Everyone has the right to say no

Despite the introduction of the Mental Capacity Act in 2005, healthcare professionals remain uncomfortable with individuals who choose not to follow medical advice - who make informed decisions to decline a treatment or management plans. This paper highlights that speech...

Is there a need for magnetic resonance imaging six-month post-radiosurgery for vestibular schwannoma?

With advances in imaging and radiation technologies, small, slowly growing vestibular schwannomas (VS) are treated primarily with either observation or stereotactic radiosurgery (SRS). Routine magnetic resonance (MRI) scans with gadolinium are obtained six months and one year after SRS in...

Virtual reality simulation training for cochlear implant surgery

Temporal bone virtual reality (VR) simulation training has been shown to be a useful tool for learning mastoidectomy. The authors aimed to evaluate the role of VR in cochlear implant (CI) surgery. The study was performed as part of a...

Occurrence of cancer in asymmetrical tonsillar enlargement in adults

With significant increase in head and neck cancer in the last decade, attributed to HPV, fast-track referrals from primary care have markedly increased, adding further to the burden on the NHS. Whether or not unilateral tonsillar enlargement alone, without red...

A useful adjuvant treatment for SNAC or IP

5-Fluorouracil (5FU) is a topical preparation used in the treatment of various dermatological, ocular and gynaecologic malignant and pre-malignant conditions, and this literature review looks at the efficacy of 5FU in treating inverted papilloma and sinonasal tumours. The authors cite...

Is pan-endoscopy necessary to detect synchronous primary in upper aerodigestive tract cancer?

Diagnosis of head and neck cancer requires speed. It has also to be comprehensive in view of the possibility of synchronous primary cancer (SPC) associated with upper aerodigestive tract cancer (UADTC). Some centres still consider pan-endoscopy essential in the diagnostic...