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What is the right balance to strike in the management of anaplastic thyroid cancer?

This is a pragmatic article on a difficult and much debated subject. Management of anaplastic thyroid cancer (ATC) can feel like making decisions between a rock and a hard place, and this article suggests one path to help navigate some...

What about the older adults?

The authors of this paper propose that significant changes in the delivery of services, including speech and language therapy management of swallowing difficulties, may be required. Among the most common causes of dysphagia in older adults are stroke, progressive neurological...

Can comorbidities predict complications after total laryngectomy? Utility of the Modified Frailty Index (mFI) score

Decision making regarding appropriate treatment for laryngeal cancer is complex. Patients undergoing total laryngectomy experience significant changes in anatomy and physiology and are at risk for significant postoperative complications. These patients represent a group with significant comorbidities. In addition, patients...

Healthcare economics and device approvals

We use several FDA-approved devices in our clinical practice but are rarely aware about the stringent procedures followed by manufacturers, as well as the FDA, before the devices become commercially available. The authors of this paper undertook a comprehensive review...

Discharge planning

For a specialty such as ENT in which so many procedures are performed as day case surgery, there is a pressing need for objective discharge criteria to facilitate safe decision making post-op. This review strikes a good balance between prescriptive...

Comprehensive Management of Vestibular Schwannoma

This is the Holy Grail of texts for anyone involved in the management of vestibular schwannoma. Edited by Matthew Carlson from the Mayo Clinic in Rochester, Minnesota, the Associate Editors are from the same department, but the 156 contributors to...

Skull Base Cancer Imaging: The Practical Approach to Diagnosis and Treatment Planning

This book was written to enhance knowledge of imaging, diagnosis, and treatment planning in skull base pathologies. It is broadly divided into anterior cranial fossae, nasal cavity, sellar and clival region, and CP angle. It is written in a manner...

Indication and timing of electrodiagnostic tests in facial palsy

This excellent review describes the benefits and limitations of electrodiagnostic testing for patients with facial paralysis. Tests such as Schirmer, stapedial reflex and electrogustometry have been largely replaced by neurophysiologic tests like nerve excitability test (NET), electroneuronography (ENoG), surface electromyography...

A move away from bony free flaps in reconstruction

Techniques for facial reconstruction have come on in leaps and bounds since the world wars. The use of titanium implants is more recent and the technology for manipulating the metal and how we use it is rapidly developing. Here the...

Vestibular schwannoma surgery and inner ear injuries

Iatrogenic inner ear injury during vestibular schwannoma (VS) surgery ranges between 20% and 30% in the literature. However, there is no up-to-date quantification of such injuries, hence this study. The authors conducted a US-multicentre database search looking for patients who...

Transoral Laser Microsurgery of Benign and Malignant Lesions

Published in 2016, this is a textbook that I have cited and recommended in a number of talks on transoral laser microsurgery (TLM). The content and layout is very similar to that of Steiner and Ambrosch’s Endoscopic Laser Surgery of...

Intratympanic steroids in Ménière's disease: what’s the evidence?

The days of drastic surgery for Ménière's disease are long gone. We know that intratympanic injections can deliver high doses of medication to the inner ear with minimal discomfort and minimal risk. But how do we choose from the myriad...