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Resection margins in head and neck surgery
Although an increasing proportion of head and neck malignancies are treated with non-surgical modalities, when surgery is undertaken an incomplete clearance results in significantly worse prognosis. However, the intraoperative assessment of an adequate margin is difficult. The personal practice of...
Delirium post-op
This is a retrospective study from Japan analysing 102 patients who underwent oral cancer resection and free flap reconstruction. Postoperative delirium occurred in a third of these patients. An increased risk was identified in those with high preoperative albumin, postoperative...
Acoustic schwannoma regression post-Gamma Knife treatment
In this retrospective study the authors studied the optimal interval following radiosurgery for differentiating between true growth of tumour versus pseudoprogression using serial volumetric data. A total of 118 patients with a median tumour volume of 0.74cm3 at Gamma Knife...
Paediatric versus adult pituitary adenomas
This retrospective study compares paediatric with adult patients undergoing pituitary adenoma surgery over a period of 26 years at a single institution. All surgeries were performed via a sublabial approach using the operating microscope. An endoscope was used occasionally for...
Rib grafts for mandibular reconstruction
Reconstruction of the mandible following ablation requires good bone stock to allow optimal function and the placement of dental implants. In the developed world, vascularised bony flaps are accepted as the gold standard but these may not be widely available...
Surgical management of refractory osteoradionecrosis
This is a French single-centre, 10-year experience of 55 surgical resection and reconstruction procedures. They claim an overall effectiveness rate of 92.3%. A total of 36 segmental and 19 marginal mandibulectomies were performed. A variety of free flaps were used,...
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...
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...
