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The Laryngectomee Guide

As a Macmillan Head and Neck Specialist Nurse, I was very pleased to be asked to review this book, The Laryngectomee Guide, by Itzhak Brook, MD. It is fair to say that for most laryngectomy patients, life does go on...

CT and intraoperative nerve monitoring to identify non-recurrent laryngeal nerve during thyroid surgery

A non-recurrent laryngeal nerve (NRLN) is a rare (incidence 0.3% to 1.3%) anatomical variant that results in a higher rate of vocal cord palsy following thyroid surgery. This team from China examined the utility of preoperative CT and intraoperative nerve...

Vascularised tissue in salvage total laryngectomy

Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...

Recording of electrode voltages (REVS) to determine extra-cochlear electrodes

Determining whether electrodes are sitting within the cochlea can be difficult as the checks run by the programming software cannot always determine this. In some cases, patients may be unable to give the audiologist detailed feedback which can complicate the...

X-ray vs. intraoperative testing for determining cochlear implant placement

Most cochlear implant centres confirm electrode position after surgery using X-rays to ensure optimal electrode placement. As well as transorbital view X-rays, this team check placement using impedance measures and neural response telemetry (NRT) performed intraoperatively. The former indicates whether...

What is the prognostic value of lymph node yield and density in head and neck cancer?

Neck dissection in addition to surgery of the primary site is commonly recommended in head and neck cancer treatment. However, there has been no consensus on the number of nodes that need to be removed to constitute a sufficient neck...

Which technique is better for turbinate reduction: surgical turbinoplasty or radiofrequency ablation?

Turbinate hypertrophy; radiofrequency; surgical turbinoplasty; visual analogue score

Is Gamma Knife Surgery effective for intracanalicular vestibular schwannomas?

Vestibular schwannomas (VSs) are rare, occurring in approximately five per 100,000 adults a year. In circa 8% of cases, the VS is contained within the internal auditory canal, i.e. intracanalicular (iVS). Although radiosurgery is a recognised treatment modality for VSs,...

Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture

Placement of voice prosthesis at the time of trachea-oesophageal puncture is well described using 20-French prostheses. There is debate about the optimal size of the prosthesis with work in the 1980s and 1990s supporting larger prostheses. The rationale was that...

Adenoid cystic carcinoma – insights from a national database

Adenoid cystic carcinoma (AdCC) is a rare cancer of the salivary glands that accounts for approximately 1% of all head and neck malignancies. Hallmarks of this cancer type include a predilection for perineural infiltration, a prolonged clinical course with late...

Is submandibular gland transfer effective in prevention of post irradiation xerostomia in head and neck cancer patients?

Post irradiation xerostomia is a common side effect of irradiation to the head and neck region, with up to 90% of patients reporting some symptoms. Submandibular glands account for 70% of resting saliva production. Surgically transferring the submandibular gland to...

Chemo-radiation in elderly patients with head and neck cancers

Chemo-radiotherapy is the standard of care for organ preservation in stage three and four oropharyngeal cancer, prospective data on patients over 65 has not been available as they are usually excluded from randomised trials. This paper reviews the experience of...