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2020 Unmasked - By Paul Howard Surridge
Throughout human existence, metaphorical masks have been worn to conceal emotional and physical imperfections, whether imagined or real. We mask the way we look; we mask the way we feel. We’re vulnerable creatures, psychologically wired to present socially acceptable characteristics...
Role of ultrasonography-guided fine-needle aspiration in management of the neck after chemoradiotherapy
Primary chemoradiotherapy (CRT) is a well-established treatment for locally advanced head and neck squamous cell carcinoma (HNSCC). However, not every patient has a complete response to this treatment modality, necessitating eventual salvage neck dissection. Some patients with persistent adenopathy following...True Cut – a dramatic biopsy from the world of surgery
True Cut is a stage play that asks: “What happens when things go wrong in healthcare?” It brings the hidden world of the operating theatre onto the theatre stage. ENT surgeon, David Alderson, talks about how the play came about....
Voice change after total thyroidectomy with intact laryngeal nerves – a common but temporary problem
It has been reported that up to 87% of patients have a degree of voice dysfunction after thyroidectomy, even when the laryngeal nerves are preserved. Postoperative inflammation, laryngeal oedema due to vascular congestion, direct damage to the cricothyroid muscles and...
A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth
It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...
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...
Can and should vestibular schwannoma surgery be carried out via the endoscopic transcanal approach?
The extent and scope of endoscopic ear surgery has rapidly progressed in recent years, and this paper, from one of the leading proponents of this technique, reports on the outcomes of a case series of patients who have had total...
