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Lymph node ratio is a significant predictor for loco-regional recurrence after neck dissection in patients with papillary thyroid cancer

Lymph node metastases are common in papillary thyroid cancer (PTC), yet the impact of nodal metastases on survival remains unclear. Lymph node density (LND) is the ratio between the number of positive lymph nodes excised and the total number of...

How best to manage single-sided deafness?

Nowadays there is a plethora of options for patients with single-sided deafness (SSD) including: Bluetooth contralateral routing of signal (CROS) aids; in-the-ear bone conduction hearing aids (TransEar); intra-oral bone conduction aids (SoundBite) and bone-anchored technologies (BAHA). Unilateral cochlear implantation is...

Is combined two wall decompression approach a better surgical outcome for Grave’s orbitopathy?

This retrospective study looked at the outcome of endoscopic medial wall combined with transcutaneous lateral orbital wall decompression in Graves’ orbitopathy. The following parameters were studied: reduction in proptosis; change in visual acuity and diplopia. A total of 36 orbits...

Risk factors for loco regional recurrence for oral SCC

Over 250,000 cases of oral squamous cell carcinomas are diagnosed annually worldwide with 128,000 registered deaths. The authors of this study are from a single institution in Germany and have conducted a retrospective audit of 517 patients with oral SCC...

An algorithm to distinguish between distant metastases and metachronous lung primary in patients with HPV-related oropharyngeal cancer

Distinguishing between distant metastases of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) and metachronous primary lung squamous cell carcinoma (SCC) is important as it has implications for treatment, prognosis counselling, and registry data. Although p16 immunohistochemistry (p16 IHC) is widely accepted...

Managing the most common branchial arch anomaly

This article is a well written, helpful summary of the management of the most common branchial anomaly in children – the second. These are characterised as cysts, sinuses or tracts between the anterior border of sternocleidomastoid, coursing between the internal...

Dutch pharyngeal pouch surgery experience

A decade’s experience of pharyngeal pouch surgery was reported in this paper from Rotterdam. A total of 94 patients were analysed. The majority (80%) underwent an endoscopic approach, either with stapling or CO2 laser-assisted. Interestingly, 13 of 75 (14%) procedures...

Management of oral white patches with malignant potential

This paper focuses on a rare but aggressive form of leukoplakia with malignant potential and is an important reminder of the need for specialist management to those in allied specialties such as ENT that may initially be referred these oral...

Reconstructing post-resective auricular defects

The auricle is split into six specific anatomic subunits that vary in skin thickness, contour, structural integrity and the availability of healthy surrounding tissues. It is important to reconstruct an aesthetically pleasing auricle as slight deformities may be prominent. The...

Neck dissection in adenoid cystic carcinoma is a risk worth taking?

This paper from Stanford University presents impressive figures to guide the debate on the extent of surgical management in adenoid cystic disease. Adenoid cystic carcinomas present a particular problem in that they can recur even after 20 years. They have...

Objective testing for Eustachian tube dysfunction

Eustachian tube dysfunction (ETD) is typically diagnosed based on subjective symptoms and examination leading to wide variation in its diagnosis and management. The search for an objective test has looked at ways of measuring the passage of air through the...

‘Close’ surgical margin in oral tongue redefined, 2.3mm is as good as 5mm

Gold standard treatment of squamous cell carcinoma (SCC) of the oral tongue remains surgical resection of the primary tumour with negative margins. The primary goal is the complete excision of the tumour with no residual cancer cells left behind. A...