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Should we reconsider induction chemotherapy in advanced stage laryngeal cancer?
Use of chemo-radiotherapy for advanced laryngeal cancer led to a major shift in treatment as an alternative to total laryngectomy. Despite widespread adoption of chemoradiotherapy, survival rates have not improved and the original premise of matching neoadjuvant chemotherapy tumour response...
Previous radiotherapy does not cause worse outcomes in patients with differentiated thyroid cancer
Radiation exposure from nuclear incidents, especially in childhood, is known to increase the risk of thyroid cancer. This large retrospective study from the Memorial Sloan Kettering Cancer Centre sought to determine if thyroid cancers in patients with prior exposure to...
Sellar surgery – when to prepare for repair
Endoscopic sellar surgery, especially for adenomas, is a relatively safe, straightforward surgery with (mostly) reproducible results and few complications. One of the commonest complications is the creation of a CSF leak with the subsequent need for repair (there is usually...
Risk factors for post laryngectomy fistula
This is a meta-analysis looking at the postoperative pharyngocutaneous fistula rates following total laryngectomy. The authors ended up with 34 studies with about 2500 patients. The most striking finding was that preoperative radiotherapy was a significant risk factor as well...
Margin control using optical techniques in head and neck surgery
Emerging optical techniques such as high-resolution microendoscopy (HRME) are currently being examined for their reliability in discriminating benign from neoplastic epithelium. These techniques may offer the potential to detect the margin of an upper aerodigestive tract tumour in a non-invasive...
Surgical anatomy for central auditory device implantation
This cadaveric study by researchers in the USA and Japan examined the cerebellopontine angles with the aid of the surgical microscope and 45o endoscope via the retrosigmoid and translabyrinthine approach. Using fibre dissection technique, the ascending auditory pathways between the...
A new flap for the perinasal region
Perinasal defects are most commonly caused by tumour extirpation or trauma. There are a number of methods to reconstruct the defect, and the method chosen depends on the size of the defect and other patient considerations. When the defect is...
Hearing preservation after Gamma knife in vestibular schwannomas
This retrospective study reports the outcomes of hearing preservation up to three years after Gamma knife radiosurgery for Gardner-Robertson Class I (SDS>70% and PTA <30dB) patients with vestibular schwannomas. The authors report that patients with no subjective or objective hearing...
Multiple free flaps for head and neck cancer
Most patients with advanced head and neck cancers now undergo microvascular free flap reconstruction. This is mainly as flaps facilitate complete tumour and margin removal by providing reliable wound coverage and better restoration of form and function. However despite this,...
Patients with advanced oral cavity carcinoma are not candidates for the ‘organ preservation’ approach
The authors of this study, from the University of Michigan, evaluated the role of induction chemotherapy for patients with stages III and IV resectable oral squamous cell carcinoma. Nineteen patients were initially enrolled in the induction chemotherapy cohort. Patients with...
