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Measuring the ‘impact’ of preoperative immunonutrition

Using preoperative nutritional supplements as part of ‘enhanced recovery’ in surgical patients is not a new concept. This interesting paper looks at the latest development in optimising patients undergoing head and neck oncological surgery. Immunonutrition (Nestle’s ‘Oral Impact’ in this...

External auditory canal carcinoma

Although uncommon, primary malignant tumours of the external auditory canal (EAC) are associated with a poor prognosis as they often present late. In this study the authors evaluate the clinical and pathological factors associated with treatment and outcome of EAC...

Auditory brainstem implant results in adults and children

Background The auditory brainstem implant (ABI) has been developed from cochlear implant (CI) technology and is indicated for people who have anatomical abnormalities of the cochlea or dysfunction of the auditory nerve. The majority of people who have received an...

Factors affecting the occurrence of salivary fistula after total laryngectomy

It is generally believed that patients should be fed by nasogastric tube for 7-10 days after undergoing total laryngectomy or laryngopharyngectomy to avoid the occurrence of post-operative salivary fistula. This study challenges this belief and looks into various factors that...

Advances in surgical innovation for head and neck cancer

This article reviews current advances in surgical treatment of head and neck cancers such as sentinel node biopsy, stereolithic modelling, transoral robotic surgery and intra-operative imaging of tumour margins. Sentinel node biopsy has been found to be especially useful for...

The role of imaging in differentiating rare temporal bone neoplasms

This paper provides a useful tool to assist in determining the diagnosis of benign neoplasms of the temporal bone using readily available imaging modalities. Specifically, this group have looked at chondrosarcoma, an expansile hypermetabolic mass lesion usually found in the...

Does transoral robotic surgery improve outcomes among patients with head and neck cancer of unknown primary?

A tonsillectomy and tongue base mucosectomy is becoming increasingly accepted as the optimal surgical intervention to aid in identifying the primary source of a p16+ / HPV-related squamous cell carcinoma (SCC) of unknown origin, given that this disease almost exclusively...

Robotic assisted orbital surgery (RAOS) – a novel approach to orbital malignancy surgery

Robotic technology in ENT surgery has been used in certain areas of head and neck cancer care but, in this article, we hear of an exciting development from the team at Guy’s & St Thomas’. Advances in surgical robotic technology...

Head and neck cancer and PET-CT

Positron emission tomography-computed tomography (PET-CT) is an imaging technique in which abnormalities of tissue metabolism are precisely superimposed onto the anatomy. It relies on the premise that malignant cells are more metabolically active compared with non-malignant cells. On this basis,...

The changing landscape of thyroid and parathyroid surgery

How has clinical practice in the management of thyroid and parathyroid disease has evolved in recent years? I perform very few head & neck operations where the patient tells me just one week following surgery that they ‘feel much better’....

The integration of targeted therapy and surgery in advanced thyroid cancer clinical trials

One of the headline speakers, Mark Zafereo, will be talking at IFOS about thyroid cancer. We hear from his team about some of the areas they will be discussing. Locally advanced thyroid cancer generally refers to patients who have significant...

Have we reached our limits in endoscopic skull base surgery?

As being an anterior skull base surgeon becomes the aspiration of many ENT trainees, Professor Nicolai gives his personal insights into the future for this exciting subspeciality. Having been directly involved in the evolution of transnasal endscopic surgery (TES) since...