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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...

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

Turbinate hypertrophy; radiofrequency; surgical turbinoplasty; visual analogue score

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...

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...

Anterior skull-base surgery: current opinion

This review examines the changes in the field of anterior skull-base surgery and the rapid advancement that has taken place in the last 10–15 years. Tumours of the anterior skull base that were once considered inoperable are now routinely resected...

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...

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...

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,...

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...

Adjuvant radiotherapy for T4N0 laryngeal cancers treated with laryngectomy

A total laryngectomy remains the gold standard for the initial treatment of advanced (T4) squamous cell carcinomas of the larynx without evidence of distant disease. Adjuvant radiotherapy (RT) is also recommended for such cancers. In the absence of other adverse...

On the shoulders of giants: a reflection on Wolfgang Steiner

Professor Wolfgang Steiner. Wolfgang Steiner inspired a whole generation of head and neck surgeons. Terry Jones gives us his own personal perspective. “We are like dwarfs on the shoulders of giants, so that we can see more than they, and...