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ENT Training: a Singapore perspective

I recently had the opportunity to participate in a week’s observation with Associate Prof Thomas Loh, a head and neck surgeon with a special interest in nasopharyngeal carcinoma at the National University Hospital of Singapore (NUHS). What was striking from...

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...

Salivary duct clipping for drooling

Drooling can be a challenging problem to manage in paediatric ENT. The variety of medical and surgical treatments suggests that there is no gold standard treatment. Nicola Stobbs and Ravi Thevasagayam describe an approach to ligating the salivary ducts. Drooling...

Balloon dilatation of the eustachian tube - largely very safe but not entirely without risk

Consent is a fundamental part of our daily working lives. This is something as simple as consent to examine a patient, consent to undertake a procedure as minor as taking blood, through to consent for a major operation. Whatever the...

Facial filler danger zones

Non-surgical facial rejuvenation techniques are increasing and are now undertaken by plastic, maxillofacial and ENT surgeons as well as non-surgeon technicians in the private sector. Although the technique of using fillers is less invasive than surgical options, it is not...

Seven things ENT surgeons can learn from the hairdressers

In a nod to our origins as barber surgeons, Australian ENT surgeon and blogger Eric Levi gives us an entertaining insight into what he has learned from his hairdresser that makes him a better doctor. I’ve been to the hairdressers...

Pharyngocutaneous fistula after total laryngectomy

Pharyngocutaneous fistula (PCF) after total laryngectomy is a serious complication post-surgery, and can lead to prolonged hospitalisation, adding delays in postoperative chemoradiotherapy. This Turkish retrospective study looked at 166 patients who underwent total laryngectomy for laryngeal cancer, although it is...

Expanding the role of FNA in thyroid nodule decision-making

Papillary thyroid cancer, the commonest histological type, has been extensively reported as having BRAF proto-oncogene mutations (most commonly the V600E mutation). There is great interest in BRAF as a molecular marker, particularly as a prognostic factor that may guide the...

Zinc and rhinosinusitis

Patients with chronic rhinosinusitis (CRS) in general, and those with nasal polyps (CRSwNP) in particular, have been shown to have down-regulation of tight junction genes. Zinc, on the other hand, is well-known for its role in immune regulation and deficiency...

Role of sentinel lymph node biopsy in managing papillary thyroid cancer

Although studies have shown that the presence of lymph nodes metastases in papillary thyroid carcinoma does not alter survival, other studies have shown that it increases morbidity and mortality and that the presence of cervical lymph node metastasis at diagnosis...

What is the evidence for contralateral tonsillectomy in TORS for known unilateral tonsil malignancy?

The concept of field changes by carcinogens within the upper aerodigestive tract is well established with reported rates of synchronous tumours of 4% and second primaries of 36%. The tonsil in particular has the highest rate of synchronous tumours, postulated...

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...