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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...

The benefits of early voice therapy for unilateral vocal cord paralysis

This retrospective review of voice outcomes following a diagnosis of unilateral vocal fold paralysis divided patients into three groups according to the time of initiation of voice therapy following the onset of paralysis. The ‘early’ group started voice therapy within...

Monstrous craws and horrid butchery: a concise history of thyroid surgery

Prior to the foundation of our speciality, thyroid surgery had a dubious reputation and universally dismal outcomes. Jenny Walton casts a critical eye over this dark chapter. Diseases of the thyroid gland have been referenced in historic texts for well...

50 Landmark Papers Every Thyroid and Parathyroid Surgeon Should Know

The motto ‘publish or perish’ has never been more fervently adopted globally than in the present age. Indeed, the preface of this book observes that between 2016 and 2019, “approximately one paper [was published] every 4 minutes”. In this ocean...

Transoral endoscopic thyroidectomy / parathyroidectomy – a new approach

Historically, scarless surgery has been popular in certain cultures. But is it gaining traction around the world? A UK team tell us more. Background Alternative, remote access approaches to thyroidectomy and parathyroidectomy are increasing in popularity, the newest of these...

American Thyroid Association Thyroid Cancer Management Guidelines: utilising risk stratification to optimise patient care

The steep rise in thyroid surgery around the globe, has led to the development of risk stratification to define the indications for surgery and the extent of surgery as well as adjuvant therapies for papillary carcinoma, to avoid over treatment....

Enhancing surgical outcomes in TOETVA – with neuromonitoring essentials by Langer Medical

Intraoperative neuromonitoring has become a standard practice in all thyroid surgery, allowing for the precise localisation and reliable monitoring of neurophysiological structures at-risk.

Giacomo Puccini’s laryngeal cancer

Giacomo Puccini, one of the best known composers of all time, was diagnosed with laryngeal cancer and died from the disease in 1924. In this article, Rosario Marchese-Ragona and Alessandro Martini describe Puccini’s experience of the disease with quotes from...

Clinical Practice Guideline on Tympanostomy Tube in Children Update (AAO-HNS)

The American Academy of Otolaryngology–Head and Neck Surgery Foundation’s ‘Clinical Practice Guideline: Tympanostomy Tubes in Children (Update)’ has been recently published - an update of the original 2013 guideline. This article forms an executive summary to accompany the full guideline....

ICG in ENT surgery

The use of fluorescence imaging is well established in the medical sphere, forming an essential arm of medical diagnostics with liver function, ophthalmic angiography, and assessment in cell biology with fluorescence microscopy. Fluorescence imaging in surgery, however, is an evolving...

A soprano’s demise: a cautionary tale for the thyroid surgeon

Prior to the mid-19th century, thyroid surgery was considered excessively dangerous. The emergence of anaesthetic, antisepsis and improved instrumentation, however, increased its feasibility and frequency in Europe. The unhurried, judiciously antiseptic and haemostatic approach, advocated by Kocher, was popularised and...

Surgical challenges in advanced or recurrent thyroid malignancy

The management of thyroid malignancy and extent of surgery is controversial, especially considering the limitations of preoperative diagnosis. Neil Tolley provides guidance and reminds us of our responsibility not to over-treat. In the UK, 16% of thyroidectomies are performed for...