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Useful algorithm to manage adults with branchial cysts

Managing a solitary cystic lateral neck mass, specifically differentiating between a simple second branchial cyst and a metastatic cyst poses a challenge. Often the diagnosis only becomes apparent on the final histology. This paper analysed 28 adults that presented to...

Allergen specific subcutaneous immunotherapy helps in prolonged control of allergic rhinitis

One of the commonest allergens involved in perennial allergic rhinitis is house dust mite. A good proportion of these cases prove intractable to treatment with oral and intranasal antihistamines and intranasal steroid sprays. Immunotherapy is considered a useful alternative and...

SPECT scans not justified in growth of the mandibular condyle

This is a paper from Hong Kong of 200 patients between January 2011 and July 2013 who underwent SPECT bone scintigraphy for assessment of growth causing condylar hyperplasia and subsequent mandibular asymmetry. Thirty-four patients were found to have active growth...

IL-25 and nasal polyps, another target

Immune response in chronic rhinosinusitis with nasal polyps (CRSwNP) is mainly via type 2 T-helper (Th2) cells while Th1 cells characterise chronic rhinosinusitis without nasal polyps (CRSsNP) immune response. CRSwNP is heterogeneous on a cytological level causing a varied response...

What should be considered a ‘close’ margin in oral cavity squamous cell carcinoma?

Achieving clear margins during surgical resection in oral cavity squamous cell carcinoma (OCSCC) is thought to reduce local recurrence (LR) and improve prognosis; however, what constitutes a clear, close, or involved margin is inconsistent in the literature and in practice....

A new bio-glue for neurosurgical wound closures

Dural closures need to be tight to prevent cerebrospinal fluid leaks. Traditional wound closure techniques involve sutures and DuraSeal which is the only FDA approved polyglycol hydrogel sealant with proven safety and efficacy profile. This article describes a new sealant,...

The earlier the better: learning to work together

Working as part of a team can be the most challenging aspect of any health professional’s job role. The authors of this article acknowledge that this is frequently considered a skill that can only be learnt ‘on the job’. Yet...

Developmental language disorder

Disorders such as attention deficit disorder (ADHD), autism spectrum disorder and developmental dyslexia have received widespread recognition. As a result, children affected by these conditions are able to receive remedial services. In this article, the author discusses the possible reasons...

Close monitoring of patients for delayed hyponatremia post-transsphenoidal surgery

he incidence of delayed hyponatremia is 16-28% and usually accounts for unplanned readmission of the patient within 30 days after transsphenoidal surgery. One of the surrogate measures of quality of care adopted by the government and regulatory agencies is 30-day...

The effect of adenotonsillectomy on the immune system

Parents often ask about the effect of adenotonsillectomy on the immune system, with concerns that the child may be prone to more infections postoperatively due to the absence of immune tissue. This Belgian literature review looked at the local and...

Tongue twisters to evaluate speech disorders

This interesting study compared errors in tongue twisters produced by adult patients with dysarthria with those produced by age-matched healthy controls. Audio recordings of all patients while they were vocalising tongue twisters were studied. The authors marked one word prominently...

Managing the most common branchial arch anomaly

This article is a well written, helpful summary of the management of the most common branchial anomaly in children – the second. These are characterised as cysts, sinuses or tracts between the anterior border of sternocleidomastoid, coursing between the internal...