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Dutch pharyngeal pouch surgery experience
A decade’s experience of pharyngeal pouch surgery was reported in this paper from Rotterdam. A total of 94 patients were analysed. The majority (80%) underwent an endoscopic approach, either with stapling or CO2 laser-assisted. Interestingly, 13 of 75 (14%) procedures...
Managing the thyroglossal duct cyst
Although the operation to remove thyroglossal cysts and their tracts is commonly performed, a full understanding of the possible anatomical locations of the tracts may be less appreciated. This article helps the reader understand the possible variations available which should...
Patient-related factors that require revision surgery for otosclerosis
Stapes surgery for otosclerosis has a high success and low complication rate but, over a period of time, good results can deteriorate, requiring revision surgery. In this study, the authors have focused on patients’ demographic data as predictive factors for...
Minimal or not so minimal?
Parathyroidectomy is usually a straightforward technique when the target gland has been accurately determined. Surgical excision is usually through a small midline incision. With the advent of video assisted surgery, trials have been made to use this technique in parathyroidectomy....
Does ‘weekend effect’ alter post tonsillectomy haemorrhage rates?
Staffing levels are generally low over the weekends and senior physicians are less easily available. It is generally believed that this affects patients undergoing high-risk surgery. Whether doing tonsillectomy at weekends adds to the risks of post tonsillectomy haemorrhage is...
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...
Pre-habilitation in head and neck cancer – a literature review to guide best practice
Curative treatment of head and neck cancer (HNC) often requires surgery; however, outcomes are impacted by the complexity of the surgery and the patient population. Increasingly ‘Enhanced Recovery After Surgery’ (ERAS) protocols are being used to maximise patient outcomes and...
Carotid artery involvement with head and neck metastases
This is a retrospective review of 27 patients radiologically diagnosed as having metastases involving the common or internal carotid arteries. All patients underwent a salvage neck dissection with surgical carotid peeling. Thirteen of the 27 achieved loco-regional control, five developed...
The perils of poor postop blood pressure control
This retrospective case control study reviews 621 patients undergoing thyroid surgery over a 10-year period from 2002-2012 looking at postoperative haemorrhage rates. This potentially catastrophic complication warrants close analysis in order to best discern how it can be minimised. The...
No soup for you…! Early identification of postoperative perforation increases the success of conservative management
Iatrogenic perforation of the hypopharynx or cervical oesophagus is a well-recognised life-threatening complication. Previous studies have demonstrated that conservative management with broad-spectrum antibiotics and withholding oral feeding may avoid morbidity associated with surgical repair. This study addresses when conservative management...
Risk factors for pharyngocutaneous fistula after laryngectomy
Pharyngocutaneous or salivary fistula is a feared complication following laryngectomy, causing significant morbidity, prolonged hospital inpatient stay / cost and mortality. Previous radiotherapy / chemoradiotherapy is a well recognised risk factor and leads many surgeons to recommend onlay pectoralis major...
