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One anastomosis or two

This is a cumulative meta-analysis from Hong Kong reviewing 27 articles and a total of 7,389 flaps. The authors, at the outset, acknowledge that the number of anastomoses is not the only factor of venous compromise and flap failure. Nonetheless...

Lymph node ratio is a significant predictor for loco-regional recurrence after neck dissection in patients with papillary thyroid cancer

Lymph node metastases are common in papillary thyroid cancer (PTC), yet the impact of nodal metastases on survival remains unclear. Lymph node density (LND) is the ratio between the number of positive lymph nodes excised and the total number of...

Can comorbidities predict complications after total laryngectomy? Utility of the Modified Frailty Index (mFI) score

Decision making regarding appropriate treatment for laryngeal cancer is complex. Patients undergoing total laryngectomy experience significant changes in anatomy and physiology and are at risk for significant postoperative complications. These patients represent a group with significant comorbidities. In addition, patients...

Surgical and non-interventional management of laryngomalacia

In this elaborate review article, the authors have described various aspects of laryngomalacia and its surgical management with supraglottoplasty or otherwise, gleaned from an extensive review of the literature which provided evidence or the lack of it in relation 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...

Which da Vinci surgical system? Novel flexible, single-port versus current multiport, rigid-arm robotic surgical system

The da Vinci robotic surgical system has transformed how oropharyngeal head and neck surgery can be delivered. The existing da Vinci Si model has challenges: the dimensions of this are larger than would be ideal for head and neck surgery...

How best to manage single-sided deafness?

Nowadays there is a plethora of options for patients with single-sided deafness (SSD) including: Bluetooth contralateral routing of signal (CROS) aids; in-the-ear bone conduction hearing aids (TransEar); intra-oral bone conduction aids (SoundBite) and bone-anchored technologies (BAHA). Unilateral cochlear implantation is...

We should all use ultrasound-guided core needle biopsy when investigating salivary gland lesions

Ultrasound core needle biopsy of salivary glands is an excellent diagnostic tool in terms of accuracy (both sensitivity and specificity), technical performance, and safety profile. This paper provided an update of the previous meta-analysis of the same question, which found...

Preoperative CT checklist (using the ‘CLOSE’ mnemonic) improves identification of anatomical variants for endoscopic sinus surgery

Computed tomography (CT) scans of the paranasal sinuses act as roadmaps for endoscopic sinus surgery (ESS) and careful inspection preoperatively warns the operating surgeon of critical anatomical variants. This study aimed to investigate if implementation of a pre-ESS CT checklist...

A review of DISE classification systems

This article looks at the wide variety of classification systems currently available for interpreting drug induced sleep endoscopy (DISE).The fact that there are so many classification systems, suggests that there is: A) a lot of disagreement about how DISE should...

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...

Can obstructive snoring affect the snorer’s ears as well?

Patients with obstructive sleep apnoea (OSA) often show severe nasal obstruction, chronic sinusitis and/or a deficit of nasal mucociliary clearance with nasopharyngeal stagnation of secretions possibly predisposing to eustachian tube dysfunction (ETD). This clinical prospective study investigates ETD, nasal resistance...