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Measuring the ‘impact’ of preoperative immunonutrition
Using preoperative nutritional supplements as part of ‘enhanced recovery’ in surgical patients is not a new concept. This interesting paper looks at the latest development in optimising patients undergoing head and neck oncological surgery. Immunonutrition (Nestle’s ‘Oral Impact’ in this...
Neurological complications associated with managing degenerative cervical myelopathy
Degenerative cervical myelopathy (DCM) is a common neuropathologic status due to degenerative changes to the cervical spine. There are multiple operative techniques available, including anterior cervical discectomy and fusion, anterior cervical corpectomy, laminoplasty, laminectomy and laminectomy with fusion. C5 palsy...
What is the evidence for duration of antibiotic prophylaxis in head and neck free-flap cases?
The topic of this systematic review is one which is commonly heard in discussions between microbiologists and head and neck surgeons – what is the evidence for antibiotic prophylaxis in clean-contaminated free-flap cases, and crucially, how long should antibiotics be...
Reactive lesions of the contralateral vocal cord – excise or leave?
It is well recognised that benign lesions of one vocal cord can give rise to reactive lesions of the contralateral vocal cord directly opposite to the primary lesion. These contralateral reactive lesions (CRLs) are thought to arise due to impact...
Evidence for diagnostic role of narrow band imaging in the outpatient setting for head and neck squamous cell carcinoma
Narrow band imaging (NBI) uses light in the blue and green spectrum to differentiate areas of carcinoma from normal or inflammatory tissue. This tertiary referral head and neck unit in Spain used white light endoscopy as initial screening for all...
Post-operative tonsillectomy bleeding with a normal clinical exam
Tonsillectomy is amongst the most common surgical procedures performed across the western world. For patients who report bleeding post-tonsillectomy, but have no clinical findings on examination, the management can be unclear. The accepted current management in most centres would be...
Auditory Brainstem Implants
This is a hardcover volume printed on a high-quality paper. The book is broken into 20 short chapters over 145 pages. It is illustrated with 149 figures. Edited by Eric P Wilkinson and Marc S Schwartz, both based in the...
Infection and other factors influencing post-tonsillectomy haemorrhage
In this detailed narrative review article, the authors have addressed several factors which could be related to postoperative bleeding after tonsillectomy. As regards to microbiology, the significance of micro-organisms present both on surface and within the tonsils is emphasised and...
The sleep nasendoscopy learning curve
There seems to be no accepted way of surgically assessing patients with sleep disordered breathing (SDB). Because of this, clinicians fall roughly into three camps: those who just use one operation for all patients, those who have given up surgery...
5-cm incision for neck dissection and free flap reconstruction
Patients with oral cavity squamous cell carcinoma (SCC) will commonly require neck dissection as it is associated with a higher rate of overall and disease free survival. Free flap reconstruction of the defect following surgical resection is considered the gold...
Finding the elusive parathyroid glands
While reading in the literature about new advances in knowledge and surgical techniques, it is often easy to lose track of the longstanding knowledge that we all acquired during our training. This is why this article on the anatomy and...
