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To drain or not to drain
These two separate papers neatly tie together the same ideas. The first, a retrospective study of 107 patients and 116 procedures over a 10-year period who underwent a CSF leak repair, 82.2% without a lumbar drain and 17.8% with. The...
Results of hypoglossal-facial nerve anastamosis techniques for facial palsy
Preserving facial nerve function is of prime importance in acoustic neuroma surgery. A comprehensive knowledge of anatomy, experience and surgical precautions can reduce the incidence significantly. Important considerations are when and how to repair if injury occurs. Several options include:...
SPECT-CT imaging improves surgical efficiency in sentinel lymph node biopsy in melanoma
Sentinel lymph node biopsy is used in clinically lymph node negative, primary cutaneous melanoma. A combination of planer lymposcintigraphy using a radiolabelled colloid detected intra-op by gamma probe, and cutaneous injection of blue dye is used. However, with lymphoscintigraphy spillage...
Incidental thyroid nodules: should we observe or operate?
Thyroid nodules are extraordinarily prevalent, detected by physical examination in 7% and by imaging studies in 67% of the population. Although most of these nodules are benign, up to 20% are found to be malignant on excision. It’s a very...
Voice therapy is an effective treatment for presbyphonia
The quality of an individual’s voice often declines with age. This deterioration occurs firstly as a result of vocal fold atrophy secondary to histologic alteration of the vocal fold mucosa as well as atrophy of the laryngeal musculature. Phonatory efficiency...
Radiation-induced dysphagia in head and neck cancer
This is a helpful reference paper that provides an overview of the biomolecular effects of radiation on the tissues of the upper aero-digestive tract. The authors explain that radiation injuries occur in a repetitive and accruing manner over the duration...
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...
Analysing videofluroscopy: does it matter how it’s done?
Videofluoroscopy, as a tool that assesses the process of swallowing, has transformed our understanding of dysphagia. Clinicians can observe the biomechanics of a bolus moving from the oral cavity through the pharynx and oesophagus and into the stomach. Over the...
Chronic rhinosinusitis – a pre-malignant condition?
Nasopharyngeal carcinoma (NPC) is a relatively uncommon diagnosis in the West but is prevalent in Southeast Asia. Several factors have been established to be associated with a higher risk of developing NPC, including salted fish consumption, smoking, alcohol, and Epstein...
Diurnal and monthly variations in secondary post-tonsillectomy haemorrhage rates
Several studies have looked into variable haemorrhagic rates with different methods of surgery and clinical backgrounds. Few have looked into non-clinical factors such as environment and diurnal influence on occurrence of post-tonsillectomy bleeding. This extensive study comprises 5357 tonsillectomy patients...
A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth
It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...
