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Transoral endoscopic thyroidectomy / parathyroidectomy – a new approach

Historically, scarless surgery has been popular in certain cultures. But is it gaining traction around the world? A UK team tell us more. Background Alternative, remote access approaches to thyroidectomy and parathyroidectomy are increasing in popularity, the newest of these...

When should revision FESS leave you reaching for the script pad?

This very interesting work from the professorial team in London seeks to define a group of patients with CRSwNP who may benefit from early biological treatment since they are at risk of failure of surgical and conventional medical management. Approximately...

Surgery plus radiotherapy keeps the helical keloid scar away

Keloid scars lead to significant psychological and cosmetic morbidity. As the pinna is a key component of facial cosmesis, pinna keloid scar formation can be aesthetically displeasing. Their stubbornness and high recurrence rate can be challenging to treat. This department,...

Nasal allergies and OSA

The first day of June is the meteorological start of summer. As a moderately wet spring slowly blurs to (a damp UK) summer, we can look forward to holidays in the countryside, enjoying the changing pollen seasons from tree to...

Patients with severe uncontrolled CRSwNP respond to biologics in the real world

Clinical trials have demonstrated that biologics are effective in treating patients with chronic rhinosinusitis with nasal polyps (CRSwNP). This multicentre (15 tertiary care centres in France) observational prospective cohort study aims to examine the effectiveness of biologics in treating CRSwNP...

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...

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...

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...