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Surgical challenges in advanced or recurrent thyroid malignancy
The management of thyroid malignancy and extent of surgery is controversial, especially considering the limitations of preoperative diagnosis. Neil Tolley provides guidance and reminds us of our responsibility not to over-treat. In the UK, 16% of thyroidectomies are performed for...
A trial of house dust mite sublingual tablet in children with allergic rhinitis
The house dust mite (HDM) is one of the commonest causative agents in allergic rhinitis (AR), affecting patients across all demographics. Recently, sublingual immunotherapy (SLIT) has been shown in clinical trials and meta-analysis to be effective compared to placebo in...
The Laryngectomee Guide
As a Macmillan Head and Neck Specialist Nurse, I was very pleased to be asked to review this book, The Laryngectomee Guide, by Itzhak Brook, MD. It is fair to say that for most laryngectomy patients, life does go on...
Pomegranate juice as an otoprotective agent
Chemotherapeutic agents such as cisplatin, given alongside irradiation, offer a survival advantage in head and neck cancer. Some patients often complain bitterly about side-effects of their treatment, one of which is ototoxicity. In this paper, the authors propose the use...
Cochlear implantation following radiotherapy treatment of vestibular schwannomas
The authors presented a case report and systematic review assessing the outcomes of patients from cochlear implantation (CI) following radiotherapy treatment for vestibular schwannoma (VS). Outcomes of cochlear implantation in these patients are uncertain due to the combination of both...
X-ray vs. intraoperative testing for determining cochlear implant placement
Most cochlear implant centres confirm electrode position after surgery using X-rays to ensure optimal electrode placement. As well as transorbital view X-rays, this team check placement using impedance measures and neural response telemetry (NRT) performed intraoperatively. The former indicates whether...
Is Gamma Knife Surgery effective for intracanalicular vestibular schwannomas?
Vestibular schwannomas (VSs) are rare, occurring in approximately five per 100,000 adults a year. In circa 8% of cases, the VS is contained within the internal auditory canal, i.e. intracanalicular (iVS). Although radiosurgery is a recognised treatment modality for VSs,...
Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture
Placement of voice prosthesis at the time of trachea-oesophageal puncture is well described using 20-French prostheses. There is debate about the optimal size of the prosthesis with work in the 1980s and 1990s supporting larger prostheses. The rationale was that...
Chemo-radiation in elderly patients with head and neck cancers
Chemo-radiotherapy is the standard of care for organ preservation in stage three and four oropharyngeal cancer, prospective data on patients over 65 has not been available as they are usually excluded from randomised trials. This paper reviews the experience of...
