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How safe is sinonasal surgery for the operating surgeon in times of COVID-19?

I’m sure we have all wondered how safe we are in the operating theatre from virus circulating in the room and therefore the risk of subsequent COVID-19 infection. The authors addressed this by measuring the airborne particle concentrations in the...

Ultrasound-guided core biopsy of neck lumps as first-line investigative modality supersedes fine needle aspiration cytology in the diagnosis of neck lumps

Ultrasound-guided fine needle aspiration cytology (USFNAC) when applied as initial investigation often proves non-diagnostic, the incidence being as high as 50% in a recent audit. In this study, the authors applied ultrasound-guided core biopsy (USCB) to neck lumps over 1cm...

Treatment outcomes and dose rate effects following gamma knife stereotactic radiosurgery for vestibular schwannomas

Gamma knife radiosurgery (GKRS) is one of the definitive stereotactic radiotherapy treatment modalities for vestibular schwannoma (VS) management. Its efficacy depends on the cobalt-60 source which has a half-life of 5.26 years. According to the study authors, the actual rate...

Follow-up of NF2 patients with ABRs, SDS and MRI

Hearing loss is one of the earliest manifestations in vestibular schwannomas with 60% of the patients having high frequency loss. Several metabolic and mechanical factors influencing the cochlea and cochlear nerve have been implicated in the hearing decline noted in...

Is a chest x-ray necessary in making urgent referrals for suspected head and neck cancer?

The article presents an audit on urgent referrals for suspected head and neck cancer in 2144 patients. Only 8.6% of cases proved positive for head and neck cancer. The Scottish Referral Guidelines were adhered only in 55.1% of cases. Interestingly,...

Modern surgical treatment for obstructive sleep apnoea indicate suppression of inflammatory cytokines

This study comprises 57 patients, 29 of which were treated by anterior palatoplasty procedure, expansion sphincter pharyngoplasty and submucosal minimal invasive lingual excision techniques and 27 by CPAP therapy. Parameters to determine success were AHI, VAS score, ESS score, mean...

An algorithm to distinguish between distant metastases and metachronous lung primary in patients with HPV-related oropharyngeal cancer

Distinguishing between distant metastases of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) and metachronous primary lung squamous cell carcinoma (SCC) is important as it has implications for treatment, prognosis counselling, and registry data. Although p16 immunohistochemistry (p16 IHC) is widely accepted...

Rhinology and 3D printing

3D printing has increasing applications in rhinology, for instance to create patient-specific preoperative models for procedure planning, including designing a template for reconstruction planning following tumour resection, patient consultation and customised prostheses. The authors focused their review on the role...

Should we reconsider induction chemotherapy in advanced stage laryngeal cancer?

Use of chemo-radiotherapy for advanced laryngeal cancer led to a major shift in treatment as an alternative to total laryngectomy. Despite widespread adoption of chemoradiotherapy, survival rates have not improved and the original premise of matching neoadjuvant chemotherapy tumour response...

Previous radiotherapy does not cause worse outcomes in patients with differentiated thyroid cancer

Radiation exposure from nuclear incidents, especially in childhood, is known to increase the risk of thyroid cancer. This large retrospective study from the Memorial Sloan Kettering Cancer Centre sought to determine if thyroid cancers in patients with prior exposure to...

Sellar surgery – when to prepare for repair

Endoscopic sellar surgery, especially for adenomas, is a relatively safe, straightforward surgery with (mostly) reproducible results and few complications. One of the commonest complications is the creation of a CSF leak with the subsequent need for repair (there is usually...

Risk factors for post laryngectomy fistula

This is a meta-analysis looking at the postoperative pharyngocutaneous fistula rates following total laryngectomy. The authors ended up with 34 studies with about 2500 patients. The most striking finding was that preoperative radiotherapy was a significant risk factor as well...