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Lymph node ratio is a significant predictor for loco-regional recurrence after neck dissection in patients with papillary thyroid cancer

Lymph node metastases are common in papillary thyroid cancer (PTC), yet the impact of nodal metastases on survival remains unclear. Lymph node density (LND) is the ratio between the number of positive lymph nodes excised and the total number of...

No soup for you…! Early identification of postoperative perforation increases the success of conservative management

Iatrogenic perforation of the hypopharynx or cervical oesophagus is a well-recognised life-threatening complication. Previous studies have demonstrated that conservative management with broad-spectrum antibiotics and withholding oral feeding may avoid morbidity associated with surgical repair. This study addresses when conservative management...

Botox application for drooling shrinks salivary glands

The large majority of sialorrhoea (drooling) in paediatric patients is managed conservatively. However in severe cases, often where there is associated developmental delay or a motor disorder, medical and surgical techniques can be used to decrease salivary flow. Botulinum toxin...

Tricky post-laryngectomy swallows

Despite improvements in chemoradiation therapy and the adoption of organ preservation for some head and neck cancers, total laryngectomy remains the treatment often providing best survival chances for advanced laryngeal cancer. This article reviews the causes of dysphagia post-laryngectomy and...

Benefit of prolonged voice rest following phonosurgery

The recommendation for voice rest following surgery is not agreed amongst surgeons, regarding either the type of voice rest (absolute or relative) or the optimal duration. In this ongoing study, 31 elective patients operated on for benign laryngeal lesions were...

Endoscopic findings and prediction of outcome in unilateral vocal cord paralysis

Unilateral vocal cord paralysis which is not due to irreversible causes such as malignancy, systemic disease or trauma varies considerably in terms of full recovery and restoration of voice. Usually electromyography is used to make possible predictions, but this facility...

Multisystem pathology in refractory otitis media with effusion

Recurrent middle ear effusion is a common problem and so is rhinosinusitis with polyposis. It is not often thought that the problem could be linked to multisystem pathology, such as eosinophilic granulomatous with polyposis. Therefore, repeated grommet insertions and surgical...

Postinfectious olfactory disorders

Recovery of olfactory function following URTI is frequent, even many years after the infectious insult. Upper respiratory tract infection is the commonest cause of olfactory loss. Many treatment options exist including topical steroids, vitamin B, acupuncture, and zinc, which can...

Military acoustic trauma: incidence and management

This is a retrospective study on the effects of acute acoustic trauma on the hearing thresholds of 225 military personnel. The main symptom after acute acoustic trauma due to firearm use was tinnitus. The authors consider it as the main...

Clival chordoma recurrence

Chordomas are generally slow growing and are histologically considered low grade tumours. Their high recurrence rate even after postoperative radiation renders them difficult to treat. This is particularly true for clival chordomas whose deep anatomic location and proximity to vital...

The Impact of sleep endoscopy for paediatric obstructive sleep-disordered breathing

Paediatric obstructive sleep apnoea (OSA) is not always resolved or improved with adenotonsillectomy. Persistent or complex cases of paediatric OSA may be due to sites of obstruction in the airway other than the tonsils and adenoids. Investigation of paediatric obstructive...

The stubborn polyp cases are ‘different’

The widely different behaviour of nasal polyp disease between patients is a major feature of rhinology practice and makes counselling of patients difficult when approaching their first operative intervention. Setting aside aspirin sensitivity (Samter’s triad), which is known to be...