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Importance of the time interval between surgery and postoperative radiation therapy in head and neck cancer

The ideal time to start postoperative radiation therapy (PORT) in head and neck cancer patients has been an issue of debate. In the USA, the National Comprehensive Cancer Network (NCCN) recommends initiating radiotherapy within six weeks from surgery. The six-week...

BPPV and bone mineral density

Over the years, attempts have been made to identify modifiable risk factors for BPPV. Due to the chemical composition of otoconia, the role of calcium metabolism and its associated conditions have been studied with no firm conclusions. The authors studied...

Postoperative radiation in early stage oropharyngeal squamous cell cancer (OPSCC)

There is significant variation in treatment strategies for OPSCC between units. This is largely due to unanswered questions which continue to exist beyond the published literature. We know that human papilloma virus status has a significant influence on prognosis but...

Beware the skinny patient…

The adverse health impacts of an excessive BMI are well known. This study highlights one laryngeal pathology for which a low BMI appears to be a significant risk factor. The records of 28 patients treated for arytenoid cartilage dislocation were...

Suspect the unsuspecting in thyroid cancer

This article reminds readers of how often invasive thyroid disease can appear, as the symptomatology is minimal. Noticeable airway symptoms appear after 50% of the airway is involved and surgeons can often fall in the unsuspecting trap of discovering locally...

Voice change after total thyroidectomy with intact laryngeal nerves – a common but temporary problem

It has been reported that up to 87% of patients have a degree of voice dysfunction after thyroidectomy, even when the laryngeal nerves are preserved. Postoperative inflammation, laryngeal oedema due to vascular congestion, direct damage to the cricothyroid muscles and...

Epistaxis and anticoagulants

The French Society of Otorhinolaryngology Head and Neck surgery issued some recommendations on the management of epistaxis in patients receiving anticoagulants, anti-platelet aggregants and anti-vitamin K drugs. This was a national multidisciplinary evidence-based concensus document. The group recommends review of...

Predicting the prognosis of oral squamous cell carcinoma after salvage surgery

Loco-regional recurrence of oral cavity squamous cell carcinoma (OCSCC) continues to be a life-threatening and difficult clinical situation. Salvage surgery can result in significant morbidities, and survival following recurrence is generally poor. In this study from Ontario, Canada, prognostic factors...

Should patients with dysphagia be allowed water freely?

Patients with dysphagia often experience dehydration as a consequence of “nil by mouth” or having to consume thickened fluids due to aspiration of thin fluids. However, not all incidents of aspiration develop into an infection. Factors that contribute to aspiration...

Which patients are more likely to have postoperative pulmonary complications after major head and neck?

Postoperative pulmonary complications (PPC) following major head and neck surgery are frequently encountered. Indeed, surgery in the head and neck area itself has been identified as a risk factor for these complications. Microvascular reconstruction is a widely accepted and proven...

The initial electroneuronography result after temporal bone trauma related facial palsy may be misleading

It is taught that a complete facial nerve (FN) palsy after temporal bone (TB) trauma should be conservatively managed if electroneuronography (ENoG) shows a less than 90% degeneration of response compared to the contralateral side. This small study from the...

Is there a ‘best’ ventilation tube?

Studies on grommet materials and sizes are not exactly new but this was a well-designed randomized study in Sweden with some useful findings. The extrusion rate and complications associated with four different ventilation tubes (grommets) were assessed prospectively in 400...