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Best timing for post-treatment PET-CT scans in head and neck cancer

Unfortunately we know that the recurrence rate for head and neck cancer can be high, up to 30-50% in some series. These recurrences tend to occur within the first two years following treatment. Optimal surveillance strategies to detect recurrences early...

Facial nerve grafting – what’s the wait?

An uninterrupted facial nerve after resection of cerebellopontine angle (CPA) tumour does not always translate into preserved facial animation. Fortunately there is a high probability spontaneous recovery may occur and hence patients are typically observed for 12 months postoperatively. However,...

Association between depression and survival in patients with head and neck cancer

Approximately 40% of patients develop major depressive disorder (MDD) during diagnosis and treatment for head and neck cancer (HNC). Depressive symptoms in these patients have a significant effect on their rehabilitation and survival. Given the small number of studies in...

Evidence based outcomes for canal wall up, canal wall down and subsequent canal wall reconstruction for primary cholesteatoma

There has been a long standing controversy over whether to treat primary cholesteatoma with open or closed technique. The general consensus is that limited disease can be treated with closed technique whereas the canal wall down approach helps reduce recidivism...

Radiosurgery for large vestibular schwannomas

The authors conducted a retrospective study of patients with large Koos grade 4 vestibular schwannomas undergoing gamma knife radiosurgery. A total of 68 patients with tumour size greater than 4 cm3 with baseline serviceable 60% hearing who received 12 Gray...

Stimulation for a good night’s sleep

This article was an interesting read. It is an update from the authors’ original paper printed in the NEJM in 2014 regarding the results of an implantable pulse generator (IPG) for stimulating the hypoglossal nerve in response to respiration. This...

CT guided cochlear implant programming improves performance

There is currently no national (UK) consensus on imaging patients for cochlear implantation. This paper may change that. It has shown increased hearing and quality of life in paediatric cochlear implant (CI) users when the programming has been assisted by...

Chronic rhinosinusitis and sleep

This is an interesting article from the Chung Shan Medical University in Taiwan. One-hundred-and-thirty-nine patients were enrolled into this five-year study. They all had chronic rhinosinusitis with or without polyposis and underwent sinus surgery. The aim was to investigate a...

The microbiological environment of the paranasal sinuses

This article reviews the ecology of the sinuses and tries to make sense of the confusing literature on the subject. This covers the details of molecular studies, particularly those which attempt to differentiate normal sinuses from those in patients with...

Implantable devices and large magnets – do they mix well?

Although all brands are MRI safe at 1.5 T, the active middle ear implant system Vibrant Soundbridge (VSB), is special since it houses two magnets. These include a magnetic floating mass transducer (FMT) and an audioprocessor fixing receiver magnet which...

Olfactory neuronal damage in sinusitis

So many patients with nasal disorders have poor olfactory function, yet sometimes the nose may seem comparatively clear of conductive problems. This study postulated that neuronal damage in the olfactory apparatus would lead to a leakage of neuron specific enolase...

What are the non-inflammatory causes of a conductive loss?

This retrospective study looked at patients with an intact tympanic membrane with non-inflammatory causes – i.e. otitis media and cholesteotoma. They document their findings based on exploratory tympanotomy. They operated depending on the findings with either a stapedectomy or a...