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Applying ‘Sal classification’ to parotid cytology to replicate the success of the Thy classification system

The usefulness of the Thy classification in thyroid gland disease has led to attempts to generate a similar cytology classification for parotid lesions. However, the accuracy of fine-needle aspiration cytology in salivary gland disease is more variable because of the...

Learning curve for sialendoscopy

Sialendoscopy represents a minimally invasive technique that permits direct salivary tree visualisation and treatment using endoscopic techniques. Previous studies have shown that it is an efficacious, safe and potentially gland preserving method to treat major salivary gland disease. However, it...

Malignant change of pleomorphic adenoma

Pleomorphic adenoma is the most common salivary gland tumour. The potential to undergo malignant transformation is rare but well described. The authors of this article present a case report of metastasis where the preceding submandibular gland pleomorphic adenoma preserves its...

Adenoid cystic carcinoma – insights from a national database

Adenoid cystic carcinoma (AdCC) is a rare cancer of the salivary glands that accounts for approximately 1% of all head and neck malignancies. Hallmarks of this cancer type include a predilection for perineural infiltration, a prolonged clinical course with late...

Techniques of Botulinum Toxin Injections in the Head and Neck

The foreword begins with a saying by George Bernard Shaw, “all great truths begin as blasphemies”. This certainly was the case with medical application of Botox initially, however, botulinum toxin now has an accepted role and is widely used in...

Otolaryngology Prep and Practice

Jennifer Shin and Michael Cunningham from Boston, USA have published an impressive book with 37 chapters in 1226 pages. It aims to enable the reader to retain ENT knowledge by presenting it in a way that enforces application of knowledge,...

Is there a limitation for excising parapharyngeal tumours transorally?

The parapharyngeal space is a complex anatomical space bounded medially by the oropharynx and laterally by the mandible. It is conceptualised as an inverted pyramid extending from base of skull above to the hyoid bone below. The space is divided...

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...

Avoiding the sweaty cheek

Frey’s syndrome is a common (10-40%) and important complication following parotid surgery. Gustatory sweating during oral stimulation can be embarrassing as it is accompanied by flushing and a sensation of heat. This is as a direct result of regenerated parasympathetic...

Predicting life-threatening complications in deep neck space infections

Deep neck space infections, arising usually from tonsils and lymph nodes in children and dental source and salivary glands in adults can be life threatening. It is therefore important to recognise the variables which indicate immediate intervention to prevent fatalities....

Risk factors for pharyngocutaneous fistula after laryngectomy

Pharyngocutaneous or salivary fistula is a feared complication following laryngectomy, causing significant morbidity, prolonged hospital inpatient stay / cost and mortality. Previous radiotherapy / chemoradiotherapy is a well recognised risk factor and leads many surgeons to recommend onlay pectoralis major...

Plunging new depths for the treatment of ranulas

Within our scope of practice, we encounter a number of salivary gland pathologies, including the sublingual gland. Clinical signs are often subtle, and even with meticulous surgical management, morbidity can easily occur. Textbooks advocate excision of the gland as the...