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Management of metastatic neck disease

This article publishes the findings of a recent expert-led evidence based management symposium in the UK with recommendations according to the SIGN level of evidence and grading. The article neatly summarises the key points, and its clarity despite the complexity...

Cost effectiveness and vestibular schwannoma surgery

This is the first cost effectiveness modelling study looking at the three main treatment options for small to medium sized vestibular schwannomas. This study uses the widely accepted cost per quality adjusted life year (QALY) outcome measure to evaluate three...

Sham controlled trial: BPPV

I was drawn to this study and it proved an enlightening read; it also is a good example of where recommendations of a Cochrane review for long-term evidence of benefit have been acted upon! The study looked at the efficiency...

Sublingual immunotherapy

This paper reviews the recent European studies on sublingual immunotherapy (SLIT). SLIT is currently widely used in Europe and is gaining popularity in the United States. It is known that longer treatment is needed with SLIT compared with subcutaneous immunotherapy...

Extranodal natural killer / T-cell lymphoma in the head and neck

The authors present a retrospective single institution review of patients with a very rare variant of non-Hodgkin lymphomas (NHL). They report on the occurrence, clinical course and outcomes of their patients with natural killer / T-cell lymphoma (NKTCL) nasal type....

Surgery safety checklists

The time-outs were based on pre-flight checklists adopted by airline pilots and were instituted in all accredited hospitals and ambulatory care centres in the United States in 2003. The guidelines originate from general surgery and are not specific for the...

Virtual reality simulation training for cochlear implant surgery

Temporal bone virtual reality (VR) simulation training has been shown to be a useful tool for learning mastoidectomy. The authors aimed to evaluate the role of VR in cochlear implant (CI) surgery. The study was performed as part of a...

CI outcome measures and different languages

Outcome measures for hearing rehabilitation strategies in children are the subject of endless debate. The underlying problem with measuring outcomes in this population is delineating the extent to which development (which is in itself variable) and hearing ability (usually the...

What is the right balance to strike in the management of anaplastic thyroid cancer?

This is a pragmatic article on a difficult and much debated subject. Management of anaplastic thyroid cancer (ATC) can feel like making decisions between a rock and a hard place, and this article suggests one path to help navigate some...

Cochlear implants in single sided deafness

Whilst the benefit of a second cochlear implant in people with bilateral deafness is well established, the benefits of implantation for single sided deafness with normal contralateral hearing have been much more modest. The reasons for this are varied, in...

Patient factors associated with spontaneous CSF leak

This article highlights the role of obesity, sleep apnoea and raised intracranial pressure as linked pathologies in the aetiology of the spontaneous cerebrospinal fluid (sCSF) leak. The authors link sCSF leak with obesity and comment on sCSF leak incidence increasing...

Is the greater auricular nerve important in parotid surgery?

The greater auricular nerve (GAN) is often partially or totally sacrificed during parotidectomy procedures. This was a retrospective study comparing auricular sensation and quality of life in patients that either had their GAN preserved or sacrificed. In the shortterm, patients...