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The role of the multidisciplinary team in laryngology and airway – the Charing Cross experience

As the National Centre for Airway Reconstruction, the Charing Cross laryngology MDT provides expert care to patients with airway problems as well as voice and swallowing disorders. In this article, the team explain their raison d’etre and why the MDT...

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...

Hearing aid microphone considerations for binaural hearing: When to select natural or aggressive directional microphone technology?

Should I use omni-directional or fixed directionality? Does it make a difference if I’m fitting a unilateral hearing loss? Mark Laureyns discusses the current evidence on directional microphones and provides practical advice on the systems and when to employ them....

Bone anchored implant stability predicted one week after implantation

Bone conduction (BC) devices can now be implanted as a single stage procedure with minimal soft tissue thinning to reduce the complications in the surrounding skin. The question of optimal loading time has to my mind not been answered. Here...

The role of artificial intelligence and applications in ENT surgery

AI is progressing apace. If you’re wondering how it might affect our working lives in ENT, read on for insights and a pilot study that show us what may be possible. The recent launch of ChatGPT, an open access artificial...

Managing the thyroglossal duct cyst

Although the operation to remove thyroglossal cysts and their tracts is commonly performed, a full understanding of the possible anatomical locations of the tracts may be less appreciated. This article helps the reader understand the possible variations available which should...

Inferior alveolar nerve recovery after ORIF fractured mandible

Mandibular fractures are quite common facial injuries, but aetiology varies with country and age. Common treatment options are open reduction and internal fixation via an intra-oral or extra-oral incision. Nerve injury or dysfunction is often seen preoperatively and may also...

Minimal or not so minimal?

Parathyroidectomy is usually a straightforward technique when the target gland has been accurately determined. Surgical excision is usually through a small midline incision. With the advent of video assisted surgery, trials have been made to use this technique in parathyroidectomy....

Pharyngocutaneous fistula after total laryngectomy

Pharyngocutaneous fistula (PCF) after total laryngectomy is a serious complication post-surgery, and can lead to prolonged hospitalisation, adding delays in postoperative chemoradiotherapy. This Turkish retrospective study looked at 166 patients who underwent total laryngectomy for laryngeal cancer, although it is...

Carotid artery involvement with head and neck metastases

This is a retrospective review of 27 patients radiologically diagnosed as having metastases involving the common or internal carotid arteries. All patients underwent a salvage neck dissection with surgical carotid peeling. Thirteen of the 27 achieved loco-regional control, five developed...

The perils of poor postop blood pressure control

This retrospective case control study reviews 621 patients undergoing thyroid surgery over a 10-year period from 2002-2012 looking at postoperative haemorrhage rates. This potentially catastrophic complication warrants close analysis in order to best discern how it can be minimised. The...

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...