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A systematic review of adjunctive probiotic therapy in the management of chronic rhinosinusitis

It is generally understood that administering substances containing live microbiologically active micro-organisms (probiotics) enhances the treatment of chronic rhinosinusitis. Probiotics manipulate and rebalance the alterations occurring in the local microbiome in chronic rhinosinusitis patients. This results in propagation of healthy...

Treating keloid scarring with pressure clips following excision: does it work?

Keloid scars can pose a difficult management problem. Whilst not harmful in themselves they can be cosmetically unappealing and lead to social embarrassment and resulting isolation, and following surgical excision they often reoccur. Mechanical pressure is an adjuvant to surgical...

Are organ-preserving treatment strategies for T3 laryngeal cancers reducing patient survival?

This article presents the 10-year results of a single institution’s treatment of advanced laryngeal cancer. The institution established a protocol based on the Dutch Head and Neck Society consensus document on laryngeal cancer diagnostics and treatment published in 1991. This...

Management of the neck in maxillary sinus carcinomas

Primary malignant tumours of the sinonasal tract account for less than 10% of head and neck cancers, of which the maxilla is the second most common subsite and squamous cell carcinoma (SCC) is the most prevalent histological type. Maxillary SCCs...

Should we reconsider induction chemotherapy in advanced stage laryngeal cancer?

Use of chemo-radiotherapy for advanced laryngeal cancer led to a major shift in treatment as an alternative to total laryngectomy. Despite widespread adoption of chemoradiotherapy, survival rates have not improved and the original premise of matching neoadjuvant chemotherapy tumour response...

Intraoperative identification of primary tumours in unknown primary head and neck cancer using transoral laser microsurgery with frozen sections

The aim of the study was to compare the sensitivity and specificity of intraoperative identification of primary tumours in patients with unknown primary head and neck squamous cell carcinoma (UP HNSCC) using transoral laser microsurgery (TLM) with frozen sections, with...

Prognostic value of neutrophil-to-lymphocyte ratio in HPV-positive oropharyngeal cancer

The authors propose that high neutrophil-to-lymphocyte ratio (NLR) is associated with poor disease-free survival (DFS) in patients with human papillomavirus positive (HPV+) oropharyngeal cancer (OPC). This is a retrospective study that compared the outcomes of 43 patients treated for HPV+...

Surgery plus radiotherapy keeps the helical keloid scar away

Keloid scars lead to significant psychological and cosmetic morbidity. As the pinna is a key component of facial cosmesis, pinna keloid scar formation can be aesthetically displeasing. Their stubbornness and high recurrence rate can be challenging to treat. This department,...

Robotic surgery for squamous cell cancer: the new frontiers

Although the da Vinci platform was FDA approved for early-stage oropharyngeal cancers, the indications have expanded. In this article, John Hardman explains how surgeons, with greater understanding of the strengths and limitations of robotic surgery, have systematically set out to...

ENT In this issue...Robotics in Head and Neck Surgery

Robotic surgery is here to stay. Within the specialty of otolaryngology, robotics has made headway across all of the subspecialties, although some advances may still be at the pre-clinical stage. The clinical applications are most acutely evident in the practice of head and neck cancer surgery, specifically transoral robotic surgery (TORS).

A therapeutic algorithm for tracheoesophageal periprosthetic leakage

Tracheoesophageal voice prosthesis leakage can be intravalvular (more common) or periprosthetic (focus of this study). The authors studied the causes of periprosthetic leakage among 115 patients attending for voice prosthesis management (1374 clinic attendances) treated between December 2014 to December...

The changing spectrum of cancer of the oropharynx: dilemmas and future directions

The association of HPV in oropharyngeal cancer has identified a ‘new disease’, with its unique biologic behaviour, and challenges for clinicians in selecting therapeutic combinations offering maximum efficacy and minimum morbidity or long-term sequela currently under study in clinical trials....