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Pre-habilitation in head and neck cancer – a literature review to guide best practice

Curative treatment of head and neck cancer (HNC) often requires surgery; however, outcomes are impacted by the complexity of the surgery and the patient population. Increasingly ‘Enhanced Recovery After Surgery’ (ERAS) protocols are being used to maximise patient outcomes and...

Steroids pre-FESS

This meta-analysis and systematic review from the Netherlands and the UK aims to answer the question of whether corticosteroids inhaled and / or taken orally are beneficial to patients with chronic rhinosinusitis undergoing functional endoscopic sinus surgery. Refreshingly 18 RCTs...

Do spreader grafts improve nasal airflow?

This Portuguese study looks at pre- and postoperative peak nasal inspiratory flow (PNIF) in 72 consecutive patients undergoing septorhinoplasty surgery. The aim was to demonstrate the functional value of spreader graft insertion, the aesthetic value having already been confirmed. In...

Risk factors for post laryngectomy fistula

This is a meta-analysis looking at the postoperative pharyngocutaneous fistula rates following total laryngectomy. The authors ended up with 34 studies with about 2500 patients. The most striking finding was that preoperative radiotherapy was a significant risk factor as well...

Predictors of complications in patients undergoing oral cavity cancer surgery

Surgical management of oral cavity cancers is complex, frequently involving extensive resections and complicated reconstructions. Quantification of risk in an individual patient may allow surgeons to more effectively identify patients at higher risk of complications and develop strategies for prevention,...

Ultrasound assessment of metastatic disease

This Japanese study of 10 patients over 15 years, assesses the role of ultrasonography in assessing metastatic disease to the thyroid gland, specifically renal clear cell carcinoma (RCCC). Whilst uncommon, the authors state that there is a favourable prognosis when...

Hyperbaric oxygen therapy and flap reconstruction: does it help?

This is a multicentresite retrospective review from four clinics in the USA on patients who received radical debridement and free flap reconstruction for osteoradionecrosis (ORN) between 1 Jan 1995 and 30 June 2011. Patients were stratified divided based on having...

Experience on the front line

21st January 2021 Back to basics Yesterday I went right back to where my medical career began. I grew up in Germany, bilingual. A prerequisite to studying medicine in Germany is that applicants have to spend two months working as...

Detecting postoperative cholesteatoma with diffusion weighted magnetic resonance imaging

Middle ear cleft cholesteatoma is an inflammatory disease that erodes local bony structures and can cause otorrhea, hearing loss, vertigo and intracranial complications. It is usually treated with surgery, typically canal wall up (CWU) or canal wall down (CWD) surgery....

Measuring client-centred outcomes in audiology: towards a parsimonious solution

From an international driver to the client-centred care model; in this article Anthony Hogan explores outcome measures for individual goal setting and measuring those outcomes. Introduction When people present for hearing help, they are typically looking for solutions to the...

Can we predict risk of adverse events preoperatively in patients undergoing head and neck cancer surgery?

Ed’s Choice reviews a paper aiming to create a reliable index to predict postoperative outcomes in head and neck cancer patients. This interesting study identifies variables that may assist in risk assessing prospective surgical candidates. There have been a few...

Don’t smoke after a septoplasty!

This is a retrospective review of 281 patients, all of whom underwent elective septoplasty. Simply put, those who smoked displayed a much higher postoperative septal perforation rate than those who did not. So, some cautionary advice for patients undergoing this...