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Detecting cancer margins during robotic head and neck cancer surgery using ambient mass spectrometry
We have known about altered metabolism in cancer cells since Otto Warburg described it 97 years ago. But can we take advantage of this knowledge in curing cancer? Jim Higginson explains the value of smoke generated during cancer surgery. The...
Do endonasal approaches for meningiomas have more CSF leaks?
Rarely, patients presenting to the ENT surgeon with anosmia may have an anterior skull base neoplasm such as a meningioma. Historically, the traditional approaches have focused on several transcranial, external routes, including the pterional craniotomy, and the subfrontal craniotomy. 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...
Damage to the cochlear nucleus with electrocautery to the cochlear nerve
This study is of importance to neurotologists and neurosurgeons. It is unclear why patients with NF2 have poorer outcomes with an auditory brainstem implant compared to non-tumour patients. This effect is postulated to be due to damage to certain cells...
Can and should vestibular schwannoma surgery be carried out via the endoscopic transcanal approach?
The extent and scope of endoscopic ear surgery has rapidly progressed in recent years, and this paper, from one of the leading proponents of this technique, reports on the outcomes of a case series of patients who have had total...Use of a diode laser for the removal of a frontal sinus osteoma
In this How I Do It, Professor Sergei Karpischenko introduces a gentle method of reduction of mobilised frontal sinus osteoma which has been successfully used in five patients in his university clinic using a diode laser in contact mode. Osteoma...
Hearing outcomes after retrosigmoid resection of smaller vestibular schwannomas are better
The authors reviewed published literature reporting hearing outcomes in patients after retrosigmoid (RS) resection of vestibular schwannoma (VS). Aggregate hearing preservation of 31% and 35% under fixed and random models respectively was observed in the 2034 patients meeting eligibility criteria...
Carotid paragangliomas and their management
Paragangliomas in the head and neck are most frequently associated with the carotid artery, classically at its bifurcation and splaying the internal and external vessels. Despite their commonality at this site, large studies of these rare tumours are still lacking...
The increasingly favourable outcomes from endoscopic endonasal approaches for the management of pituitary adenomas
Historically, pituitary tumours have been surgically managed with an open, transcranial approach. Although this approach still has its merits in large intracranial adenomas, technological advancement has allowed smaller tumours to be debulked via a transseptal microscopic technique. These days, the...
T1 lip cancer and cervical lymph node metastases
The management of large lip squamous cell carcinoma (SCC) (T2, T3, T4 tumours) or those with nodal disease is well established. However the management of T1N0 tumours is controversial due to the assumed low risk of occult lymph node metastases....
‘Close’ surgical margin in oral tongue redefined, 2.3mm is as good as 5mm
Gold standard treatment of squamous cell carcinoma (SCC) of the oral tongue remains surgical resection of the primary tumour with negative margins. The primary goal is the complete excision of the tumour with no residual cancer cells left behind. A...
