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‘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...

Best timing for post-treatment PET-CT scans in head and neck cancer

Unfortunately we know that the recurrence rate for head and neck cancer can be high, up to 30-50% in some series. These recurrences tend to occur within the first two years following treatment. Optimal surveillance strategies to detect recurrences early...

Botox application for drooling shrinks salivary glands

The large majority of sialorrhoea (drooling) in paediatric patients is managed conservatively. However in severe cases, often where there is associated developmental delay or a motor disorder, medical and surgical techniques can be used to decrease salivary flow. Botulinum toxin...

British Skull Base Society Clinical Consensus Document on Management of Head and Neck Paragangliomas (HNPGLs)

All forms of HNPGLs should be managed by a multidisciplinary team (MDT) of core members from skull base otolaryngology, head and neck surgery, clinical genetics, oncology, endocrinology, vascular surgery, radiology and pathology. Extended members include neurosurgery, endocrine surgery, nuclear medicine,...

Acoustic Immittance Measures: Basic and Advanced Practice

Writing a short yet comprehensive textbook to explore the vast and developing field of acoustic immittance measures seems like a challenge. This book aims to explore the core concepts behind immittance testing and provide an update on recent developments within...

Prognostic value of vascular ultrasonographic findings in patients with idiopathic sudden sensorineural hearing loss

Sudden sensorineural hearing loss is often idiopathic. Although the aetiology of idiopathic sudden sensorineural hearing loss (ISSNHL) is unclear, vascular compromise is one of the frequently proposed hypotheses to explain its pathophysiology. Existing studies have shown an association between ISSNHL...

Pulsatile tinnitus, one more piece in the jigsaw

Pulsatile tinnitus (PT) is a common ENT symptom. It can generally be divided into venous and arterial. Arterial PT might be investigated with a CT scan while a venous one with an MRI or an MRV (MRI Venogram). Anecdotally, arachnoid...

Reducing the risk of Frey’s syndrome after parotidectomy – which methods are best?

Gustatory sweating or Frey’s syndrome is a well-recognised complication of parotid surgery. The reported incidence is highly variable, from 4% to 96%, with around 30% of patients reporting symptoms. A number of intraoperative techniques can be used to reduce the...

Combination PPI and intralesional steroid treatment for recurrent laryngeal granuloma

The existence of a wide range of treatments for recurrent laryngeal granulomas (repeat surgery, high-dose proton pump inhibitor (PPIs), surgery with botulinum toxin injection, botulinum toxin injection alone, etc) is a testament to the refractory nature of this condition, with...

Pharmacologic treatment options for tinnitus

This article summarises potential medications that could be used to treat tinnitus and the evidence behind their use. Effective medications to eliminate tinnitus remain elusive but treatment could be divided into two broad categories: treatment to reduce perception of tinnitus...

Active smoking predicts poor outcome in HPV positive oropharyngeal squamous cell carcinoma

Tobacco smoking is a well-known risk factor in human papilloma virus (HPV)-negative head and neck squamous cell cancer. Its effects include increased risk of treatment failure, distant metastases and reduced overall survival. HPV has been increasingly implicated as a causative...

Tonsillectomy in or out?

Although tonsillectomy is the most common surgical act performed in ENT practice, there is still some concern about the safety of outpatient or day surgery scheduling, especially in adults. Although this has been common practice in many departments for some...