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Head and neck cancer and PET-CT

Positron emission tomography-computed tomography (PET-CT) is an imaging technique in which abnormalities of tissue metabolism are precisely superimposed onto the anatomy. It relies on the premise that malignant cells are more metabolically active compared with non-malignant cells. On this basis,...

Salivary Gland Neoplasms

Salivary Gland Neoplasms is another useful addition to the Advances in Otolaryngology series. This issue (Vol 78) sees Prof Patrick Bradley (Nottingham) and David Eisele (Baltimore) co-edit a 206-page edition, nicely divided into 23 chapters, covering basics like molecular pathology,...

The stigma of HPV in oral cancer

The increase of oropharyngeal carcinoma (OPC) in the developed world seems to be largely caused by infection with the human papillomavirus (HPV). HPV is a group of 150 DNA viruses that are common and most people will be infected at...

The unknown primary again

In this retrospective study of 35 patients, the authors followed a systematic protocol for the detection and management of malignant cervical lymph nodes without an apparent primary lesion. Although their one, three and five year survival results are consistent with...

Resection margins in head and neck surgery

Although an increasing proportion of head and neck malignancies are treated with non-surgical modalities, when surgery is undertaken an incomplete clearance results in significantly worse prognosis. However, the intraoperative assessment of an adequate margin is difficult. The personal practice of...

Brown classification of a maxillary defect and prognosis

This is a retrospective study from Peking over the 10-year period, 2000-2010, for 137 patients with maxillary squamous cell carcinoma assessed. The overall survival rate was comparable with other studies at 64.8%. The most common Brown maxillary defect was 2b...

Endoscopic transsphenoidal surgery versus dopamine agonist therapy for microprolactinomas

This study addresses the importance of the location of microprolactinomas in determining prognosis after surgery. Long-term dopamine agonist treatment is the current standard of treatment for microprolactinomas. However, patients often seek surgical removal. The authors of this study retrospectively analysed...

Sinonasal undifferentiated carcinoma – slowly getting there

The rarest of the rare, sinonasal tumours form only a small part of the total number of head and neck tumours and undifferentiated carcinoma (SNUC) is one of the rarest of this group. There is some data (and some expert...

Red flag head and neck cancer symptoms

This was a prospective study of 1589 patients that were enrolled in the Scottish Audit of Head and Neck Cancer between 1999 and 2001. It recorded their presenting symptoms and assessed their long-term survival with respect to symptoms and subsites...

What should be considered a ‘close’ margin in oral cavity squamous cell carcinoma?

Achieving clear margins during surgical resection in oral cavity squamous cell carcinoma (OCSCC) is thought to reduce local recurrence (LR) and improve prognosis; however, what constitutes a clear, close, or involved margin is inconsistent in the literature and in practice....

Indication and timing of electrodiagnostic tests in facial palsy

This excellent review describes the benefits and limitations of electrodiagnostic testing for patients with facial paralysis. Tests such as Schirmer, stapedial reflex and electrogustometry have been largely replaced by neurophysiologic tests like nerve excitability test (NET), electroneuronography (ENoG), surface electromyography...

Adjuvant intratympanic steroid therapy in sudden sensorineural hearing loss

Sudden sensorineural hearing loss (SNHL) means abrupt hearing loss by 30dB affecting three consecutive frequencies within 72 hours. This is treated by high tapering doses of systemic steroids, the role of which is controversial and fraught with possible complications in...