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Thyroid cancer – the last decade
Professor Ashok Shaha describes the evolution in the treatment of thyroid cancer that he has witnessed over the last decade and the invaluable progress made by himself and others, from their contributions to staging systems and guidelines. Nuances and paradigm...Old age is hard to swallow
This article takes us through the diagnosis and management of swallowing problems common in older age. As our global population continues to grow and live longer, dysphagia will continue to be a global problem which needs to be recognised, understood...Elasticated retraction in head and neck surgery – a trainee’s perspective
The effectiveness of surgical technique and satisfactory outcome is greatly dependent on good surgical exposure. Retraction requires adequate traction and counter-traction of tissues in order to expose the tissue or organ under scrutiny for the surgeon. This is a universal...
Increasing tongue strength to reduce dysphagia: what is the potential benefit of a device driven exercise?
Weakness in tongue muscle strength and laryngeal elevation is known to have an adverse impact on swallowing function. Various swallowing exercises are often recommended to improve function of these important structures with the goal of preventing aspiration and improving swallow...
Grading dysphagia as a toxicity in treating head and neck cancer
Common Terminology Criteria for Adverse Events (CTCAE) is a system used by clinicians to grade the toxicity of oncology treatments in a standardised manner. Dysphagia is perhaps the most common long-term toxicity of head and neck cancer treatment. Currently, a...
How well do different assessments of swallowing correlate with one another?
Swallowing (dys)function may be assessed by three key measures: 1. instrumental swallowing techniques such as the modified barium swallow (MBS) or videofluoroscopy; 2. functional measures of diet texture that patients can eat comfortably (usually rated by the clinician); and 3....
Predicting which oropharyngeal SCC HPV-positive patients should avoid de-escalated treatment
This study is timely for many reasons and raises very important questions in the management of the current rise in HPV-positive patients with oropharyngeal cancer (OPC). The uniqueness of this group within head and neck cancer in terms of favourable...
Preoperative risk factors: when do you need to refer to the haematologist?
It is essential that clinicians are able to identify and assess which patients are in the high risk category for bleeding during ENT surgery. A full history, including medications, herbal remedies taken, any other medical co-morbidities and family history of...Step change in care – changing the quality of life and supporting the NHS
Up to 500,000 GP appointments could be saved per annum with patient self-referral to audiology practices - easing pressure on the NHS, according to a new report.Near-miss in otolaryngology head and neck surgery
It is recommended by John Fenton that we as a specialty need to embrace the concept of, take responsibility for and learn from all near-miss events, rather than our traditional haphazard approach of an occasional educational anecdote or case report....
