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The newest robot from da Vinci – what can it offer for hypopharyngeal cancer surgery?

The standard existing da Vinci surgical robot (the Si model) has been much maligned for not being optimally designed for transoral access and endoscopic manoeuvrability in head and neck surgery. This preclinical work from Holsinger and his team looks at...

Preventing major postoperative haemorrhage following TORS

Transoral robotic surgery (TORS) has become an increasingly utilised treatment modality in the management of oropharyngeal squamous cell carcinoma (OPSCC). Postoperative haemorrhage, although uncommon, is a significant complication. To ameliorate this risk, transcervical ligation of branches of the external carotid...

Which da Vinci surgical system? Novel flexible, single-port versus current multiport, rigid-arm robotic surgical system

The da Vinci robotic surgical system has transformed how oropharyngeal head and neck surgery can be delivered. The existing da Vinci Si model has challenges: the dimensions of this are larger than would be ideal for head and neck surgery...

Risk factors for TORS treatment failure in HPV-related oropharyngeal cancers

HPV-related squamous cell cancers are an increasingly common cause of malignancy in the oropharynx. There is evidence that these cancers are associated with a significantly improved overall survival compared to conventional HPV-negative tumours. The optimal treatment for such cancers is...

Endoscopic Approaches to the Parsanasal Sinuses and Skull Base

This is an excellent book to cover the endoscopic approaches to the paranasal sinuses and skull base with a step-by-step anatomic dissection guide. The editors are a group of eminent skull base otolaryngologists and neurosurgeons in Barcelona, Spain, and they...

The pioneer of precision: Wolfgang Steiner and the evolution of transoral laser surgery

It is rare that a single clinician entirely changes the course of the management of a particular condition. Steiner was one such clinician. Wolfgang Steiner was to transoral laser microsurgery what Grandmaster Flash was to hip-hop or James Brown was...

Transoral Laser Microsurgery of Benign and Malignant Lesions

Published in 2016, this is a textbook that I have cited and recommended in a number of talks on transoral laser microsurgery (TLM). The content and layout is very similar to that of Steiner and Ambrosch’s Endoscopic Laser Surgery of...

Medical control of allergic rhinitis in children

The authors of this randomised trial aim to answer an important question – which is better: daily versus on demand use of intranasal steroids (fluticasone probionate) or antihistamines (levocetirizine dihydrochloride) for symptomatic control of allergic rhinoconjunctivitis secondary to pollen? The...

Narrow band imaging in the management of carcinoma of unknown primary

This was a retrospective study to assess the utility of narrow band imaging (NBI) in the detection of a primary site in carcinoma of unknown primary (CUP). Patients with CUP who underwent transoral robotic surgery (TORS) and preoperative imaging with...

Advances in surgical innovation for head and neck cancer

This article reviews current advances in surgical treatment of head and neck cancers such as sentinel node biopsy, stereolithic modelling, transoral robotic surgery and intra-operative imaging of tumour margins. Sentinel node biopsy has been found to be especially useful for...

What is the evidence for contralateral tonsillectomy in TORS for known unilateral tonsil malignancy?

The concept of field changes by carcinogens within the upper aerodigestive tract is well established with reported rates of synchronous tumours of 4% and second primaries of 36%. The tonsil in particular has the highest rate of synchronous tumours, postulated...

Contemporary UK experience of oropharyngeal transoral laser microsurgery

It is well recognised that the current emergence of HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) as a distinct disease entity requires a fresh look at standard treatment modalities that are based on chemoradiotherapy for stage III/IVa OPSCC. The Newcastle experience...