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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...
How best to manage single-sided deafness?
Nowadays there is a plethora of options for patients with single-sided deafness (SSD) including: Bluetooth contralateral routing of signal (CROS) aids; in-the-ear bone conduction hearing aids (TransEar); intra-oral bone conduction aids (SoundBite) and bone-anchored technologies (BAHA). Unilateral cochlear implantation is...
Preoperative CT checklist (using the ‘CLOSE’ mnemonic) improves identification of anatomical variants for endoscopic sinus surgery
Computed tomography (CT) scans of the paranasal sinuses act as roadmaps for endoscopic sinus surgery (ESS) and careful inspection preoperatively warns the operating surgeon of critical anatomical variants. This study aimed to investigate if implementation of a pre-ESS CT checklist...
A review of DISE classification systems
This article looks at the wide variety of classification systems currently available for interpreting drug induced sleep endoscopy (DISE).The fact that there are so many classification systems, suggests that there is: A) a lot of disagreement about how DISE should...
SPECT scans not justified in growth of the mandibular condyle
This is a paper from Hong Kong of 200 patients between January 2011 and July 2013 who underwent SPECT bone scintigraphy for assessment of growth causing condylar hyperplasia and subsequent mandibular asymmetry. Thirty-four patients were found to have active growth...
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...
Shoulder function in patients undergoing neck dissection: its effects on work and leisure activities
Shoulder dysfunction is common after neck dissection and includes shoulder pain, limited abduction and scapular winging. Modifications of the radical neck dissection were designed to limit morbidity, however, even with accessory nerve-sparing neck dissections, shoulder dysfunction can be seen. Shoulder...
Identifying early flap failure
The holy grail of flap monitoring is an easy, reliable and predictive method to identify impending compromise. Does this paper provide it? Various methods have been used to improve our ability to monitor the viability of a flap and here...
Guidelines for management of orbital infections
Orbital infections predominantly affect the paediatric population and complications can be very serious. The cellulitis can be preseptal or orbital and the abscess can be confined within the periosteum or extend into the orbit. Cavernous sinus thrombosis can complicate the...
Margin control using optical techniques in head and neck surgery
Emerging optical techniques such as high-resolution microendoscopy (HRME) are currently being examined for their reliability in discriminating benign from neoplastic epithelium. These techniques may offer the potential to detect the margin of an upper aerodigestive tract tumour in a non-invasive...
Endoscope assisted removal of jugular foramen schwannomas
This article, written by a renowned surgeon with extensive experience in removal of jugular foramen and skull base lesions, describes a new classification for jugular foramen schwannomas (JFS) and a template for selection of surgical approach for endoscope assisted removal....
