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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...

The sentinel lymph nodes revisited

The concept of sentinel lymph node sampling has been around for some time. However, its acceptability in routine head and neck practice has yet to be established. This article presents the authors’ experience in 10 patients with Merkel cell carcinoma...

To scan or not to scan?

This comprehensive review article seeks to establish how useful is MRI in the evaluation of patients with a history of smell loss or distortion. Interestingly, while some studies found the imaging unhelpful, one paper described found a 25% rate of...

Core biopsies are good enough for lymphomas

This paper, from the South of England, has reviewed ultrasound-guided core needle biopsies over a six-year period investigating the use of the detection of head and neck lymphomas. There were 367 samples included from 226 patients; 215 of the 226...

A safe and useful surgical procedure for allergic rhinitis?

Although the best management of allergic rhinitis is medical, intractable cases are not uncommon. Immunotherapy helps but is more practical if there is a single allergen involved. The authors compare the effects of submucosal inferior turbinoplasty alone with submucosal turbinoplasty...

Can you hear the speech disorder?

Dysarthria is often the first or most pronounced feature of a Parkinson’s disease (PD) presentation, yet may be difficult to discern from normal ageing changes that impact voice and speech. Thus, it is important to be able to differentiate in...

Is bone scanning still of value?

This is an article from Australia of 109 patients, 83 of which had CT, 72 MRI and the presence of bone invasion on imaging was compared with the histopathology. Bone invasion was present in 44 of 109 resection specimens. Bone...

Differences between paediatric and adult cholesteatomas

An understanding of the differences between adult and paediatric cholesteatomas should be helpful in more effective management of the disease in children. In this study, the authors focused their comparison between paediatric and adult cholesteatomas to the operative findings, rates...

One anastomosis or two

This is a cumulative meta-analysis from Hong Kong reviewing 27 articles and a total of 7,389 flaps. The authors, at the outset, acknowledge that the number of anastomoses is not the only factor of venous compromise and flap failure. Nonetheless...

Objective testing for Eustachian tube dysfunction

Eustachian tube dysfunction (ETD) is typically diagnosed based on subjective symptoms and examination leading to wide variation in its diagnosis and management. The search for an objective test has looked at ways of measuring the passage of air through the...

Are upper respiratory symptoms and macroscopic changes in children always due to gastro-oesphageal reflux?

In children, symptoms such as chronic cough, wheezing, stridor, voice changes, persistent asthma and dental erosion are often presumed to be due to gastro-oesophageal reflux and empirical treatment with PPIs is offered. Usual investigations, such as a barium meal, gastroscopy...

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