Management of Recurrent HPV-Positive Oropharyngeal Squamous Cell Carcinoma: a Contemporary Review.

Purpose Of Review: To review the impact of contemporary treatment strategies on salvage outcomes in patients with recurrent human papilloma virus-positive oropharyngeal squamous cell carcinoma (HPV + OPSCC).

Recent Findings: Secondary to HPV, changes in disease biology have impacted primary treatments and subsequent approaches to patients with recurrence. With treatment strategies more inclusive of upfront surgery, the characteristics of patients with recurrence HPV + OPSCC have been further redefined.

Review article: Topical antibiotic treatments for acute otitis externa: Emergency care guidelines from an ear, nose and throat perspective.

Acute otitis externa (AOE), also known as 'swimmer's ear', is a common acute problem. It is one of the most common ED presentations. Atypical organisms, recalcitrant disease and antibiotic options contribute to making AOE a clinical challenge.

Sport-Related Structural Brain Injury and Return to Play: Systematic Review and Expert Insight.

Background: Sport-related structural brain injury (SRSBI) is intracranial pathology incurred during sport. Management mirrors that of non-sport-related brain injury. An empirical vacuum exists regarding return to play (RTP) following SRSBI.

Therapeutic implications of immune-profiling and EGFR expression in salivary gland carcinoma.

Background: Data relating to the efficacy of immune checkpoint inhibitors (ICI) for salivary gland carcinomas (SGC) is gradually evolving with responses varying among different histotypes. To address these disparities, this retrospective analysis examined the prevalence of recognized biomarkers of response to ICI; namely programmed death-1 (PD-1), programmed death-ligand 1 (PD-L1), combined positive score (CPS), epidermal growth factor receptor (EGFR), and microsatellite instability (MSI) in patients with SGC with an aim to determine any prognostic or survival benefits and stratify the use of ICI in this disease.

Patients And Methods: Of 52 patients with primary SGC eligible for this study, the most common histological types were adenoid cystic carcinoma (n = 17, 33%), salivary duct carcinoma (n = 14, 27%), mucoepidermoid carcinoma (n = 11, 21%), and acinic cell carcinoma (n = 6, 11%).

Predictive Value of Preoperative and Intraoperative Neurophysiology in Evaluating Long-term Facial Function Outcome in Acoustic Neuroma Surgery.

Objective: To determine the role of neurophysiological preoperative and intraoperative parameters in providing prognostic information regarding facial nerve (FN) function at 1 year after translabyrinthine acoustic neuroma (AN) resection surgery.

Study Design: Prospective observational study in a tertiary referral center. Patients treated via translabyrinthine surgical approach for sporadic AN microresection between December 2015 and 2018.

Management of advanced adenoid cystic carcinoma infiltrating the skull base: a contemporary review.

Introduction: This article provides an overview of the natural history and management of adenoid cystic carcinoma infiltrating the skull base (SB ACC).

Methods: A comprehensive review of the available literature and discussion regarding the current management of SB ACC.

Results: This review describes the unique pathology, appropriate diagnostic work-up and contemporary management options in SB ACC.

Cerebral Venous Sinus Thrombosis After Translabyrinthine Vestibular Schwannoma-A Prospective Study and Suggested Management Paradigm.

Objective: To prospectively evaluate the incidence, risk factors and natural history of postoperative cerebral venous sinus thrombosis (pCVST) in translabyrinthine vestibular schwannoma microsurgical resection and propose a potential management paradigm.

Study Design: Prospective, single cohort, multicenter study.

Setting: State-wide academic tertiary referral centers.

Advanced adenoid cystic carcinoma of the skull base - The role of surgery.

Background: Adenoid cystic carcinoma (ACC) is a salivary gland malignancy with a propensity for perineural spread and diffuse soft tissue infiltration. In the head and neck this unique biological behaviour can result in skull base involvement. A lack of consensus regarding management of ACC involving the skull base in conjunction with the technical and reconstructive challenges of oncological resection in this region has led to variation in practice between institutions.

Paediatric inhaled airway foreign bodies: An update.

Background: Given the often subacute nature of airway foreign bodies (AFB), which may have no or limited symptoms, patients with AFB sometimes present to general practitioners (GPs). It is important that AFB are promptly recognised and referred for appropriate tertiary management.

Objective: The aim of this paper is to outline how AFB may present in the general practice setting and review the appropriate clinical work-up and tertiary referral.

Prospective controlled cohort study of Troponin I levels in patients undergoing elective spine surgery for degenerative conditions: Prone versus supine position.

Unlabelled: Prior studies have suggested that elevated serum Troponin-I (TnI) levels immediately after non-cardiac surgical procedures (8-40%) represent subclinical cardiac stress which independently predicts increased 30-day mortality. Routine post-operative TnI monitoring has therefore been suggested as a standard of care. However, no prior studies have focussed on elective degenerative spine surgery, whilst few have measured pre-op TnI.

A small animal model for early cerebral aneurysm pathology.

Prior studies, using systemic hypertension and elastase infusion, have induced cerebral aneurysm (CA) formation in mice. However, the CAs induced were rapidly formed, relatively large, and often ruptured. These features are not completely representative of human CAs.

Post-traumatic amnesia.

Of patients hospitalised for traumatic brain injury (TBI), most pass through a state of altered consciousness known as "post-traumatic amnesia" (PTA). Despite the lack of a consistent definition, PTA is widely used as a construct in neurosurgical practice to guide decision-making and prognosis. Accurate PTA assessment is important, because over-evaluation leads to excess social, financial and opportunity costs, whilst under-evaluation risks patient welfare.

Blocked ventriculoperitoneal shunt causing raised intracranial pressure diagnosed by prominent sinus pericranii.

We present a 3.5-year-old male infant who had been treated at 3 weeks of age with a ventriculoperitoneal (VP) shunt for intraventricular haemorrhage with resultant hydrocephalus. Since his initial treatment he had normal developmental milestones.

In vivo assessment of hydrocephalus shunt.

Objectives: Over a 3-year period, we have performed 312 tests in 197 shunted patients. The data have been analyzed retrospectively to: (1) investigate the parameters describing CSF dynamics that correlate with shunt under-drainage and (2) estimate accuracy of this method.

Methods: Constant rate infusion tests into shunt prechamber were performed.

Bilateral trigeminal neuralgia associated with limited systemic sclerosis.

A young patient with limited systemic sclerosis and medically resistant bilateral trigeminal neuralgia was successfully treated with microvascular decompression. To our knowledge, this is the first published report of this type of case.

Intracranial pressure: more than a number.

Many doctors involved in the critical care of head-injured patients understand intracranial pressure (ICP) as a number, characterizing the state of the brain pressure-volume relationships. However, the dynamics of ICP, its waveform, and secondarily derived indices portray useful information about brain homeostasis. There is circumstantial evidence that this information can be used to modify and optimize patients' treatment.

A technique for producing demyelination of the rat optic nerves.

Demyelination is a major cause of neurological disability within the human population, and the end product of a number of pathological processes, though the most common is the disease multiple sclerosis. This disease commonly affects the optic pathway, particularly the optic nerve and chiasm. This paper reports a novel technique of producing chemical glial toxin induced demyelination in the rat optic nerves and chiasm by the direct instillation of the glial toxin ethidium bromide into the rat cranial subarachnoid space causing demyelination of the optic nerves and chiasm.

Preliminary study of shunt related death in paediatric patients.

Hydrocephalus is a condition commonly encountered in paediatric and adult neurosurgery and cerebrospinal fluid (CSF) shunting remains the treatment of choice for many cases. Despite improvements in shunt technology and technique, morbidity and mortality remain. The incidence of early shunt obstruction is high with later failures seen less frequently.

Spinal schistosomiasis.

A 23 year old female presented to Townsville General Hospital seven months after a positive urine test for Schistosomiasis with conus modularize signs. MRI confirmed a conus medullaris enhancing lesion. Serology was positive for Schistosoma IgG : IgM, 3.

Acute subdural haematomas and enoxaparin.

Townsville General Hospital (TGH) has 285 beds and serves a population of approximately 500,0000 in North Queensland. In the period November 1998 until December 1999 there were three acute subdural haematomas (ASDH) related to therapeutic doses of enoxaparin. These culminated in death or severe neurological disability.