Publications by authors named "Iain Nixon"

Post/Long COVID (syndrome) is defined as a condition with symptoms persisting for more than 12 weeks after the onset of SARS-CoV-2 infection that cannot be explained otherwise. The prevalence of self-reported otorhinolaryngological Post/Long COVID symptoms is high. The aim of this review was to analyze the current literature regarding the actual prevalence, knowledge of the etiopathology, and evidence-based treatment recommendations of otorhinolaryngology-related Post/Long COVID symptoms.

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Article Synopsis
  • - The study aimed to evaluate the safety and effectiveness of treatments for recurrent respiratory papillomatosis (RRP) in UK NHS hospitals, involving data collection from patients between April 2018 and August 2022, along with some retrospective data from earlier years.
  • - A total of 304 patients (including 65 children) were analyzed; findings showed that children had a more severe form of RRP compared to adults, with microdebrider surgeries being the most common treatment.
  • - The research concluded that RRP is more aggressive in children, treatment varies by age, and overall management was safe, with few complications and effective results; it highlighted the need for standardized reporting to better track disease progression and safety. *
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  • - The study aimed to evaluate how effective surgical loupes are in preventing complications like recurrent laryngeal nerve (RLN) palsy and hypocalcemia after thyroid surgery.
  • - A total of 813 patients from six studies were analyzed, showing that using loupes significantly reduced the incidence of temporary RLN palsy by about 41.8%.
  • - Although trends suggested lower rates of permanent RLN palsy and hypocalcemia with loupes, these results were not statistically significant, indicating potential benefits that need further research.
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Background: Iatrogenic injury of the parathyroid glands is the most frequent complication after total thyroidectomy.

Objective: To determine the effectiveness of near-infrared autofluorescence (NIRAF) in reducing postoperative hypocalcemia following total thyroidectomy.

Methods: PubMed, Scopus, and Google Scholar databases were searched.

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  • More people are getting thyroid cancer, so doctors need to better understand how risky certain thyroid nodules (Bethesda III nodules) are for becoming cancerous.
  • Different methods like special tests and scans are being studied to help figure out these risks more accurately.
  • Using both tests and scans together can help doctors make better choices for their patients, possibly avoiding unnecessary surgeries and personalizing treatment for each person.
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Poorly differentiated thyroid carcinomas (PDTC) are rare diseases; nevertheless, they account for the majority of deaths from non-anaplastic follicular cell-derived thyroid carcinomas. Establishing the diagnosis and treatment of PDTC is challenging given the low incidence and the lack of standardization of diagnostic criteria. These limitations hamper the ability to compare therapeutic modalities and outcomes between recent and older studies.

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Immunoglobulin G4-related disease (IgG4-RD) is a multi-organ disorder characterized by a highly variable clinical presentation depending on the affected organ/s, extent of tumefactive fibroinflammatory lesions, and associated functional impairment. The disease pursues a chronic, relapsing, often asymptomatic course and hence may pose a significant diagnostic challenge. Diagnostic delay can lead to progressive fibrosis and irreversible organ damage resulting into significant morbidity and even mortality.

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Objective: This study investigates the impact of primary care utilisation of a symptom-based head and neck cancer risk calculator (Head and Neck Cancer Risk Calculator version 2) in the post-coronavirus disease 2019 period on the number of primary care referrals and cancer diagnoses.

Methods: The number of referrals from April 2019 to August 2019 and from April 2020 to July 2020 (pre-calculator) was compared with the number from the period January 2021 to August 2022 (post-calculator) using the chi-square test. The patients' characteristics, referral urgency, triage outcome, Head and Neck Cancer Risk Calculator version 2 score and cancer diagnosis were recorded.

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Differentiated thyroid carcinomas (DTC) have an excellent prognosis, but this is sometimes overshadowed by tumor recurrences following initial treatment (approximately 15% of cases during follow-up), due to unrecognized disease extent at initial diagnosis or a more aggressive tumor biology, which are the usual risk factors. The possible sites of recurrence are local, regional, or distant. Local and regional recurrences can usually be successfully managed with surgery and radioiodine therapy, as are some isolated distant recurrences, such as bone metastases.

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We present a thorough review of the literature on Riedel thyroiditis (RT) with emphasis on aetiology, diagnosis and management, using the PubMed, Sinomed, and China National Knowledge Infrastructure databases. Although the exact aetiology of RT remains obscure, the histopathological features are consistent with a localized form of IgG-related systemic disease (IgG-RSD). Nevertheless, IgG4-RSD as a systemic fibroinflammatory disorder per se rarely affects the thyroid in the context of multiorgan manifestations.

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Adequate pain control enhances patients' quality of life and allows a quick return to normal activities. Current pain management practices may contribute to the crisis of opioid addiction. We summarize the evidence that evaluates locoregional interventions to decrease pain and neck discomfort after thyroidectomy.

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Vitamin D (VitD) deficiency has garnered significant attention in contemporary medical research. Although the canonical biological activity of VitD manifests itself mainly in the regulation of calcium-phosphorus metabolism, recent studies show that, thanks to the presence of numerous receptors, VitD may also play an important role in regulating the immune system. VitD deficiency has been demonstrated to impact autoimmune disease, coeliac disease, infections (including respiratory/COVID-19), and patients with cancer.

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Lymph node metastases in non-well differentiated thyroid cancer (non-WDTC) are common, both in the central compartment (levels VI and VII) and in the lateral neck (Levels II to V). Nodal metastases negatively affect prognosis and should be treated to maximize locoregional control while minimizing morbidity. In non-WDTC, the rate of nodal involvement is variable and depends on the histology of the tumor.

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Article Synopsis
  • - Surgery is the main treatment for well-differentiated thyroid carcinoma, and radioactive iodine is used for those at higher risk of recurrence; however, relapses can still happen.
  • - Patients with recurring or advanced disease often face long survival times, which may lead to the need for further treatments over time.
  • - The review discusses various treatment options like surgery, surveillance, radioactive iodine, and newer therapies, emphasizing the importance of a knowledgeable surgical team in managing thyroid cancer.
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Introduction: This study aimed to determine if post-treatment HPV cell-free DNA (cfDNA) can assist in the decision-making process for salvage neck dissection in patients following non-surgical treatment of oropharyngeal squamous cell carcinoma (OPSCC) with a partial response in the neck on imaging at 12 weeks post-treatment.

Methods: 86 patients who completed treatment were prospectively recruited through the regional multidisciplinary team (MDT). Treatment response was categorised as complete response (CR), partial response (PR) or progressive disease on 12-week post-treatment imaging.

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Article Synopsis
  • Oropharyngeal squamous cell carcinoma (OPSCC) is increasingly common and can be linked to human papillomavirus (HPV), with a new method using cell-free DNA (cfDNA) in plasma showing promise for detecting and monitoring this cancer.
  • A study involving 104 OPSCC patients demonstrated that droplet digital PCR (ddPCR) of cfDNA had a 95% agreement with standard tissue tests and was effective for tracking patient outcomes over time, especially in HPV-positive patients.
  • The results indicate that elevated cfDNA-HPV levels after treatment can predict treatment failure and recurrence, suggesting that cfDNA-HPV testing could improve clinical management of OPSCC, but further clinical trials are needed to confirm its
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Background: This study aims to investigate radiological and clinical factors which predict malignancy in indeterminate pulmonary nodules in patients with head and neck cancer (HNC).

Methods: Prospective data were collected in 424 patients who were reviewed in the NHS Lothian HNC multidisciplinary meeting from May 2016 to May 2018. Staging and follow-up CT chest imaging were reviewed to identify and assess pulmonary nodules in all patients.

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Introduction: Strengthening The Reporting Of Cohort Studies in Surgery (STROCSS) guidelines were developed in 2017 in order to improve the reporting quality of observational studies in surgery and updated in 2019. In order to maintain relevance and continue upholding good reporting quality among observational studies in surgery, we aimed to update STROCSS 2019 guidelines.

Methods: A STROCSS 2021 steering group was formed to come up with proposals to update STROCSS 2019 guidelines.

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Article Synopsis
  • - The study focuses on low-risk thyroid carcinoma and examines the various treatments available, such as open surgery and active surveillance, highlighting the lack of consensus on which treatment to choose.
  • - A systematic review of 69 studies was conducted to determine the inclusion and exclusion criteria for selecting patients with low-risk carcinomas for different management strategies, emphasizing factors like nodule size and tumor confirmation.
  • - The findings indicate significant variability in the selection criteria for different treatment methods, with open thyroidectomy still being the benchmark for evaluating alternative therapies.
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Introduction: Multifocality is increasingly observed in papillary thyroid carcinoma (PTC) due to improvements in imaging and histopathological analysis. However, its significance in management, particularly as a sole risk-factor, remains controversial. This study aimed to investigate the prognostic value of multifocality in predicting recurrence following thyroid lobectomy in a contemporary group of PTC patients managed in the UK.

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