Implementation of the Symptom Based Risk Calculator for Head and Neck Cancer HaNC-RC v.2 Post COVID-19 Pandemic. A Single Centre Audit.

Background: As the incidence of head and neck cancer continues to rise, the volume of referrals to our urgent suspected cancer clinics continues to rise with it. Cancer referral and review time targets are not being met within the UK, and our centre has experienced an increase in volume of referrals which cannot be met by available clinic slots. We proposed a pathway to the North East London Cancer Alliance to safely triage these patients using the Head and Neck Cancer Risk Calculator version 2 (HaNC-RCv2).

Eagle syndrome and carotid artery dissection: a rare skull base cause of stroke.

Eagle's syndrome is a rare collection of symptoms that occur secondary to an elongated styloid process or calcified stylohyoid ligament irritating its surrounding structures. Classically, this presents as unilateral throat pain or rarely, as acute neurological symptoms secondary to compression of the internal carotid artery: so called 'stylocarotid syndrome'. Significant neurological events in teenagers, secondary to Eagle syndrome have not been reported.

Endoscopic removal of ectopic dentition in ethmoid sinus.

A 66-year-old woman presented with a 6-month history of unilateral right nasal obstruction and rhinorrhoea not responding to medical therapy. She had a history of dental implantation for an unerupted tooth on the right side 3 years ago. Physical examination including flexible nasendoscopy demonstrated yellow debris in the right middle meatus.

Surgeon-performed ultrasound in a head and neck surgical oncology clinic: saving time and improving patient care.

Introduction: Surgeon-performed ultrasound (SUS) for head and neck masses is increasingly being performed by head and neck surgeons. This is the first study assessing its impact in a head and neck surgical oncology clinic, examining the effect on various parameters.

Methods: Retrospective analysis was conducted on a database, analysing and comparing all new patients reviewed 6 months prior to (pre-SUS group) and 6 months following (post-SUS group) the introduction of SUS to the outpatient head and neck surgical oncology clinic.

Multiple Upper Aerodigestive Tract Masses Presenting With Stridor-A Rare Case of Aggressive Multifocal Extramedullary Plasmacytoma.

Extramedullary plasmacytomas represent a rare group of B-cell malignancies that arise outside the bone marrow and their disease process is still poorly understood. Here, we will describe a case of a 76-year-old patient who presented with a large chest wall and subglottic mass causing airway compromise and stridor. Biopsies showed atypical plasma cells with prominent nucleoli which were in keeping with an extramedullary plasmacytoma.

Cervical Nodal Metastatic Pituitary Carcinoma: A Case Report.

Pituitary carcinomas are rare tumors with only 170 cases reported in the literature. They form a very small proportion of pituitary tumors, which are commonly benign adenomas. Metastatic disease diagnosed by fine needle aspiration cytology is extremely rare and has only been reported in 6 patients, 3 of whom had cervical nodal metastases, with other sites of metastases being the liver and cervical vertebra.

Survival outcomes for head and neck cancer patients with N3 cervical nodal metastases.

Background: Management of metastatic N3 nodal disease from primary head and neck squamous cell carcinoma (HNSCC) is controversial. Recently, there has been a move to observation of the neck for those who achieve complete response (CR) after chemoradiotherapy (CRT). We sought to determine survival outcomes for N3 nodal disease, particularly for patients with human papilloma virus (HPV)-positive HNSCC.

Diagnostic performance of high resolution computed tomography in otosclerosis.

Aim: To determine the sensitivity and specificity of high resolution computed tomography (HRCT) in the diagnosis of otosclerosis.

Methods: A systematic literature review was undertaken to include Level I-III studies (Oxford Centre for Evidenced based Medicine) that utilised HRCT to detect histology confirmed otosclerosis. Quantitative synthesis was then performed.

Prosthetic reconstruction of the trachea: A historical perspective.

This review discusses the history of tracheal reconstruction; from early work to future challenges. The focus is primarily on prosthetic tracheal reconstruction in the form of intraluminal stents, patch repairs, circumferential repairs and replacement of the trachea. A historical perspective of materials used such as foreign materials, autografts, allografts, xenografts and techniques, along with their advantages and disadvantages, is provided.

When continuous positive airway pressure (CPAP) fails.

Obstructive sleep apnoea (OSA) is increasingly prevalent, particularly in the context of the obesity epidemic, and is associated with a significant social, health and economic impact. The gold standard of treatment for moderate to severe OSA is continuous positive airway pressure (CPAP). However compliance rates can be low.

Massive lipoma of the posterior neck.

Giant lipomas are a rare, benign cause of painless neck mass. We describe the case of a 63-year-old man with a giant lipoma of the left posterior neck, which presented with intermittent upper limb paraesthesia. Surgical excision confirmed the diagnosis of spindle-cell lipoma and resulted in complete resolution of neurological symptoms.

Otorhinolaryngological aspects of sleep-related breathing disorders.

Snoring and obstructive sleep apnoea (OSA) are disorders within a wide spectrum of sleep-related breathing disorders (SRBD). Given the obesity epidemic, these conditions will become increasingly prevalent and continue to serve as a large economic burden. A thorough clinical evaluation and appropriate investigations will allow stratification of patients into appropriate treatment groups.

Paediatric subglottic stenosis - Have things changed? Our experience from a developing tertiary referral centre.

Background: Paediatric airway disorders are common, particularly in the context of improved ventilation methods for neonates in intensive care units. Management is not standardised.

Objectives: To assess the number, severity, management and outcomes of all patients diagnosed with subglottic stenosis at a developing tertiary referral centre.

Improving efficiency and saving money in an otolaryngology urgent referral clinic.

A closed loop audit of the ear nose and throat (ENT) urgent referral clinic at a London hospital was conducted assessing the number of patients reviewed, referral source, appropriateness of referral, presenting complaint and assigned follow-up appointments. Data was sourced from clinic letters and the patient appointment system over a 3-mo period. The initial cycle analysed 490 patients and the subsequent cycle 396.

The changing face of the paediatric microlaryngobronchoscopy (MLB): A two year prospective study.

Background: Changes in the management and survival of paediatric patients with airway complaints combined with improving survival rates of premature babies have resulted in a different patient population for the paediatric airway surgeon than that previously described in the literature.

Objectives: To examine the presentation, diagnosis, clinical course and outcomes for patients undergoing microlaryngobronchoscopy (MLB).

Study Design: 2 year prospective longitudinal study.

Accuracy of clinician-clinical coder information handover following acute medical admissions: implication for using administrative datasets in clinical outcomes management.

Background: We evaluated the accuracy, limitations and potential sources of improvement in the clinical utility of the administrative dataset for acute medicine admissions.

Methods: Accuracy of clinical coding in 8888 patient discharges following an emergency medical hospital admission to a teaching hospital and a district hospital over 3 years was ascertained by a coding accuracy audit team in respect of the primary and secondary diagnoses, morbidities and financial variance.

Results: There was at least one change to the original coding in 4889 admissions (55%) and to the primary diagnosis of at least one finished consultant episodes of 1496 spells (16.

Endoscopic ear surgery: A case series and first United Kingdom experience.

Aim: To present the United Kingdom's first case series of 70 otological cases of endoscopic and non-endoscopic ear surgeries.

Methods: Prospective case series incorporating a range of endoscopic procedures performed using a 4 mm, 18 cm rigid endoscope, performed by a single surgeon at a single centre. Primary outcome measures included mean average pre and post-operative air-bone gap hearing thresholds and duration of surgery.