Preoperative and postoperative optimisation of patients undergoing thyroid surgery: a multicentre quality improvement project at Barts Health NHS Trust.

Hypocalcaemia following thyroid surgery can occur in up to 38% of patients. With over 7100 thyroid surgeries performed in 2018 in the UK, this is a common postoperative complication. Undertreated hypocalcaemia can result in cardiac arrhythmias and death.

Primary Immunoglobulin G4-Related Laryngeal Disease: A Case Series and Review of Literature.

Objective: Immunoglobulin G4-related disease (IgG4-RD) is an increasingly recognised cause of various systemic fibro-inflammatory conditions. However, laryngeal involvement as a primary feature is extremely rare. We aimed to report on a case series of such patients and examine the global literature relating to laryngeal involvement.

Atypical F-FDG PET-CT uptake in the head and neck; a case-based pictorial review.

Positron emission tomography - computed tomography (PET-CT) with fluorine-18-fluorodeoxy-d-glucose (F-FDG) has an increasing role in head and neck imaging. Interpretation of F-FDG-tracer uptake in the head and neck requires an understanding of normal physiological patterns of tracer uptake, as well as knowledge of potential pitfalls and atypical patterns. This article presents a select series of unusual patterns of F-FDG uptake on PET-CT imaging of the head and neck.

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.

Feasibility of a synthetic temporal bone for training in mastoidectomy: face, content, and concurrent validity.

Objective: To investigate the face, content, and concurrent validity of the synthetic Pettigrew temporal bone (PTB) for mastoidectomy training as compared with cadaveric temporal bone (CTB).

Study Design: A prospective evaluation study.

Methods: Participants were invited to perform a step-by-step modified radical mastoidectomy using both bones and complete a 22-item, 5-point Likert scale questionnaire.

A multidisciplinary audit of head and neck referrals: considerations for patients' timelines and outcomes.

The Rapid Diagnostic Clinic (RDC) was introduced to comply with NICE recommendations for improving head and neck cancer services (National Institute of Clinical Excellence 2004 Improving outcomes in head and neck cancer: the manual. NICE, London). It provides multi-modality specialist assessment for new referrals, with on-site sonography and cytology.

Branchiootic syndrome--a clinical case report and review of the literature.

Branchiootoic syndrome is part of the spectrum of brachiootorenal disorders. Brachiootorenal disorder is a rare autosomal dominant condition, characterized by malformations of the outer, middle, and inner ear, which are associated with branchial and renal anomalies. We describe a case of bilateral branchiootoic syndrome and discuss the anatomy of second branchial cleft fistulae and the surgical management of this uncommon condition.

Free jejunum reconstruction of upper esophageal defects.

The free jejunum has become an important method for reconstructing extensive oncologic defects of the upper esophagus and pharynx. The advantages of a single-staged reconstruction with a low incidence of morbidity have generally outweighed criticisms such as the requirement for a laparotomy and poor voice quality. The aim of the study was to present the technique and outcomes of free jejunal reconstruction of the upper esophagus in 31 consecutive cases.

Outcome of treating airway compromise due to bronchial stenosis with intralesional corticosteroids and cutting-balloon bronchoplasty.

Objectives: To determine the feasibility, safety, and efficacy of treating benign bronchial stenosis with laryngoscopy, jet ventilation, intralesional corticosteroids, and cutting-balloon bronchoplasty.

Study Design: Case series with planned data collection.

Setting: National airway unit.

The impact of mixing surgical subspecialty patients on wound infection rates.

To investigate the impact of mixing surgical subspecialty patients on post-operative wound infections. A retrospective analysis of post-operative wound infections in head and neck surgery patients before and after mixing them with urology patients. We selected two periods that are identical in duration and seasonal spread.

Outcome of endoscopic treatment of adult postintubation tracheal stenosis.

Objectives/hypothesis: To assess the results of primary endoscopic treatment of adult postintubation tracheal stenosis, to identify predictors of a successful outcome, and better define the scope and limitations of minimally-invasive surgery for this condition.

Methods: Sixty-two consecutive patients treated between April 2003 and 2006 with initial endoscopic surgery were prospectively studied. Patient and lesion characteristics, treatment details, complications, decannulation, and open surgery rates were recorded.

Operative training in otolaryngology in the United Kingdom: a specialist registrar survey.

Objective: To assess the current status of operative training for otolaryngology specialist registrars in the United Kingdom.

Design: Web-based questionnaire survey.

Participants: All otolaryngology specialist registrars in the United Kingdom.

Conjunctival melanoma: the role of conservative surgery and radiotherapy in regional metastatic disease.

Objective: To evaluate prognostic factors and determine the role of conservative surgery and radiotherapy in managing metastatic conjunctival malignant melanoma (MM) involving preauricular/submandibular lymph nodes.

Method: A retrospective analysis (1990-2003) of clinical and histopathologic data from 12 patients presenting with regional metastases after failed local treatment for conjunctival MM. Patients received a common, multispecialty, conservative management approach: wide local excision, topical cryotherapy or radiotherapy to conjunctival MM (orbital exenteration for more advanced local disease), lumpectomy, and adjuvant "ring" radiotherapy of regional metastases, with chemotherapy for distant metastases.

Pseudosarcomatous fibrovascular proliferative tissue masquerading as a primary subglottic angiosarcoma.

A unique case of pseudosarcomatous fibrovascular proliferative tissue causing biphasic stridor and simulating a primary subglottic angiosarcoma is reported. The patient presented with a wheeze and was diagnosed initially with asthma. He subsequently developed worsening biphasic stridor.

Endoscopic CO2 laser management of laryngocele.

Objective: To report on the management of laryngoceles by CO2 laser-assisted endoscopic excision.

Study Design: A 15-year retrospective study of 12 adult patients (7 men and 5 women) who presented with a laryngocele. Nine patients had an internal laryngocele, one patient had an external laryngocele, and two patients had combined internal-external components.