Transcervical pharyngeal pouch stapling.

Background: Pharyngeal pouches are generally treated with surgery, via either an endoscopic or an external approach. Large pouches extending to the mediastinum carry an increased risk of post-operative mediastinitis in the event of a leak following external approach surgery, and may not always be amenable to endoscopic stapling.

Methods: Transcervical stapling is a newly described technique that uses the endoluminal stapling approach but in which the diverticuloscope is inserted into the pharynx via a neck incision.

How we do it: 'tonsil swabs please' - an alternative use in open neck surgery.

Background: Thyroid and parathyroid surgery often involves the use of heated instruments for dissection. Whilst these are beneficial, accidental thermal damage to the exposed skin edges can occur, resulting in an unsatisfactory cosmetic outcome. Tonsil swabs can be used in head and neck surgery intra-operatively to control bleeding.

Malignancy rates and initial management of Thy3 thyroid nodules in a district general hospital: The 'Reading' experience.

Background: Ultrasound-guided fine-needle aspiration cytology is the gold standard for investigating thyroid nodules. Stratifying the Thy3 thyroid nodule risk of malignancy is essential for clinical decision-making. According to the Royal College of Pathologists Guidance (2016), the rate of malignancy for Thy3a is 5-15% and for Thy3f 15-30%.

Preventing trauma during rigid oesophagoscopy in the edentulous patient: how I do it.

Background: Rigid oesophagoscopy is a widely used therapeutic and diagnostic procedure. Smooth friction-free insertion of the rigid scope is important to prevent oral and oesophageal mucosal damage, as such damage can cause delays in oral intake or more serious complications such as perforation. Protection appliances such as gum guards are useful adjuncts to cushion the teeth in rigid oesophagoscopy; however, there are no specific adjuncts for the edentulous patient.