Nomenclature of the symptoms of head and neck cancer: a systematic scoping review.

Introduction: Evolution of a patient-reported symptom-based risk stratification system to redesign the suspected head and neck cancer (HNC) referral pathway (EVEREST-HN) will use a broad and open approach to the nomenclature and symptomatology. It aims to capture and utilise the patient reported symptoms in a modern way to identify patients' clinical problems more effectively and risk stratify the patient.

Method: The review followed the PRISMA checklist for scoping reviews.

Healing patient, harming planet? A drive towards sustainable surgery: review of waste production and recyclability of surgical instrument packaging.

Introduction: Healthcare contributes more than 1% of all domestic waste in the United Kingdom (UK), with operating theatre waste alone accounting for approximately 50% of all hospital waste. In November 2022, the UK Surgical Royal Colleges issued an Intercollegiate Climate Emergency Declaration and called for urgent action. We review waste production and the recyclability of surgical instrument packaging used in a common ear, nose and throat procedure (thyroidectomy) and suggest strategies to make this surgery more sustainable,.

Investigation of serum calcium and vitamin D levels in superior semicircular canal dehiscence syndrome: A case control study.

Objective: It remains unknown whether calcium metabolism has any effect on the clinical presentation of superior semicircular canal dehiscence (SSCD). Our aim was to analyse the adjusted calcium and vitamin D levels in SSCD patients compared to a control group.

Methods: This was a prospective case-control study performed in a tertiary referral center, university teaching hospital in the UK.

Swallowing outcomes following division of pseudo-epiglottis resulting from vertical pharyngeal closure in laryngectomy.

Background: Vertical closure of the pharynx after laryngectomy can result in an outpouch of the anterior wall of the neopharynx below the tongue base, called a pseudo-diverticulum. The prolapsed mucosa that separates the rest of the neopharynx from the pseudo-diverticulum is termed a pseudo-epiglottis.

Methods: Prospective study of patients with pseudo-epiglottis.

10-Year Experience with the Modified Pectoralis Major Flap: The Use of the Deltopectoral Flap to Reduce Skin Tension.

: Pectoralis major myocutaneous flap has been the work horse flap for head and neck reconstruction. However, due to the bulky nature of the pedicle it is not uncommon to struggle to achieve tension free closure of the neck skin incision. This case series presents a modified pectoralis major flap technique to overcome the difficulty of tight closure or the need to graft the residual cutaneous defect.

Primary care triaging of head and neck cancer referrals using the head and neck cancer risk calculator version 2: impact on a tertiary head and neck service.

Objective: This study aimed to investigate the use of the head and neck cancer risk calculator version 2 in a primary care setting and to evaluate the impact of the risk calculator on the number of referrals stratified by urgency and cancer yield.

Method: Referrals between April 2019 and August 2019, April 2020 and July 2020 (pre-risk calculator) and August 2020 and July 2021 (post-risk calculator) were analysed. Referral urgency, head and neck cancer risk calculator version 2 score, cancer diagnosis, cancer type and further investigations were recorded.

Symptom-based remote assessment in post-treatment head and neck cancer surveillance: A prospective national study.

Objectives: To report the incidence of locoregional recurrence in head and neck cancer (HNC) patients under surveillance following treatment undergoing symptom-based remote assessment.

Design: A 16-week multicentre prospective cohort study.

Setting: UK ENT departments.

Comparison of endoscopic vs microscopic ossiculoplasty: a study of 157 consecutive cases.

Purpose: The relatively new technique of trans-canal endoscopic ear surgery (TEES) when compared to microsurgery for ossiculoplasty has advantages of better visualization and no external incision but also has the disadvantage of being a one-handed procedure. Our study aimed to compare audiometric outcomes following ossiculoplasty performed via TESS with results of microsurgery.

Materials And Methods: Data from a prospective audit of 157 consecutive patients who underwent ossiculoplasty by a single otologist from 2009 to 2018 was analyzed.

Six-canal video head impulse test in patients with labyrinthine and retrolabyrinthine pathology: detecting vestibulo-ocular reflex deficits.

Background: Abnormal gains in six-canal video head impulse test are attributed to semi-circular canal deficits. However, as video head impulse test responses are linked to the vestibulo-ocular reflex, it was hypothesised that abnormal gains can be caused by vestibulo-ocular reflex pathway deficits.

Methods: This study compared video head impulse test gains in 20 patients with superior semi-circular canal dehiscence (labyrinthine cause) and 20 side- and gender-matched patients with vestibular schwannomas (retrolabyrinthine cause), and investigated correlations between them (Mann-Kendall trend test).

Sinogenic polymicrobial anaerobic orbital cellulitis: the importance of source control and broad empirical antibiotics.

A man in his twenties with a history of recurrent sinusitis was urgently referred to the emergency department (ED) by an out-of-hours general practitioner following a 2-day history of increasing right eye pain, redness and swelling after a week of coryzal symptoms. He denied visual impairment and any history of recent dental pain or procedures. Initial assessment in ED noted fever, tachycardia and hypotension.

Deltopectoral Flap Reconstruction of the Posterior Pharyngeal Wall: A Single Stage Pedicle Flap Alternative Solution to the Free Flap Reconstruction of Circumferential Laryngopharyngeal Defects.

The first option for reconstruction of a circumferential pharyngeal defect following extensive pharyngo-laryngectomy is free tissue transfer. Despite that, pedicled flaps can be used when microsurgical expertise is not available or if other patient related or region related issues deem free tissue transfer unfavourable. The aim of this study was to review the operative feasibility and functional outcomes following dual flap reconstruction of circumferential pharyngeal defects.

Remote triage incorporating symptom-based risk stratification for suspected head and neck cancer referrals: A prospective population-based study.

Background: Remote triage for suspected head and neck cancer (HNC) referrals was adopted by many institutions during the initial peak of the coronavirus disease 2019 pandemic. Its safety in this population has not been established.

Methods: A 16-week, prospective, multicenter national service evaluation was started on March 23, 2020.

Video Head Impulse Test (vHIT) Findings in Patients With Superior Semicircular Canal Dehiscence: A Case-Control Study.

Objective: To explore the usefulness of the responses of video head impulse testing (vHIT) in assessing symptomatic patients with superior semicircular canal dehiscence (SSCD).

Methods: This was a prospective case-control study performed in a tertiary skull base referral Centre in the UK. It included all patients ¬diagnosed with SSCD from January 2015 to January 2019 and compared to a control group of age and gender-matched unaffected indi¬viduals.

Imaging Post Stereotactic Radiosurgery for Vestibular Schwannomas-When Should We Scan?

Objective: To identify the optimal time for imaging following stereotactic radiosurgery (SRS) in patients with vestibular schwannomas (VS).

Study Design: Retrospective case series.

Setting: Tertiary, university center.

Effect of Personal Protection Equipment (PPE) and the Distance From the Eye Piece of Surgical Microscope on the Field of Vision; An Experimental Study.

Background: During the Covid-19 pandemic, otolaryngologists are at risk due to aerosol-generating procedures such as mastoidectomy and need enhanced personal protective equipment (PPE). Eye protection can interfere with the use of a microscope due to a reduction in the field of vision. We aimed to study the effect of PPE on the microsurgical field.

Planning considerations prior to laryngectomy for a patient infected with severe acute respiratory syndrome coronavirus-2 pre-operatively.

Background: Coronavirus disease 2019 was declared a pandemic on 11th March 2020. All non-urgent surgical procedures have been postponed indefinitely. The British Association of Head and Neck Oncology state that only those with treatable head and neck cancer unsuitable for alternative treatment should undergo surgery.

Rapid implementation of an evidence-based remote triaging system for assessment of suspected referrals and patients with head and neck cancer on follow-up after treatment during the COVID-19 pandemic: Model for international collaboration.

Background: Outpatient telemedicine consultations are being adopted to triage patients for head and neck cancer. However, there is currently no established structure to frame this consultation.

Methods: For suspected referrals with cancer, we adapted the Head and Neck Cancer Risk Calculator (HaNC-RC)-V.

Head and neck cancer risk calculator (HaNC-RC)-V.2. Adjustments and addition of symptoms and social history factors.

Objectives: Head and neck cancer (HNC) diagnosis through the 2-week wait, urgent suspicion of cancer (USOC) pathway has failed to increase early cancer detection rates in the UK. A head and neck cancer risk calculator (HaNC-RC) has previously been designed to aid referral of high-risk patients to USOC clinics (predictive power: 77%). Our aim was to refine the HaNC-RC to increase its prediction potential.

Temporal Bone Anatomy in Superior Semicircular Canal Dehiscence: A Case Control Study on Bone Pneumatization and the Level of Middle Cranial Fossa.

Objectives: To assess for any association between the presence of superior semicircular canal dehiscence (SSCD) and temporal bone pneumatization and the height of middle fossa in symptomatic patients.

Study Design: Retrospective case-control study.

Setting: Tertiary, university referral center.

The role of allied healthcare professionals in head and neck cancer surveillance: A systematic review.

Objectives: The roles of Allied Health Care Professionals (AHPs) in Head and Neck Cancer (HNC) are wide ranging but not clearly defined. Inter-regional variability in practice results from a lack of standardisation in approaches to the Multidisciplinary Team (MDT) make-up and structure. Traditionally, the follow-up of HNC patients is clinician led with multiple scheduled follow-up appointments.

Menière's disease treated by grommet insertion.

Introduction: Menière's disease (MD) is an uncommon cause of sudden profound vertigo. A variety of medical and surgical treatments have been used to manage this condition. This study reviewed the outcomes of patients treated with grommet insertion and transtympanic steroid injection.

Upper airway tract complications of endotracheal intubation.

The gold standard in airway maintenance is translaryngeal endotracheal intubation, but this is not without its complications. Trauma to the upper airway as a result of the act of endotracheal intubation is a common event in adults undergoing procedures under general anaesthesia. Sites requiring attention during intubation include the laryngeal apparatus, the pharynx and oral cavity as well as the nasal cavity when nasopharyngeal intubation is performed.

Prevertebral neck abscess with : a case presentation and literature review.

We describe an unusual case of a 58-year-old man with type 2 diabetes mellitus (T2DM) developing sepsis secondary to a prevertebral neck abscess. Following cross-sectional imaging, the patient underwent surgical drainage. was isolated from urine, blood and pus cultures.