FNA in the diagnosis of malignant salivary gland tumours

Salivary gland tumours are relatively rare and occur with an incidence of 2.5-3% per 100,000 people. Histologically they are extremely diverse with several patterns; some of which overlap and exact diagnosis can be difficult. Indeed it can be difficult to...

Outcomes of heavily pre-treated oral squamous cell carcinomas

Oral squamous cell carcinoma is one of the more common cancers worldwide. Surgery is the mainstay of treatment and often these patients have had adjuvant therapies. In spite of improving five year survival rates, local recurrent progressive disease is still...

Significance of exterior capsular spread in a clinically negative neck

This is a retrospective paper from Zagreb of 61 patients with a clinically T1-T3 N0 squamous cell carcinoma undergoing primary surgical treatment. All patients had a level I-IIII/IV elective neck dissection. Those who had adverse histological features, including extracapsular spread,...

Postoperative antibiotics after a free flap surgery – is one dose enough?

Major head and neck surgery with ablation of oral cancer, neck dissection and free flap reconstruction is a well-established part of maxillofacial surgery. These patients however already have significant co-morbidities and together with a long operation, large wounds open for...

Lymph node ratio – another predictor of outcomes in tongue SCC

Oral squamous cell carcinoma (SCC) is an increasing disease with over 263,000 diagnosed new cases and 128,000 deaths annually worldwide. Although there have been significant advances in diagnostics, surgery and anaesthetics there has been no increase in the survival rates...

Transnasal endoscopic choanal atresia surgery

Surgery is currently the only definitive treatment for congenital choanal atresia (CCA). There are various surgical approaches including transnasal, transeptal or transpalatal. The authors propose that the preferred option is transnasal endoscopic choanal atresia surgery (TECAS) and set out to...

Which patients are more likely to have postoperative pulmonary complications after major head and neck?

Postoperative pulmonary complications (PPC) following major head and neck surgery are frequently encountered. Indeed, surgery in the head and neck area itself has been identified as a risk factor for these complications. Microvascular reconstruction is a widely accepted and proven...

First signs of late nodal metastases

This is a retrospective review of 65 patients who had late metastases during follow-up after initial curative treatment. They analyse the detection methods of palpation, ultrasound, CT and subjective symptoms. Palpation detected the nodes in 31 patients, ultrasound in 17,...

Reconstruction with scapular tip following hemi-maxillectomy and rehabilitation with dental implants

Post ablative defects in the maxilla can be extremely complex, involve all three dimensions and result in significant morbidity. Rehabilitation is fraught with difficulties, and a number of options are available, such as an obturator or surgical reconstruction with a...

Inferior alveolar nerve (IAN) recovery after ORIF fractured mandible

Mandibular fractures are quite common facial injuries, but aetiology varies with country and age. Common treatment options are open reduction and internal fixation via an intra oral or extra oral incision. Nerve injury or dysfunction is often seen preoperatively and...

Treating laryngeal and hypopharyngeal cancers with pharyngolaryngectomy

The debate amongst head and neck surgeons, as to whether a skin flap or enteric flap offers superior outcomes in pharyngeal reconstruction, still rumbles on. The evidence pool is very shallow, even accounting for the so-called ‘landmark’ papers that swung...

Basic principles of bioengineering and regeneration

The ability to create de novo tissue to replace that removed from patients during surgery is a relatively recent advance. However, this is a fast-moving field and one which surgeons must be aware of from practical, ethical and scientific viewpoints....