Quality of life (QoL) following transoral robotic surgery (TORS) resection of parapharyngeal space tumours.

Introduction: Parapharyngeal space tumours (PSTs) can be challenging to manage in view of their distinct location and proximity to vital neurovascular structures. Numerous surgical approaches have been described including minimally invasive techniques utilising transoral robotic surgery (TORS). This study aims to evaluate the role of TORS in the management of PSTs with a special focus on quality of life (QoL) outcomes.

Patient reported voice outcomes following multi-disciplinary approach to botulism toxin for spasmodic dysphonia.

Purpose: Spasmodic dysphonia (SD) is a debilitating disorder primarily affecting voice production. Current treatment includes repeat botulinum toxin (botox) injections for symptomatic management. The aim of this study is to review the impact of botox injections on patient reported outcome measures (PROM), using a novel and unique quality of life, proforma, and side effects in patients treated at our centre.

Otolaryngology Education in Medical Training: A Literature Review of Current Practice, Challenges, and Future Directions.

Introduction: Concerns about the adequacy of ENT education are widespread, particularly in the UK. Limited exposure during undergraduate and postgraduate training are key factors. This review aims to synthesize the literature on ENT education, identify gaps, and explore strategies for improvement.

Consensus regarding transoral robotic surgery (TORS) complications for use in a proposed standardised consent form.

Consenting patients for surgery is a vital process with ethical and legal implications. The use of a standardised consent form may provide a solution to issues related to poor communication surrounding the consenting process. To date, there is no standardised consent form available for use specifically for transoral robotic surgery (TORS) across robotic centres.

Utilisation of Near Infrared Autofluorescence in Parathyroid Identification During Thyroidectomy: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

Objective: Unintentional parathyroid gland resection during total thyroidectomy can result in permanent hypoparathyroidism and lifelong replacement therapy. Near infrared autofluorescence (NIRAF) imaging may aid intraoperative identification and preservation of the parathyroid glands. This article aims to review NIRAF's effectiveness in the prevention of post-operative hypoparathyroidism.

Quality of Life and Sleep Outcomes in Obstructive Sleep Apnoea Following Transoral Robotic Surgery: A Meta-Analysis.

Objective: Obstructive sleep apnoea (OSA) can have a significant health burden in terms of sleep outcomes, systemic morbidity including cardiovascular and urological complications, and quality of life (QoL). Transoral robotic surgery (TORS) constitutes a novel option for patients where continuous positive airway pressure (CPAP) is not tolerated. This study aimed to assess OSA patients managed with TORS in terms of QoL and sleep outcomes.

Clinical Findings in Symptomatic Patients With Radiologically Isolated Sphenoid Sinus Disease: A Systematic Review and Meta-Analysis.

Objective: To explore the clinical presentations of isolated sphenoid sinus disease (ISSD).

Setting And Design: A literature search was conducted on 23 December 2023 across electronic databases including Medline, Embase, Web of Science, and Cochrane. We performed a meta-analysis of proportions using a random-effects model to determine the prevalence of clinical findings in patients who presented with symptoms and had ISSD on radiological imaging.

The sinus surgery completeness score: a radiological assessment of the extent of endoscopic sinus surgery.

Purpose: Chronic rhinosinusitis (CRS) often requires endoscopic sinus surgery (ESS) for symptom control. However, there is currently a high reported revision rate. The introduction of biologics offers an alternative treatment, but patient criteria are ambiguous, particularly regarding the definition of "previous ESS.

Rationalising surgical instruments in tonsillectomy: a pilot study to reduce greenhouse gas emissions and costs.

Objective: The healthcare industry is estimated to contribute 4.4 per cent of global greenhouse gas emissions. This pilot study aimed to investigate the impact of rationalising surgical instruments in tonsillectomy trays on greenhouse gas emissions and costs.

Primary Tumour Detection in Carcinoma of Unknown Primary with Transoral Robotic Surgery (TORS) Tongue Base Mucosectomy: A Meta-analysis.

Background: Head and neck carcinoma of unknown primary (CUP) represents a challenging diagnostic process when standard work-up fails to identify the primary tumour site. The aim of this systematic review and meta-analysis was to evaluate the diagnostic utility and complication profile of transoral robotic surgery (TORS) tongue base mucosectomy (TBM) in the management of CUP.

Patients And Methods: An electronic database search was performed in the EMBASE, MEDLINE, PubMed and Cochrane databases.

Quality of life outcomes comparing primary Transoral Robotic Surgery (TORS) with primary radiotherapy for early-stage oropharyngeal squamous cell carcinoma: A systematic review and meta-analysis.

Background: Transoral Robotic Surgery (TORS) and radiotherapy are considered oncologically equivalent primary treatment options for early-stage HPV-positive oropharyngeal squamous cell carcinoma (OPSCC). Quality of Life (QoL) and Patient Reported Outcome Measures (PROMs) are therefore imperative in supporting clinical decision-making and optimising patient-centred care. The aim of this article is to evaluate how these primary treatment modalities compare in terms of QoL.

Blood, Sweat, and Tonsils: Bleeding After Abscess Tonsillectomy for Quinsy-A Meta-Analysis.

Objective: Abscess tonsillectomy is performed during an active episode of quinsy. Apprehensions regarding an elevated bleeding risk have hindered its widespread acceptance. This study aims to assess the prevalence of post-tonsillectomy bleeding (PTB) associated with abscess tonsillectomy.

Correlation of maximal nasal septal deviation with deviation at the maxillary insertion.

Purpose: It is unclear if septal deviation at the insertion points to the nasal cavity is associated with the overall septal deviation. This study aimed to assess septal deviation at the cribriform plate (CP) and maxillary crest (MC) using CT scans and to see if there was any correlation with overall septal deviation.

Methods: All consecutive CT sinus scans between January 2020 and December 2021 were retrospectively reviewed.

Carolyn's window approach for spontaneous frontal sinus meningoencephalocele.

Spontaneous meningoencephaloceles (MECs) are sparsely documented in the literature. Those occurring in the frontal sinus are an exceedingly rare entity. MECs are commonly associated with cerebrospinal fluid (CSF) rhinorrhoea.

Comparing the use of high dose to standard dose corticosteroids for the treatment of sudden sensorineural hearing loss in adults - A systematic review.

Objective: Idiopathic sudden sensorineural hearing loss (SSNHL) is typically treated with systematic or intratympanic corticosteroids. Current ENT-UK guidelines suggest treatment with a dose of oral prednisolone 1mg/kg/day for 7 days then tapered over a further 5 days. However, there is no consensus on the effectiveness of corticosteroids for idiopathic SSNHL and no universally accepted optimal regime.

Effect of the COVID-19 pandemic on surgery for indeterminate thyroid nodules (THYCOVID): a retrospective, international, multicentre, cross-sectional study.

Background: Since its outbreak in early 2020, the COVID-19 pandemic has diverted resources from non-urgent and elective procedures, leading to diagnosis and treatment delays, with an increased number of neoplasms at advanced stages worldwide. The aims of this study were to quantify the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic; and to evaluate whether delays in surgery led to an increased occurrence of aggressive tumours.

Methods: In this retrospective, international, cross-sectional study, centres were invited to participate in June 22, 2022; each centre joining the study was asked to provide data from medical records on all surgical thyroidectomies consecutively performed from Jan 1, 2019, to Dec 31, 2021.

Reconstruction and Cerebrospinal Fluid Leaks in Endoscopic Endonasal Approach for the Management of Clival Chordomas-A Systematic Review.

The success of the endoscopic endonasal approach (EEA) to surgically manage clival chordomas (CC) relies on robust repair methods to reduce complications, such as cerebrospinal fluid (CSF) leaks. Our study aims to evaluate the existing literature to assess reconstructive techniques utilised and post-operative CSF leak rates in this cohort. A systematic review and analysis was performed of all published data related to CC patients managed with an EEA.

Comparing the Use of High-Dose to Standard-Dose Corticosteroids for the Treatment of Bell's Palsy in Adults-A Systematic Review and Meta-analysis.

Objective: Bell's palsy is typically treated with oral corticosteroids (40-60 mg daily). Concomitant antivirals are currently not recommended. The objective of this systematic review and meta-analysis was to examine the effect of high-dose versus standard-dose corticosteroids, without antivirals, in the management of Bell's palsy.

Surgical Implications of Superior Thyroid Cornu Agenesis in Laryngeal Malignancy.

The most commonly reported superior thyroid cornu (STC) anatomical variation is in STC syndrome, where the cornu is enlarged or medially displaced. STC agenesis is a rare laryngeal variation that can be unilateral or bilateral. Previous studies have reported STC agenesis in cadaveric or forensic studies in patients with an otherwise normal larynx.

Synchronous mucoepidermoid carcinoma and papillary microcarcinomas of the thyroid gland.

Thyroid mucoepidermoid carcinoma (MEC) is a rare thyroid malignancy first documented in 1977. The majority of thyroid MECs are indolent, low-grade tumours with excellent prognosis. A woman in her 60s presented with an ongoing sensation of a lump in the left neck.

The Effectiveness of a Specific Foundation Year 1 Induction Programme in Improving Confidence for Newly Qualified Doctors in the UK.

Background: Despite the completion of 5 or 6 years of undergraduate study, the transition to a newly qualified foundation year 1 doctor (FY1) in the UK has been recognised as challenging. We created a specific FY1 Induction Programme and aimed to evaluate its effectiveness on perceived confidence and preparedness for newly qualified doctors by assessing their responses to surveys before and after the delivery of the course.

Methods: Pre- and post-course surveys were administered at the start and end of the course, respectively.

Endonasal endoscopic management of spontaneous cerebrospinal fluid rhinorrhoea: The Birmingham UK experience.

Background: Spontaneous cerebrospinal fluid (CSF) leaks (SCSFL) occur in the absence of trauma, surgery, or underlying intracranial pathology. They represent a significant healthcare burden on patients with complications such as meningitis. We present our experience of SCSFL repair via the endonasal endoscopic approach.

Evaluating the role of the self-assembling topical haemostat PuraBond® in Transoral Robotic Surgery (TORS) for oropharyngeal cancer: A case series.

Background: Transoral Robotic Surgery (TORS) has been increasingly employed in head and neck surgery for the assessment and treatment of malignancies over the last two decades. PuraBond® is a self-assembling viscous solution that forms a transparent hydrogel 3-D matrix to promote local haemostasis. This study aimed to assess the utility of PuraBond® in patients undergoing TORS for Human Papilloma Virus (HPV) positive oropharyngeal squamous cell carcinoma (OPSCC).