52 results
Search Results
2. Bilateral Warthin's tumour of the parotid gland: a 16-year retrospective analysis and systematic review.
- Author
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Siddiqui, Zohaib, Gupta, Ahaan, Nam, Ronald H K, Huynh, Richard C T, Jan, Mikaeel, Dusu, Keli, and Dhar, Vikram
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HEAD & neck cancer , *SEX distribution , *ONCOLOGY , *SYSTEMATIC reviews , *MEDLINE , *AGE factors in disease , *CANCER cells , *MEDICAL databases , *ONLINE information services , *HISTOLOGY , *HOSPITAL wards ,PAROTID gland tumors - Abstract
Objective: Warthin's tumours are the second most common benign parotid tumours in the UK. The World Health Organization states that 5–14 per cent of patients have bilateral Warthin's tumours. This study aimed to: assess the presence of contralateral Warthin's tumours in patients who underwent surgery over the past 16 years at a head and neck unit in England, and perform the first systematic literature review on bilateral Warthin's tumours. Methods: A retrospective analysis was conducted on patients diagnosed with Warthin's tumour based on histology between 2005 and 2020. Additionally, a systematic review (International Prospective Register of Systematic Reviews ('PROSPERO') registration number: CRD42022326846) was performed using PubMed and the Cochrane Library. Results: Among 290 patients diagnosed with Warthin's tumours based on histology following surgery, 24.5 per cent had bilateral Warthin's tumours. The systematic review identified 157 papers, with 14 meeting the inclusion criteria. Conclusion: This study revealed that 24.5 per cent of patients had bilateral Warthin's tumours, deviating from the suggested range. These findings are of interest to surgeons discussing the disease with patients. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
3. Litigation in thyroid surgery: a pan-specialty review of National Health Service (UK) data.
- Author
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Arwyn-Jones, James, Ross, Talisa, Navaratnam, Annakan, George, Manish, Machin, John T, Briggs, Tim W R, and Tolley, Neil
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NATIONAL health service laws , *NEGLIGENCE , *THYROID diseases , *LEGAL liability , *HOSPITAL costs , *MEDICAL errors , *HEALTH insurance reimbursement , *INFORMED consent (Medical law) , *COST analysis , *DAMAGES (Law) , *DIAGNOSTIC errors - Abstract
Objective: Thyroid surgery carries risks that significantly impact patients. This paper describes the landscape of thyroid surgery related litigation claims in the National Health Service from April 2015 to April 2020, to establish learning points in order to improve patient care and minimise litigation risk. Methods: Data were requested from National Health Service Resolution and Hospital Episode Statistics. Claims were classified into operative and non-operative causes. Subspecialty information, incident details and claim costings were analysed. Results: Sixty claims were identified. Thirty-eight claims (63.3 per cent) were closed, with an average total claim cost of £68 816 and average damages paid of £36 349. Claims related to diagnostic issues were most common (n = 19); of claims associated with operative causes (n = 30), those relating to nerve injury were most common (n = 8), with issues of nerve monitoring and consent being cited. Conclusion: Utilisation of well-established protocols will likely reduce litigation in thyroid surgery, as we move towards a landscape in which the patient journey is thoroughly scrutinised for targeted improvements. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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4. Two abstracts from oral presentations at the Royal Society of Medicine Matthew Yung Short Papers Competition (March 2021).
- Author
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Farr, M R B, Abbas, L, Cacciabue-Rivolta, D I, Ray, J, Rivolta, M N, Cresswell, M, Casanova, F, Beaumont, R N, Wood, A R, Ronan, N M, Hilton, M P, and Tyrrell, J
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TINNITUS , *TISSUE banks , *VESTIBULAR apparatus diseases , *SEVERITY of illness index , *TREATMENT effectiveness , *QUALITY of life , *HEMATOPOIETIC stem cells , *MEDICAL needs assessment , *DISEASE risk factors - Published
- 2021
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5. How I do it: intracapsular coblation tonsillectomy.
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Thompson, G and Bateman, N
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SURGICAL education , *SURGICAL technology , *TONSILLECTOMY , *OCCUPATIONAL adaptation - Abstract
Background: There has been increased interest in the adoption of an intracapsular tonsillectomy technique in the UK in recent years. The adoption of any newer surgical technique inevitably is accompanied by an educational need. Objectives: This paper aims to outline the equipment preparation and surgical steps for intracapsular coblation tonsillectomy, including recognition of the tonsillar capsule. The paper also discusses how to avoid and deal with common complications and technical difficulties. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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6. Dysphagia presentation and management following coronavirus disease 2019: an acute care tertiary centre experience.
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Dawson, C, Capewell, R, Ellis, S, Matthews, S, Adamson, S, Wood, M, Fitch, L, Reid, K, Shaw, M, Wheeler, J, Pracy, P, Nankivell, P, and Sharma, N
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HOSPITALS , *ARTIFICIAL respiration , *CRITICAL care medicine , *DEGLUTITION disorders , *TRACHEOTOMY , *TERTIARY care , *COVID-19 - Abstract
Objectives: As the pathophysiology of Covid-19 emerges, this paper describes dysphagia as a sequela of the disease, including its diagnosis and management, hypothesised causes, symptomatology in relation to viral progression, and concurrent variables such as intubation, tracheostomy and delirium, at a tertiary UK hospital. Results: During the first wave of the Covid-19 pandemic, 208 out of 736 patients (28.9 per cent) admitted to our institution with SARS-CoV-2 were referred for swallow assessment. Of the 208 patients, 102 were admitted to the intensive treatment unit for mechanical ventilation support, of which 82 were tracheostomised. The majority of patients regained near normal swallow function prior to discharge, regardless of intubation duration or tracheostomy status. Conclusion: Dysphagia is prevalent in patients admitted either to the intensive treatment unit or the ward with Covid-19 related respiratory issues. This paper describes the crucial role of intensive swallow rehabilitation to manage dysphagia associated with this disease, including therapeutic respiratory weaning for those with a tracheostomy. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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7. Electrochemotherapy for the palliative management of non-skin-origin head and neck cancer: case series and UK national survey.
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McCaffer, C, Wong, B Y W, Murugan, C S, Muir, T, and Lester, S
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HEAD tumors , *CANCER chemotherapy , *METASTASIS , *SURVEYS , *CASE studies , *SURVIVAL analysis (Biometry) , *ELECTROTHERAPEUTICS , *NECK tumors , *PALLIATIVE treatment , *LONGITUDINAL method , *EMAIL - Abstract
Objectives: Electrochemotherapy uses electric fields to facilitate the influx of chemotherapy into cancer cells, producing a targeted effect. For head and neck cancer, it is mainly used for palliation of non-skin-origin metastases. It is used infrequently in the UK. This paper presents our experience and a UK survey to identify its frequency of use. Methods: Between 2016 and 2019, a prospective database was created and reviewed. Only patients with non-skin-origin metastatic head and neck cancer, with no other palliative options, were included. Survival length, complications and symptomatic benefit were assessed. The survey was conducted via e-mail. Results: Five patients were included: three with squamous cell carcinoma, one with esthesioneuroblastoma and one with hepatocellular carcinoma. Survival ranged from 1 month to over 20 months. Minor complications were seen. Only 15 out of 69 UK head and neck multidisciplinary teams offer electrochemotherapy. Conclusion: Electrochemotherapy is a well-tolerated adjunct to standard palliation of metastatic head and neck cancer, and is offered by a limited number of UK multidisciplinary teams. [ABSTRACT FROM AUTHOR]
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- 2022
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8. Experiences in academic publication among ENT trainees in the UK: results from a national survey.
- Author
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Shahidi, S, Osborne, M S, Jama, G M, Bola, S, and Murphy, J
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PUBLISHING , *HOSPITAL medical staff , *OPERATIVE otolaryngology , *CROSS-sectional method , *SURVEYS , *DESCRIPTIVE statistics , *GRADUATE education , *CERTIFICATION - Abstract
Objective: This study aimed to provide an objective means of identifying patterns in academic publication among ENT trainees during their higher surgical training. Method: A cross-sectional survey was distributed to ENT higher surgical trainees. Results: A total of 153 ENT specialty trainees participated, giving a response rate of 46.5 per cent. Across all years of training, the mean number of first author publications was three and the mean number of non-first author publications was two. For trainees at specialty trainee year 8 level, these figures were nine and five, respectively. Participants with doctoral degrees and those in academic programmes published more papers but the mean difference was only significant for the doctoral subgroup (p < 0.0001). Those with additional undergraduate degrees and those in less than full-time training had an overall lower number of publications. Conclusion: Participants in the current survey achieved a higher average number of academic publications than is presently required to successfully complete higher surgical training in ENT. It is hoped that these results act as a guide for trainees planning the research component of their training to ensure that they remain competitive at consultant interview. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
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9. Head and neck cancer surgery during the coronavirus pandemic: a single-institution experience.
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Jeannon, J-P, Simo, R, Oakley, R, Townley, W, Orfaniotis, G, Fry, A, Arora, A, Taylor, C, and Ahmad, I
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HEAD tumors , *ELECTIVE surgery , *ASSOCIATIONS, institutions, etc. , *SPECIALTY hospitals , *COVID-19 , *CONVALESCENCE , *SURGERY , *PATIENTS , *CROSS infection , *CANCER treatment , *CANCER patients , *TREATMENT effectiveness , *NECK tumors , *COVID-19 pandemic , *DISCHARGE planning - Abstract
Objective: The coronavirus disease 2019 pandemic resulted in the cessation of elective surgery. The continued provision of complex head and neck cancer surgery was extremely variable, with some UK centres not performing any cancer surgery. During the pandemic, Guy's and St Thomas' NHS Foundation Trust received high numbers of coronavirus disease 2019 admissions. This paper presents our experience of elective complex major head and neck cancer surgery throughout the pandemic. Methods: A head and neck cancer surgery hub was set up that provided a co-ordinated managed care pathway for cancer patients during the pandemic; the Guy's Cancer Centre provided a separate, self-enclosed coronavirus-free environment within the hospital campus. Results: Sixty-nine head and neck cancer patients were operated on in two months, and 13 patients had a microvascular free tissue transfer. Nosocomial infection with coronavirus disease 2019 was detected in two cases (3 per cent), neither required critical care unit admission. Both patients made a complete recovery and were discharged home. There were no deaths. Conclusion: Performing major head and neck surgery, including free flap surgery, is possible during the pandemic; however, significant changes to conventional practice are required to achieve desirable patient outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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10. Endonasal surgery in the coronavirus era – Birmingham experience.
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Naik, P P, Tsermoulas, G, Paluzzi, A, McClelland, L, and Ahmed, S K
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CROSS infection , *DISEASES , *ENDOSCOPY , *HOSPITAL emergency services , *INDUSTRIAL safety , *LONGITUDINAL method , *SCIENTIFIC observation , *OPERATIVE otolaryngology , *POSTOPERATIVE period , *RETROSPECTIVE studies , *COVID-19 pandemic - Abstract
Background: The World Health Organization declared coronavirus disease 2019 a pandemic on 11th March 2020. There is concern regarding performing endonasal surgical procedures because of a high viral load in the nasopharynx. This paper describes our experience in conducting emergency and urgent endonasal operations during the peak of the coronavirus disease 2019 pandemic in the UK. Objectives: To show the outcome of endonasal surgery during the peak of the coronavirus disease 2019 pandemic and to assess the post-operative rate of nosocomial coronavirus disease 2019 infection. Methods: A retrospective cohort study was conducted of all patients who underwent high priority endoscopic nasal surgery or anterior skull base surgery between 23rd March and 15th June 2020 at University Hospitals Birmingham NHS Trust. Results: Twenty-four patients underwent endonasal surgery during the study period, 12 were males and 12 were females. There was no coronavirus-related morbidity in any patient. Conclusion: This observational study found that it is possible to safely undertake urgent endonasal surgery; the nosocomial risk of coronavirus disease 2019 can be mitigated with appropriate peri-operative precautions. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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11. Papers presented at the Association of Otolaryngologists in Training Annual Meeting, 20 June 2014, Exeter, UK.
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Awad, Zaid, Williams, Richard, Ronan, Natalie, Hickey, S A, Khalil, H, Evans, A, Jones, T, Skinner, D, Kumar, B N, Rainsbury, J, Narula, A, and Powles, J
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CONFERENCES & conventions , *OTOLARYNGOLOGY - Abstract
Abstracts of papers presented during the Association of Otolaryngologists in Training Annual Meeting on June 20, 2014 in Exeter, England is presented on topics including the parotid tumor, quality improvement, and procedures of limited clinical value in ear, nose, and throat (ENT).
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- 2015
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12. Preliminary outcomes of endoscopic middle-ear surgery in 103 cases: a UK experience.
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Yiannakis, C P, Sproat, R, and Iyer, A
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MIDDLE ear surgery , *AUDIOMETRY , *EAR surgery , *ENDOSCOPY , *LONGITUDINAL method , *MICROSURGERY , *HEALTH outcome assessment , *STAPEDIUS muscle , *SURGICAL complications , *TYMPANIC membrane , *WOUND healing - Abstract
Background: Totally endoscopic ear surgery and endoscope-assisted microsurgery are still new concepts, with relatively few centres in the UK performing them. Advantages include better visualisation of difficult to reach areas, such as the sinus tympani, and limited external incisions. This paper reports our short-term outcomes for endoscopic middle-ear surgery. Methods: A prospective review was conducted of the first 103 consecutive patients undergoing totally endoscopic ear surgery or endoscope-assisted microsurgery in 1 centre performed by 1 operator. The outcomes assessed were: tympanic membrane healing, audiological data and complications. Results: Twenty-five patients underwent endoscope-assisted microsurgery, while 78 had totally endoscopic ear surgery. There were no reported cases of dead ear or permanent facial nerve palsy. The average air–bone gap following stapedectomy was 7.38 dB. The tympanic membrane healing rate was 89 per cent. Conclusion: Our results confirm that endoscopic middle-ear surgery is safe, and the short-term outcomes are comparable with conventional surgery. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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13. The British Rhinological Society multidisciplinary consensus recommendations on the hospital management of epistaxis.
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NOSEBLEED treatment , *ANTIFIBRINOLYTIC agents , *BANDAGES & bandaging , *CAUTERY , *CONSENSUS (Social sciences) , *HEALTH care teams , *MEDICAL needs assessment , *MEDICAL protocols , *NASAL cavity , *NOSEBLEED , *ADULTS - Abstract
Objective: Epistaxis is a common ENT emergency in the UK; however, despite the high incidence, there are currently no nationally accepted guidelines for its management. This paper seeks to recommend evidence-based best practice for the hospital management of epistaxis in adults. Methods: Recommendations were developed using an Appraisal of Guidelines for Research and Evaluation ('AGREE II') framework. A multifaceted systematic review of the relevant literature was performed and a multidisciplinary consensus event held. Management recommendations were generated that linked the level of supporting evidence and a Grading of Recommendations Assessment, Development and Evaluation ('GRADE') score explaining the strength of recommendation. Recommendations: Despite a paucity of high-level evidence, management recommendations were formed across five management domains (initial assessment, cautery, intranasal agents, haematological factors, and surgery and radiological intervention). Conclusion: These consensus recommendations combine a wide-ranging review of the relevant literature with established and rigorous methods of guideline generation. Given the lack of high-level evidence supporting the recommendations, an element of caution should be used when implementing these findings. [ABSTRACT FROM AUTHOR]
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- 2017
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14. Airway and head and neck high dependency unit: a single-centre experience.
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Bannister, M, Trotter, P, Jawad, A, and Veitch, D Y
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HOSPITAL care , *LENGTH of stay in hospitals , *OTOLARYNGOLOGY , *RETROSPECTIVE studies , *DESCRIPTIVE statistics - Abstract
Objective:Dedicated otolaryngology high dependency units are uncommon. This paper reports the first experiences of such a facility in the UK, assessing reason for admission, duration of stay, occupancy rate and need for care escalation. The study sought to assess the presence of similar units in the UK.Methods:A retrospective review of high dependency unit admissions over an 18-month period and a national survey of otolaryngology departments in the UK were conducted to establish the overall presence and location of similar high dependency units.Results:A total of 128 patients were admitted during the study period, mainly following surgery and because of airway compromise. The average duration of stay was 2–3 days (range, 1–12 days). The occupancy rate was 31.7 per cent. No patients required their care to be escalated to the intensive care unit. Seven similar high dependency units were identified in the UK.Conclusion:The care provided prevented the need for escalation of care to an intensive care unit. This challenges the need for patient management on intensive care units following major surgery or airway compromise for those not requiring assisted ventilation. High dependency units similar to ours are not widespread. [ABSTRACT FROM PUBLISHER]
- Published
- 2016
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15. Subcranial craniofacial resection for advanced sinonasal malignant tumours involving the anterior skull base.
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Yong, C C, Soni-Jaiswal, A, and Homer, J J
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MAXILLOFACIAL surgery , *SKULL surgery , *CANCER relapse , *FACIAL bones , *PARANASAL sinus cancer , *REOPERATION , *SURGICAL complications , *PLASTIC surgery , *TREATMENT effectiveness , *DESCRIPTIVE statistics , *CEREBROSPINAL fluid rhinorrhea , *SURGERY - Abstract
Background:The subcranial approach is a modification of traditional craniofacial resection. It provides similar broad access to the anterior skull base, but with lower mortality and morbidity. It has been the surgical technique of choice at our institution since 2006 for treating advanced stage sinonasal tumours (American Joint Committee on Cancer stage III or above). This paper reports our experience and outcomes.Method and results:Eighteen patients underwent subcranial craniofacial resection over a seven-year period, this being combined with a second adjunctive procedure in 89 per cent of cases. Forty per cent of patients required reconstruction of the primary defect. No peri-operative deaths occurred. One patient had a transient cerebrospinal fluid leak. The major complication rate was 33 per cent, of which 67 per cent were directly related to soft tissue reconstruction. Tumour recurrence rate was 17 per cent and the five-year disease-free survival estimate was 40 per cent.Conclusion:The subcranial approach is a safe and effective technique that may be used to successfully treat advanced sinonasal malignancies with anterior skull base extension. [ABSTRACT FROM PUBLISHER]
- Published
- 2016
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16. Anti-tumour necrosis factor therapy is associated with certain subtypes of chronic rhinosinusitis.
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LEONARD, C. G., MASIH, C., MCDONALD, S., TAYLOR, G., MAIDEN, N., and LEYDEN, P. J.
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ANTIRHEUMATIC agents , *CHI-squared test , *CHRONIC diseases , *CONFIDENCE intervals , *SCIENTIFIC observation , *SINUSITIS , *SURVEYS , *TELEPHONES , *TUMOR necrosis factors , *DESCRIPTIVE statistics , *ODDS ratio , *CHEMICAL inhibitors - Abstract
Background: Chronic rhinosinusitis has many risk factors; however, the effect of anti-tumour necrosis factor therapy has not been investigated in depth. Our experience points to a detrimental clinical effect in overall prevalence of chronic rhinosinusitis, despite its benefit in certain subtypes. Method: A telephone survey was performed to parallel the findings of the Global Allergy and Asthma European Network chronic rhinosinusitis screening survey. This was itself based on the widely recognised European Position Paper on Rhinosinusitis and Nasal Polyps criteria. Results: A total of 120 patients responded to the survey. The prevalence of chronic rhinosinusitis in the anti-tumour necrosis factor therapy population was 20 per cent (95 per cent confidence interval = 12.84-27.16). When compared using a chi-square test, for a two-by-two contingency table, this finding was significant against the prevalence recorded in the normal population. Conclusion: This is the first observational study indicating increased prevalence of chronic rhinosinusitis in patients treated with anti-tumour necrosis factor therapy. These clinical findings require investigation in greater depth to clarify the nature of pathologies currently diagnosed and treated as chronic rhinosinusitis. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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17. Head and neck melanoma (excluding ocular melanoma): United Kingdom National Multidisciplinary Guidelines.
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AHMED, O. A. and KELLY, C.
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HEAD tumors , *MEDICAL protocols , *MELANOMA , *NECK tumors , *SKIN tumors - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the United Kingdom. This paper provides consensus recommendations on the management of melanomas arising in the skin and mucosa of the head and neck region on the basis of current evidence. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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18. Education of trainees, training and fellowships for head and neck oncologic and surgical training in the UK: United Kingdom National Multidisciplinary Guidelines.
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SIMO, R., ROBSON, A., WOODWARDS, B., NIBLOCK, P., and MATTEUCCI, P.
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HEAD tumors , *MEDICAL protocols , *NECK tumors , *ONCOLOGISTS , *SURGEONS , *CLINICAL competence , *EDUCATION - Abstract
Since the previous edition of these guidelines, significant changes have taken place in the training and assessment of surgeons and oncologists who treat patients with head and neck cancer. For those intending to become head and neck surgeons, a fellowship in head and neck surgery is virtually mandatory. This paper summarises the current career structure to specialise in head and neck oncology and surgery in the UK. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
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19. Chemotherapy: United Kingdom National Multidisciplinary Guidelines.
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KELLY, C. G.
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CANCER chemotherapy , *HEAD tumors , *MEDICAL protocols , *NECK tumors - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper summarises the role of chemotherapy in head and neck cancer management, recent advances and what the future holds for this modality. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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20. Organisation and provision of head and neck cancer surgical services in the United Kingdom: United Kingdom National Multidisciplinary Guidelines.
- Author
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STAFFORD, F., AH-SEE, K., FARDY, M., and FELL, K.
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ASSOCIATIONS, institutions, etc. , *CANCER patients , *CANCER patient medical care , *HEAD tumors , *MEDICAL protocols , *NECK tumors - Abstract
This is the official guideline endorsed by the surgical specialty associations involved in the care of head and neck cancer patients in the UK. This paper summarises the current state of play in the organisation and provision of head and neck cancer surgical services in the UK. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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21. Management of thyroid cancer: United Kingdom National Multidisciplinary Guidelines.
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MITCHELL, A. L., GANDHI, A., SCOTT-COOMBES, D., and PERROS, P.
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PROFESSIONAL associations , *CANCER patients , *CANCER patient medical care , *HEAD tumors , *MEDICAL protocols , *NECK tumors , *THYROID gland tumors , *DISEASE management - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper provides recommendations on the management of thyroid cancer in adults and is based on the 2014 British Thyroid Association guidelines. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
22. Management of Salivary Gland Tumours: United Kingdom National Multidisciplinary Guidelines.
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SOOD, S., MCGURK, M., and VAZ, F.
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CANCER patients , *CANCER patient medical care , *HEAD tumors , *MEDICAL needs assessment , *MEDICAL protocols , *NECK tumors , *SALIVARY gland tumors , *DISEASE management - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. Salivary gland tumours are rare and have very wide histological heterogeneity, thus making it difficult to generate high level evidence. This paper provides recommendations on the assessment and management of patients with cancer originating from the salivary glands in the head and neck. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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23. Reconstructive considerations in head and neck surgical oncology: United Kingdom National Multidisciplinary Guidelines.
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RAGBIR, M., BROWN, J. S., and MEHANNA, H.
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NECK tumors , *HEAD tumors , *MEDICAL protocols , *PLASTIC surgery , *SURGERY - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. The reconstructive needs following ablative surgery for head and neck cancer are unique and require close attention to both form and function. The vast experience accrued with microvascular reconstructive surgery has meant a significant expansion in the options available. This paper discusses the options for reconstruction available following ablative surgery for head and neck cancer and offers recommendations for reconstruction in the various settings. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
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24. Non-melanoma skin cancer: United Kingdom National Multidisciplinary Guidelines.
- Author
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NEWLANDS, C., CURRIE, R., MEMON, A., WHITAKER, S., and WOOLFORD, T.
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BASAL cell carcinoma , *CANCER patients , *CANCER patient medical care , *HEAD tumors , *MEDICAL protocols , *MELANOMA , *NECK tumors , *SKIN tumors , *SQUAMOUS cell carcinoma , *DISEASE management - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper provides consensus recommendations on the management of cutaneous basal cell carcinoma and squamous cell carcinoma in the head and neck region on the basis of current evidence. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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25. Follow-up after treatment for head and neck cancer: United Kingdom National Multidisciplinary Guidelines.
- Author
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SIMO, R., HOMER, J., CLARKE, P., MACKENZIE, K., PALERI, V., PRACY, P., and ROLAND, N.
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HEAD tumors , *PATIENT aftercare , *MEDICAL protocols , *NECK tumors , *SKULL tumors - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. In the absence of high-level evidence base for follow-up practices, the duration and frequency are often at the discretion of local centres. By reviewing the existing literature and collating experience from varying practices across the UK, this paper provides recommendations on the work up and management of lateral skull base cancer based on the existing evidence base for this rare condition. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
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26. Speech and swallow rehabilitation in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.
- Author
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CLARKE, P., RADFORD, K., COFFEY, M., and STEWART, M.
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CANCER patients , *CANCER patient medical care , *CANCER patient rehabilitation , *DEGLUTITION disorders , *HEAD tumors , *MEDICAL protocols , *NECK tumors , *SPEECH therapy , *THERAPEUTICS - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. The disease itself and the treatment can have far reaching effects on speech and swallow function, which are consistently prioritised by survivors as an area of concern. This paper provides recommendations on the assessments and interventions for speech and swallow rehabilitation in this patient group. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
27. Nose and paranasal sinus tumours: United Kingdom National Multidisciplinary Guidelines.
- Author
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LUND, V. J., CLARKE, P. M., SWIFT, A. C., MCGARRY, G. W., KERAWALA, C., and CARNELL, D.
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CANCER patients , *CANCER patient medical care , *HEAD tumors , *MEDICAL protocols , *NECK tumors , *NASAL tumors , *PARANASAL sinus cancer , *DISEASE management , *DISEASE incidence - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. With only limited high-level evidence for management of nasal and paranasal sinus cancers owing to low incidence and diverse histology, this paper provides recommendations on the work up and management based on the existing evidence base. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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28. Hypopharyngeal cancer: United Kingdom National Multidisciplinary Guidelines.
- Author
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PRACY, P., LOUGHRAN, S., GOOD, J., PARMAR, S., and GORANOVA, R.
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AGE distribution , *CANCER patients , *CANCER patient medical care , *HEAD tumors , *MEDICAL protocols , *NECK tumors , *DISEASE management , *HYPOPHARYNX , *DISEASE incidence , *TUMORS - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. With an age standardised incidence rate of 0.63 per 100 000 population, hypopharynx cancers account for a small proportion of the head and neck cancer workload in the UK, and thus suffer from the lack of high level evidence. This paper discusses the evidence base pertaining to the management of hypopharyngeal cancer and provides recommendations on management for this group of patients receiving cancer care. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
29. Oropharyngeal cancer: United Kingdom National Multidisciplinary Guidelines.
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MEHANNA, H., EVANS, M., BEASLEY, M., CHATTERJEE, S., DILKES, M., HOMER, J., O'HARA, J., ROBINSON, M., SHAW, R., and SLOAN, P.
- Subjects
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CANCER patients , *CANCER patient medical care , *HEAD tumors , *MEDICAL protocols , *NECK tumors , *PAPILLOMAVIRUSES , *DISEASE incidence , *OROPHARYNGEAL cancer , *CANCER treatment - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. There has been significant debate in the management of oropharyngeal cancer in the last decade, especially in light of the increased incidence, clarity on the role of the human papilloma virus in this disease and the treatment responsiveness of the human papilloma virus positive cancers. This paper discusses the evidence base pertaining to the management of oropharyngeal cancer and provides recommendations on management for this group of patients receiving cancer care. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
30. Nasopharyngeal carcinoma: United Kingdom National Multidisciplinary Guidelines.
- Author
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SIMO, R., ROBINSON, M., LEI, M., SIBTAIN, A., and HICKEY, S.
- Subjects
- *
AGE distribution , *CANCER patients , *CANCER patient medical care , *HEAD tumors , *MEDICAL protocols , *NECK tumors , *DISEASE management , *DISEASE incidence ,NASOPHARYNX tumors - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. Although much commoner in the eastern hemisphere, with an age-standardised incidence rate of 0.39 per 100 000 population, cancers of the nasopharynx form one of the rarer subsites in the head and neck.¹ This paper provides recommendations on the work up and management of nasopharyngeal cancer based on the existing evidence base for this condition. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
31. Laryngeal cancer: United Kingdom National Multidisciplinary guidelines.
- Author
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JONES, T. M., DE, M., FORAN, B., HARRINGTON, K., and MORTIMORE, S.
- Subjects
- *
CANCER patients , *CANCER patient medical care , *MEDICAL protocols , *TUMOR treatment ,LARYNGEAL tumors - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. Significantly new data have been published on laryngeal cancer management since the last edition of the guidelines. This paper discusses the evidence base pertaining to the management of laryngeal cancer and provides updated recommendations on management for this group of patients receiving cancer care. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
32. Imaging in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.
- Author
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LEWIS-JONES, H., COLLEY, S., and GIBSON, D.
- Subjects
- *
HEAD tumors , *NECK tumors , *MEDICAL protocols , *DIAGNOSIS - Abstract
This guideline is endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper summarises the current imaging modalities in use for head and neck cancer evaluation. It highlights their role in the management with recommendations on modality choice for each cancer subsite. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
33. Nutritional management in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.
- Author
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TALWAR, B., DONNELLY, R., SKELLY, R., and DONALDSON, M.
- Subjects
- *
DIET therapy , *HEAD tumors , *MEDICAL protocols , *NECK tumors , *NUTRITIONAL assessment - Abstract
Nutritional support and intervention is an integral component of head and neck cancer management. Patients can be malnourished at presentation, and the majority of patients undergoing treatment for head and neck cancer will need nutritional support. This paper summarises aspects of nutritional considerations for this patient group and provides recommendations for the practising clinician. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
34. Anaesthesia for head and neck surgery: United Kingdom National Multidisciplinary Guidelines.
- Author
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CHARTERS, P., AHMAD, I., PATEL, A., and RUSSELL, S.
- Subjects
- *
NECK tumors , *ANESTHESIA , *HEAD tumors , *MEDICAL protocols , *SURGERY - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. The anaesthetic considerations for head and neck cancer surgery are especially challenging given the high burden of concurrent comorbidity in this patient group and the need to share the airway with the surgical team. This paper provides recommendations on the anaesthetic considerations during surgery for head and neck cancer. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
35. Pre-treatment clinical assessment in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.
- Author
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ROBSON, A., STURMAN, J., WILLIAMSON, P., CONBOY, P., PENNEY, S., and WOOD, H.
- Subjects
- *
HEAD tumors , *NECK tumors , *MEDICAL protocols , *DIAGNOSIS - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper provides recommendations on the pre-treatment clinical assessment of patients presenting with head and neck cancer. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
36. Recurrent head and neck cancer: United Kingdom National Multidisciplinary Guidelines.
- Author
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MEHANNA, H., KONG, A., and AHMED, S. K.
- Subjects
- *
HEAD tumors , *MEDICAL care , *MEDICAL protocols , *NECK tumors , *PATIENTS , *DISEASE relapse - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. Recurrent cancers present some of the most challenging management issues in head and neck surgical and oncological practice. This is rendered even more complex by the poor evidence base to support management options, the substantial implications that treatments can have on the function and quality of life, and the difficult decision-making considerations for supportive care alone. This paper provides consensus recommendations on the management of recurrent head and neck cancer. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
37. Tumour assessment and staging: United Kingdom National Multidisciplinary Guidelines.
- Author
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ROLAND, N., PORTER, G., FISH, B., and MAKURA, Z.
- Subjects
- *
HEAD tumors , *MEDICAL needs assessment , *MEDICAL protocols , *NECK tumors , *TUMOR classification - Abstract
In general, the first decision to be made in a patient with a confirmed head and neck cancer is whether or not to treat the patient before deciding what form of management strategy is appropriate. There is no more important an aspect of head and neck cancer care than the initial evaluation of the patient and the patient's tumour. The practice requires specific expertise and judgement. The current tumour-node-metastasis system relies on morphology of the tumour (anatomical site and extent of disease) but the final decision on treatment hinges on a full assessment of the patient including physiological age and general condition. The aim of this paper is primarily to describe why and how we appraise a patient and their tumour. It addresses the general principles applicable to the topic of evaluation, classification and staging. In addition, the limitations and pitfalls of this process are described. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
38. ENT entry requirements for UK armed forces.
- Author
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Jones, G H, Murphy, R, Agrawal, S, and Isles, M G
- Subjects
- *
HEALTH , *MILITARY personnel , *EAR diseases , *EMPLOYEE recruitment , *HEARING , *HEARING disorders , *NOSE diseases , *OTOLARYNGOLOGY , *PHARYNX , *PHYSICAL fitness , *STANDARDS - Abstract
Background:Minimum health requirements exist for entry into the UK armed forces. Both pre-existing and iatrogenic ENT conditions may impact on an individual's medical fitness and their ability to enter the forces.Methods:The relevant literature was examined and military otolaryngology advisors were interviewed in order to define the ENT-specific conditions that restrict an individual joining the armed forces.Results:The ENT diseases and disabilities that inhibit an individual's ability to join the forces are described. Treatments that may facilitate or restrict recruitment are also discussed.Conclusion:Members of the armed forces operate in arduous environments and are required to pass a screening medical assessment before joining. Personnel may be isolated away from specialist care and therefore cannot be dependent on specialist devices or medicines. This paper aims to arm ENT specialists with occupational knowledge to enable them to correctly counsel patients and offer appropriate treatment. [ABSTRACT FROM PUBLISHER]
- Published
- 2015
- Full Text
- View/download PDF
39. Intrinsic facial nerve tumours of the temporal bone: a proposed management guideline.
- Author
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Watson, G J and Irving, R M
- Subjects
- *
TUMOR treatment , *AUDITORY perception testing , *COMPUTED tomography , *FACE , *FACIAL nerve diseases , *HEARING disorders , *MAGNETIC resonance imaging , *TEMPORAL bone , *DISEASE management , *TREATMENT effectiveness , *PRE-tests & post-tests , *RETROSPECTIVE studies , *DESCRIPTIVE statistics , *THERAPEUTICS ,TUMOR surgery - Abstract
Objective:The aim of this paper was to propose a guideline for the management of intrinsic facial nerve tumours based on our practice and findings in the literature.Method:A retrospective review of intrinsic facial nerve tumours over the last 15 years was performed. Parameters measured included age, presenting symptoms, pre- and post-treatment hearing and House–Brackmann grading, tumour position, treatment and duration of follow up.Results:A total of 15 patients presented with intrinsic facial nerve tumours over the study period. The most common presenting complaint was facial symptoms (93.3 per cent), followed by hearing loss (46.7 per cent). Three patients with stable facial nerve function (House–Brackmann grades II–III) were treated conservatively. Twelve patients underwent surgery to treat progressive or recurrent symptoms. Facial function was maintained or improved in 60.0 per cent of patients and hearing was preserved in 66.7 per cent.Conclusion:We propose that all stable tumours associated with good facial function of grade III or below should be treated conservatively. For symptomatic or progressive lesions, tailored surgery depending on the tumour site and hearing level should be offered to preserve native nerve function and facial musculature. For patients with prolonged paralysis, tumours can be monitored and other forms of facial reanimation and support offered. [ABSTRACT FROM PUBLISHER]
- Published
- 2015
- Full Text
- View/download PDF
40. An audit of ‘dead ear’ after ear surgery.
- Author
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Prinsley, P
- Subjects
- *
MASTOID process surgery , *ACADEMIC medical centers , *AUDITING , *CHOLESTEATOMA , *DEAFNESS , *EAR surgery , *INFORMED consent (Medical law) , *SURGICAL complications , *TOMOGRAPHY - Abstract
Introduction:‘Dead ear’ is a rare and serious complication of ear surgery. This paper presents an audit of this complication.Method:Over 6 years, data for all 617 middle-ear operations performed under the care of a single consultant were recorded for the International Otology Audit. All cases of dead ear were identified and assessed.Results:A post-operative dead ear occurred in 6 cases (approximately 1 per cent). No cases of post-operative dead ear occurred following the 83 otosclerosis operations and the 62 children's procedures. Amongst 187 adult patients undergoing mastoid surgery for cholesteatoma, there were 5 cases of post-operative dead ear (2.7 per cent of cases).Conclusion:The occurrence of dead ear after cholesteatoma surgery in adults is less rare than previously thought. This has implications for the surgical consenting process. The current series suggests that, whilst dead ear is often avoidable, it is sometimes inevitable. [ABSTRACT FROM PUBLISHER]
- Published
- 2013
- Full Text
- View/download PDF
41. Is there a change in the epidemiology of nasal fractures in females in the UK?
- Author
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Trinidade, A, Buchanan, M A, Farboud, A, Andreou, Z, Ewart, S, Mochloulis, G, Kothari, P, Frosh, A C, and Vlastarakos, P V
- Subjects
- *
NASAL bone , *AGE distribution , *ALCOHOL drinking , *BONE fractures , *MEDICAL cooperation , *RESEARCH , *SOCIAL skills , *PSYCHOLOGY of women , *RETROSPECTIVE studies , *WOUNDS & injuries - Abstract
Objective:To determine whether there is a change in the epidemiology of nasal fractures in females in the UK, and the potential contribution of the ‘ladette’ culture.Methods:This paper reports a multi-centre retrospective study. Operating theatre data for all females who underwent manipulation of nasal fractures under anaesthesia between 2002 and 2009 were analysed. In addition, the case notes of all females presenting with nasal fractures over a five-year period (2004–2009) were retrospectively reviewed and the cited cause of the fracture was noted.Results:From 2002 to 2009, there was an 825 per cent increase in nasal fractures in women aged 13–20 years. Almost one-quarter of all nasal fractures in one centre was attributed to non-domestic violence. The highest incidence of nasal fractures (67 per cent) was amongst white British females.Conclusion:There is an increasing trend in the number of women sustaining nasal fractures in the UK. The cause may be multi-factorial, but could be partially attributed to a rise in ladette culture. Further research on the role of alcohol consumption in this phenomenon is needed. [ABSTRACT FROM PUBLISHER]
- Published
- 2013
- Full Text
- View/download PDF
42. Tissue banking in ENT: challenges and methods.
- Author
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Warner, E, Birchall, M, and Lowdell, M W
- Subjects
- *
DATABASE management , *ORGAN donation , *BIOMARKERS , *GENETICS ethics , *HOSPITALS , *INFORMED consent (Medical law) , *MEDICAL ethics , *MEDICAL protocols , *OTOLARYNGOLOGY , *PRIVACY , *TISSUE banks , *WORLD Wide Web , *COST analysis , *HUMAN research subjects - Abstract
Background:Biobanking is the process of storing high quality human biospecimens alongside linked clinical data, for research purposes. The aim is to identify novel biomarkers with prognostic or diagnostic significance. However, the challenges implicit in the collection and storage of human tissue for research have curtailed the impact of this technique to date.Aim:This paper aims to summarise the challenges faced by biobanking within the ENT specialty in the UK, and to present protocols used for the routine collection, freezing and storage of tissue specimens at the Royal National Throat, Nose and Ear Hospital. These protocols could be used to guide other ENT departments (in the UK and worldwide) wishing to initiate the routine collection and storage of tissue samples. Their publication could also help to establish basic standards and ensure consistency in ENT tissue storage.Methods:Interviews conducted with industry experts, and a literature review of ‘best practice’ in biobanking.Conclusion:The ENT specialty must stay abreast of progress in human tissue research in order to ensure the best possible management of its patients. Our protocol for the routine banking of ENT tissue at the Royal National Throat, Nose and Ear Hospital could be used as a template for other ENT departments (in the UK and worldwide) to encourage widespread implementation of high quality tissue banking. [ABSTRACT FROM PUBLISHER]
- Published
- 2013
- Full Text
- View/download PDF
43. Actinomycosis of the middle ear.
- Author
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Kullar, PJ and Yates, P
- Subjects
- *
TYMPANOPLASTY , *ANTIBIOTICS , *ACTINOMYCOSIS , *HISTOLOGICAL techniques , *MIDDLE ear , *TOMOGRAPHY , *SYMPTOMS , *DIAGNOSIS ,MASTOID process diseases - Abstract
Objective:To present the first case of middle-ear actinomycosis in the UK in the last 60 years. The diagnosis and management of actinomycosis of the middle ear is also presented, as well as a review of the recent literature.Case report:This paper reports the case of a nine-year-old girl who presented with recurrent otorrhoea caused by actinomycosis. Mastoid exploration with clearance of the infected tissue, in conjunction with six months amoxicillin, resulted in long-term disease remission. Histology revealed Gram-positive, silver avid (on Grocott staining) and diastase-resistant periodic acid-Schiff negative staining of colonies; this profile was in keeping with the characteristic ‘sulphur granules’ of actinomycosis.Conclusion:Actinomycosis of the middle ear and mastoid is rare, with less than 45 cases presented in the worldwide literature. This case confirms that the disease should be treated with full surgical clearance and long-term antibiotics. [ABSTRACT FROM PUBLISHER]
- Published
- 2013
- Full Text
- View/download PDF
44. Future perspectives: United Kingdom National Multidisciplinary Guidelines.
- Author
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KING, E. V. and HARRINGTON, K.
- Subjects
- *
FORECASTING , *HEAD tumors , *MEDICAL protocols , *NECK tumors , *ONCOLOGISTS , *PARADIGMS (Social sciences) , *SURGEONS - Abstract
The multidisciplinary management of head and cancer has changed radically in the last decade. This paper provides a glimpse of the emerging surgical and oncological interventions that may play major roles in the treatment paradigms of tomorrow. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
45. Surgery in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.
- Author
-
HOMER, J. J.
- Subjects
- *
NECK tumors , *CANCER patients , *CANCER patient medical care , *COGNITION , *HEAD tumors , *MEDICAL protocols , *SURGERY - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. Surgery is one of the key modalities used in head and neck cancer treatment. Recent advances and a greater awareness of the short- and long-term toxicities associated with non-surgical modalities and newer technologies that permit minimal access resections have led to a resurgence in surgery. This paper provides an overview of the role of surgery in head and neck cancer practice. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
46. Co-phenylcaine Forte spray: innovative ways of minimising cost.
- Author
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Gungadeen, A, Ramakrishnan, Y, and Cocks, H C
- Subjects
- *
NATIONAL health services , *DISPOSABLE medical devices , *MEDICAL equipment reuse , *COST effectiveness , *CROSS infection , *DRUG adulteration , *LOCAL anesthetics , *INHALATION administration , *ECONOMICS - Abstract
Objective:To investigate whether multiple-use Co-phenylcaine Forte® spray was more cost-effective than single-use vials.Methods:A literature review was conducted to determine the risk of cross-contamination associated with multiple-use topical nasal anaesthetic spray. The costs of multiple-use Co-phenylcaine Forte and single-use co-phenylcaine were compared, and potential savings were calculated. The cost of procuring these drugs from other sources was also examined.Results:Switching to multiple-use Co-phenylcaine Forte spray would lead to at least 40 per cent savings if bought from our local retailer. Potential savings of more than 70 per cent could be made if the drugs were procured from sources other than our local distributor.Conclusion:Multiple-use Co-phenylcaine Forte spray is safe to use and more cost-effective than single-use vials. This paper illustrates how money can be saved within the National Health Service through changes in drug procurement. Similar cost savings to those calculated for our department could be made in other ENT departments nationally, depending on their annual consumption of co-phenylcaine. [ABSTRACT FROM PUBLISHER]
- Published
- 2013
- Full Text
- View/download PDF
47. Tonsil tie simulator.
- Author
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Duodu, J and Lesser, T H J
- Subjects
- *
RESEARCH methodology , *SIMULATED patients , *TONSILLECTOMY , *TEACHING methods - Abstract
Background:The surgical trainee has to acquire surgical skills in an era of reduced training hours and greater demands for efficient use of operating theatre time. Many surgical specialties are utilising model and simulation-based training to provide safe, low-pressure training opportunities for today's trainee.Method and results:This paper describes a simple, relatively inexpensive tonsillectomy model that enables the practice of tonsil removal and ligation of bleeding vessels. The model is beneficial for the patient, trainee and trainer.Conclusion:The pseudo mouth and active bleeding components of this model provide the trainee with a relatively inexpensive, realistic model with which to gain confidence and competence in the skill of ligating tonsillar blood vessels with a tonsil tie. [ABSTRACT FROM PUBLISHER]
- Published
- 2013
- Full Text
- View/download PDF
48. Management of intra-operative cerebrospinal fluid leak following endoscopic trans-sphenoidal pituitary surgery.
- Author
-
Hobbs, C G L, Darr, A, and Carlin, W V
- Subjects
- *
PITUITARY surgery , *ADHESIVES in surgery , *CEREBROSPINAL fluid , *ENDOSCOPY , *NASAL secretions , *OPERATIVE surgery , *TRANSPLANTATION of organs, tissues, etc. , *RETROSPECTIVE studies ,PREVENTION of surgical complications - Abstract
Objective:Cerebrospinal fluid leakage is the most common complication of endoscopic trans-sphenoidal pituitary surgery. However, there is no uniformly accepted way of managing this complication when it occurs intra-operatively. This paper describes a quick, simple technique, involving layered fibrin glue and gelatin sponge, which does not compromise post-operative patient follow up.Method:Retrospective review of all endoscopic pituitary surgery cases conducted at a single institution since the introduction of this technique in 2002.Results:A total of 120 endoscopic pituitary operations were performed (96 primary procedures and 24 revisions). All intra-operative cerebrospinal fluid leaks were managed using the described method, with a failure rate of 3.6 per cent. The overall post-operative leakage rate was 1.7 per cent.Conclusion:This simple, conservative technique avoids the need for further dissection and the use of non-absorbable foreign material, and has a low incidence of post-operative cerebrospinal fluid leakage. [ABSTRACT FROM PUBLISHER]
- Published
- 2011
- Full Text
- View/download PDF
49. Student-selected components: bringing more ENT into the undergraduate curriculum.
- Author
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R M Newbegin, J C Rhodes, L M Flood, and H C Richardson
- Subjects
- *
UNDERGRADUATE programs , *OTOLARYNGOLOGY , *CURRICULUM , *MEDICAL schools , *MEDICAL students , *MEDICAL education policy - Abstract
Exposure to otolaryngology is currently minimal in the UK undergraduate medical curriculum. This may lead to difficulties in attracting graduates into higher ENT surgical training and in ensuring a reasonable standard of ENT knowledge amongst primary care practitioners.A recent innovation, of which many ENT units may be unaware, is the introduction to the undergraduate curriculum of ‘student-selected components’. Like the traditional elective, this allows students to undertake an attachment to a speciality and department of their choice. Units which do not regularly teach medical students but which have a welcoming and enthusiastic approach to undergraduate training may well be ideal hosts.This paper introduces the concepts underlying student-selected components, outlines the preparation required and offers a template for such an attachment, for which ENT is ideally suited. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
50. Radiotherapy in head and neck cancer management: United Kingdom National Multidisciplinary Guidelines.
- Author
-
NUTTING, C.
- Subjects
- *
CANCER patients , *CANCER patient medical care , *HEAD tumors , *MEDICAL protocols , *NECK tumors - Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. Radiotherapy is one of the key treatment modalities used in head and neck cancer management. This paper summarises the current role and some of the recent advances in radiotherapy in head and neck cancer management. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
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