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Background: Quality of life (QoL) assessment forms an integral part of modern cancer care and research. The aim of this study is to determine patients' preferences and willingness to complete commonly used head‐and‐neck cancer (HNC) QoL questionnaires (QLQs) in routine follow‐up clinics. Methods: This is a randomised control trial of 583 subjects from 17 centres during follow‐up after treatment for oral, oropharyngeal or laryngeal cancer. Subjects completed three structured validated questionnaires: EORTC QLQ‐HN35; FACT‐HN and UW‐QOL, and an unstructured patient‐generated list. The order of questionnaire presentation was randomised, and subjects were stratified by disease site and stage. Patients self‐rated the questionnaires they found most helpful to communicate their health concerns to their clinicians. Results: Of the 558 respondents, 82% (457) found QLQs useful to communicate their health concerns to their clinician (OR = 15.76; 95% CI 10.83–22.94). Patients preferred the structured disease‐specific instruments (OR 8.79; 95% CI 5.99–12.91), while the open list was the most disliked (OR = 4.25; 95% CI 3.04–5.94). There was no difference in preference by treatment modality. More women preferred the FACT‐HN (OR = 3.01, 95% CI 1.05–8.62), and patients under 70 preferred EORTC QLQ‐HN35 (OR = 3.14, 95% CI 1.3–7.59). However, only 55% of patients expressed preference to complete questionnaires routinely at the clinic. Conclusions: Most patients found QLQs helpful during their follow‐up and 55% supported routine questionnaires in follow‐up clinics. Males and people over 70 years old were the least willing to complete the routine questionnaires and preferred shorter questionnaires (e.g., UW‐QOL). Women preferred FACT‐HN, and younger patients preferred EORTC QLQ‐HN35. Reasons for the reluctance to complete questionnaires require elucidation. [ABSTRACT FROM AUTHOR]

Objectives: This study describes a technique of measurement for neck cyst amylase content and reviews the experience of a tertiary referral center for cases of suspected plunging ranula. Methods: A retrospective study was performed at the Manukau Surgical Center in Auckland, New Zealand. Patients with a possible diagnosis of plunging ranula based on clinical presentation and diagnostic aspiration of the cyst contents were included. Demographic data, imaging and laboratory findings were collected, along with findings from surgery and histology. The technique for measuring the amylase of the aspirated cyst contents was also carefully recorded. Results: The 37 cases of confirmed plunging ranula included in this study had a submandibular cystic swelling that was aspirated. Imaging features consistent with a plunging ranula were seen in 89% of the study group. All cases had detectable levels of amylase of ≥3 U/L in the ranula contents. There was large variability (range: 5–560 U/L) in the concentration of amylase, with 70% of the cases demonstrating an amylase concentration below 200 U/L. Aspirates were typically described as viscous (87.5%) and yellow or straw‐colored. Conclusion: The combination of clinical presentation, imaging and the presence of amylase in the cyst contents is diagnostic for plunging ranula. Level of Evidence: 4 Laryngoscope, 133:535–538, 2023 [ABSTRACT FROM AUTHOR]

Objectives: This qualitative systematic review evaluates the evidence in support of the use of oral corticosteroids in patients undergoing sialendoscopy for the treatment of obstructive sialadenitis. Design: Qualitative systematic review. Methods: A literature search was conducted from January 1985 and September 2020. Inclusion criteria embraced peer-reviewed articles in which adult patients undergoing interventional sialendoscopy for obstructive salivary gland disease received oral corticosteroids. The results were initially screened based on title and abstract, and the remaining articles were reviewed for eligibility. Results: About 218 papers were selected by title and abstract, 96 were selected for full-text review, and 9 met the inclusion criteria. Eight published reports were retrospective observational studies and 1 was a prospective comparative study. Overall, the heterogeneity of clinical data stood out in this systematic review. The pooled success rate in the studies was 873/979 (89%). Only 5 studies described a rationale for oral corticosteroid use as part of the post-operative management. In 4 studies, a prednisone total daily dose of 40 to 50 mg was used. One study clearly showed a lower recurrence rate in patients who received oral steroids for more than 7 days in addition to sialendoscopy for management of ductal stenoses. Conclusion: This systematic review showed that most centers that prescribe oral corticosteroids after sialendoscopy are unaware of the specific results with this treatment. For ductal stenoses, only 1 paper clearly showed the benefits of oral corticosteroids after sialendoscopy but more high-quality evidence is required in the form of a comparative study or randomized controlled trial, with appropriate long-term follow up. [ABSTRACT FROM AUTHOR]

Objective/Hypothesis: To evaluate clinical outcomes following failed endoscopic extraction of salivary calculi and to assess any relation between clinical outcome and calculi location, number, size, and mobility. If sialendoscopy fails to extract the calculus, subsequent spontaneous passage of the calculus out of the ductoglandular system or secondary effects of sialendoscopy could mitigate the clinical impact of a residual sialolithiasis. Study Design: Prospective observational study. Methods: Prospective comparative study of endoscopic procedures for sialolithiasis performed in the Manukau Surgery Center, in Auckland, New Zealand, from 2010 to 2020. The recurrent symptoms and the variables related to the need for additional surgical intervention for salivary calculi were analyzed. Results: Among the 465 sialendoscopy procedures, 154 (33.1%) were for obstructive sialolithiasis. Among these, there were 30 (19.4%) with unsuccessful stone extraction with re‐operation for these failures performed in 14 of the 27 failed submandibular cases (52%) and 2 of the 3 parotids (66.7%). Location of calculi was a significant factor in predicting the need of further surgery. Patients with perihilar stones were 5 times more likely to have a failed procedure (P =.001). If the stone was intraglandular, the likelihood increased to 8.5 times (P =.005). The likelihood for a revision procedure increased almost 11 times if the stone was intraglandular (P =.004). Calculi size, mobility, multiple calculi, and presence of concurrent stenosis did not correlate with need for further surgery. Conclusions: A significant proportion of "failed" sialendoscopy did not require further intervention. Stone location was a significant factor in predicting a failed procedure and the need for re‐intervention. Laryngoscope, 132:1029–1033, 2022 [ABSTRACT FROM AUTHOR]

Objective: To examine the Manukau Salivary Symptom Score (MSSS) questionnaire as a validated tool to assess obstructive sialadenitis-specific symptoms to both indicate disease severity and assess the outcome after sialendoscopic procedures. Study Design: A prospective observational study was performed from 2010 to 2019 comprising 164 patients undergoing sialendoscopy for nonneoplastic chronic obstructive salivary gland disease (COSGD). Setting: Department of Otolaryngology–Head and Neck Surgery at the Manukau Surgical Centre, Auckland, New Zealand, between June 2010 and September 2019. Methods: A prospective observational study was performed from 2010 to 2019 comprising 164 patients undergoing sialendoscopy for nonneoplastic COSGD. Patients completed the MSSS preoperatively and at postoperative follow-up. Statistical tests were used to compare pre- and postoperative answers. Cronbach's α was used to measure internal consistency. Finally, construct validity was determined by comparing the 5-question MSSS questionnaire to the preexisting 20-question Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire. Results: Postoperatively, patients had significant improvements in pain, eating, talking, swelling, and quality of life (P <.001). The MSSS questionnaire was found to have high internal consistency (α = 0.938). Questions in the MSSS had a very strong positive correlation with 3 COSS questions, a strong positive correlation with 8, a moderate positive correlation with 4, and a weak positive correlation with 1. Four COSS questions were not considered relevant and were not included in the MSSS questionnaire. Conclusion: The MSSS questionnaire is a simple, validated questionnaire that is useful for assessing the impact of sialendoscopy in patients with COSGD. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to review the effects of short‐ and long‐term oral administration of postoperative corticosteroids in patients undergoing sialendoscopy for the treatment of obstructive sialadenitis due to ductal stenosis. Study Design: Prospective comparative study. Methods: A prospective observational study was conducted at Manukau Surgical Center in Auckland, New Zealand, where patients undergoing sialendoscopic surgery for recurrent obstructive sialadenitis due to ductal stenoses were reviewed. Univariable and multivariable analysis, and also logistic regression were performed to identify variables correlated with the likelihood of the need for revision surgery for persistent or recurrent symptoms. Results: In this study, sialendoscopy was performed in 142 patients: 162 parotid glands (86.6%) and 25 submandibular glands (13.4%). Postoperative oral steroids were prescribed for 48 patients (34%); 19 (13%) were prescribed for less than 7 days and 29 (20%) for more than 7 days. In total, 33 patients (23.2%) required a revision sialendoscopy during follow‐up due to recurrence of symptoms. Oral steroids prescribed for more than 7 days after a sialendoscopy reduced the likelihood of a revision procedure by 93% when compared with patients who did not receive this medication, and by 96% when compared with patients who received steroids for less than 7 days. Conclusion: The results showed that in our population oral administration of corticosteroids for more than 7 days after sialendoscopy for the treatment of recurrent obstructive sialadenitis due to ductal stenosis markedly reduced the need for later revision surgery. Routine use of corticosteroids for more than 7 days is recommended after sialendoscopy in patients with ductal stenosis. Level of Evidence: II Laryngoscope, 131:E1503–E1509, 2021 [ABSTRACT FROM AUTHOR]

Objectives: We present a series of bilateral plunging ranula patients to examine the etiology, diagnosis, treatment, and prognosis of this condition.Methods: A retrospective chart review was performed on all cases of plunging ranula treated at the Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, New Zealand, between 2001 and 2019.Results: There were 17 patients with bilateral plunging ranulas from a total of 187 plunging ranula patients. Eight patients were of Pacific Island descent; six were Maori; and three were Asian. There were no European patients with bilateral plunging ranulas. There were three types of bilateral plunging ranula patients: 1) Metachronous plunging ranulas-Five patients presented with a unilateral plunging ranula with no evidence of a contralateral plunging ranula on initial imaging. Despite negative contralateral imaging findings, these patients developed a clinically evident contralateral plunging ranula 21 to 61 months later. 2) Synchronous plunging ranulas detected on imaging-Eight patients presented with a clinically evident unilateral plunging ranula but also had a contralateral plunging ranula detected on imaging. 3) Clinically evident synchronous plunging ranulas-Four patients presented with bilateral clinically evident plunging ranulas, which were also evident on imaging. Twelve patients underwent bilateral transoral sublingual gland excision and plunging ranula evacuation.Conclusion: All patients with a unilateral plunging ranula should be advised of the potential for developing contralateral disease, and this should be emphasized in patients of Pacific Island, Maori, and Asian descent.Level Of Evidence: 4 Laryngoscope, 131:73-77, 2021. [ABSTRACT FROM AUTHOR]

Background Although thyroid disease is known to have significant ethnic variability, ethnic disparities in outcomes of thyroid surgery have been poorly studied. Method Retrospective review of 716 consecutive thyroid operations at Counties Manukau Health, a public health provider in New Zealand, from January 2002 to August 2013. Results Compared with Europeans, Māori and Pacific Islanders have longer operation times ( P < 0.001) and heavier thyroid glands ( P < 0.001). Polynesians also had higher risk of post-operative haemorrhage compared with non- Polynesians ( P = 0.016). They also have higher body mass index, American Society of Anesthesiologists scores and rates of smoking. There were no differences in length of inpatient stay and readmission rates. Conclusions There are significant ethnic differences in certain outcomes of thyroid surgery. Part of this may be explained by higher co-morbid characteristics. [ABSTRACT FROM AUTHOR]

A ranula is an extravasation salivary pseudocyst from the sublingual gland (SLG) lined by inflamed granulation tissue. An ultrasound scan (USS) showed bilateral mylohyoid dehiscence with herniation of the SLGs (Fig.). Herniation of the bilateral sublingual glands (SLGs) through the bilateral mylohyoid muscle dehiscence (MH). [Extracted from the article]

Conclusion: Some variation from the ‘classical’ clinical picture for Warthin’s tumours is evident in these patients. A predilection for the parotid tail and a propensity for multiplicity has been confirmed.Objectives: This study sought to analyse demographic and clinical features of a Warthin’s patient population.Methods: Retrospective review of patients presenting with a benign parotid tumour. The group of Warthin’s tumours was compared with the group of patients with other benign parotid tumours.Results: Of 170 primary parotid tumours, 41 (24%) were Warthin’s tumour. Mean age of Warthins patients was significantly older (60 years vs 48 years,p = 0.001) and male gender more prevalent (61% vs 33%,p = 0.015) than in other benign tumours. Most (86%) Warthin’s tumours were found in the parotid tail, compared with 61% of other benign tumours (p = 0.002). There was no significant ethnic predilection for Warthin’s tumours. Bilaterality (30%) and multiplicity (27%) were common. Significance of gender differences disappeared with logistic regression analysis. [ABSTRACT FROM PUBLISHER]

The objective of this review study was to encompass the relevant literature and current best practice options for this challenging, sometimes incurable problem. The source of the data was Ovid MEDLINE from 1946 to 2014. Review methods consisted of articles with clinical correlates. The most important cause of recurrence is enucleation with rupture and incomplete tumor excision at operation. Incomplete pseudocapsule, extracapsular extension, pseudopods of pleomorphic adenoma tissue, and satellite pleomorphic beyond the pseudocapsule are also likely linked to recurrent pleomorphic adenoma. Most recurrent pleomorphic adenoma are multinodular. Magnetic resonance imaging is the imaging study of choice for recurrent pleomorphic adenoma. Nerve integrity monitoring may reduce morbidity for recurrent pleomorphic adenoma. Treatment of recurrent pleomorphic adenoma must be individualized. Total parotidectomy, given the multicentricity of recurrent pleomorphic adenoma, is appropriate in many patients, but may be inadequate to control recurrent pleomorphic. There is accumulating evidence from retrospective series that postoperative radiation therapy results in significantly better local control. Laryngoscope, 125:888-893, 2015 [ABSTRACT FROM AUTHOR]

Background There has been increasing use of satellite facilities for elective surgery to allow more efficient use of major hospital resources. Manukau Surgical Centre (MSC) is a stand-alone elective surgical centre which operates in conjunction with Middlemore Hospital (MMH). MSC has limited services, particularly after-hours and clinically unstable patients are required to be transferred to MMH for further management. Purpose This study evaluated whether the introduction of a formal handover process -- "the huddle" - had an effect on reducing the proportion of such after-hours transfers. Methods Patient transfers between MSC and MMH over the periods of August to November 2014 (pre-huddle) and March to June 2015 (post-huddle) were included in the study. Primary outcomes included proportion of after-hours transfers (as a function of total transfers). Secondary outcomes included monthly transfer rate. Results There were no significant differences in the proportion of after-hours transfers between pre- and post-huddle months with an odds ratio of 0.898 (p = 0.76). Monthly transfers overall were also not statistically different. There was a significant increase (22.5%) in the number of patients being transferred for further radiological investigations (p = 0.033). In addition, there was a significant increase in the proportion of transfers under the presumed diagnosis of venous thromboembolism (VTE) of 23.4% (p = 0.0023). Conclusions The "huddle" did not demonstrate significant differences in reducing the proportion of after-hour transfers from MSC to MMH. However, there were significantly more transfers that required radiological investigations as well as transfers under the presumptive diagnosis of VTE. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to review the effects of short- and long-term oral administration of postoperative corticosteroids in patients undergoing sialendoscopy for the treatment of obstructive sialadenitis due to ductal stenosis., Study Design: Prospective comparative study., Methods: A prospective observational study was conducted at Manukau Surgical Center in Auckland, New Zealand, where patients undergoing sialendoscopic surgery for recurrent obstructive sialadenitis due to ductal stenoses were reviewed. Univariable and multivariable analysis, and also logistic regression were performed to identify variables correlated with the likelihood of the need for revision surgery for persistent or recurrent symptoms., Results: In this study, sialendoscopy was performed in 142 patients: 162 parotid glands (86.6%) and 25 submandibular glands (13.4%). Postoperative oral steroids were prescribed for 48 patients (34%); 19 (13%) were prescribed for less than 7 days and 29 (20%) for more than 7 days. In total, 33 patients (23.2%) required a revision sialendoscopy during follow-up due to recurrence of symptoms. Oral steroids prescribed for more than 7 days after a sialendoscopy reduced the likelihood of a revision procedure by 93% when compared with patients who did not receive this medication, and by 96% when compared with patients who received steroids for less than 7 days., Conclusion: The results showed that in our population oral administration of corticosteroids for more than 7 days after sialendoscopy for the treatment of recurrent obstructive sialadenitis due to ductal stenosis markedly reduced the need for later revision surgery. Routine use of corticosteroids for more than 7 days is recommended after sialendoscopy in patients with ductal stenosis., Level of Evidence: II Laryngoscope, 131:E1503-E1509, 2021., (© 2020 American Laryngological, Rhinological and Otological Society Inc, "The Triological Society" and American Laryngological Association (ALA).)