Salvage neck dissection for squamous cell carcinoma is performed for residual or recurrent nodal disease after chemoradiotherapy or radical radiotherapy for locally advanced head and neck cancer. Our study aims to investigate the extent to which salvage neck dissection can be safely performed in treating recurrent or residual nodal metastasis.

A retrospective analysis of 53 patients with suspected residual or recurrent nodal disease after primary treatment (January 2016 to December 2018) was performed.

Pathological confirmation of viable squamous cell carcinoma following surgery was found in 43.4 per cent of patients. Post-operative infection, accessory and vagal nerve injuries were more common in patients with dissection of levels I–V than that of levels II–IV. There was no significant difference in three-year survival rate between patients with levels II–IV dissection and that of levels I–V dissection (p = 0.84).

The extent of salvage neck dissection can be limited to reduce post-operative complications while maintaining acceptable oncological outcomes.

This study aimed to explore the influence of laryngopharyngeal reflux on the features of vocal fold polyps and prognosis after office-based transnasal vocal fold polypectomy.

Eighty-four vocal fold polyp patients were retrospectively analysed. Patients were assigned to laryngopharyngeal reflux or non-laryngopharyngeal reflux groups using pre-operative Reflux Symptom Score-12.

The laryngopharyngeal reflux group had significantly higher pre-operative Reflux Sign Assessment scores, worse lifestyle and worse eating habits than the non-laryngopharyngeal reflux group. After office-based transnasal vocal fold polypectomy, the Reflux Symptom Score-12 and Reflux Sign Assessment score decreased in both groups, although the laryngopharyngeal reflux group still had higher values. The non-laryngopharyngeal reflux group had better vocal fold morphology recovery than the laryngopharyngeal reflux group. Multivariate logistic regression analysis demonstrated that smoking and a higher pre-operative Reflux Symptom Score-12 score were independent risk factors for poor prognosis.

Laryngopharyngeal reflux is detrimental to vocal fold recovery of vocal fold polyp patients following office-based transnasal vocal fold polypectomy. For vocal fold polyp patients with laryngopharyngeal reflux, lifestyle and diet guidance should be focused.

Surgical treatment of auricular concha, the helix root and the external auditory canal tumours, and their reconstruction, is a challenge because of the complexity of this anatomic region and the significant functional and aesthetic requirements of these treatments. The purpose of this study is to describe our experience with the retroauricular revolving door island flap technique.

This was a retrospective descriptive study (series of nine clinical cases) conducted between 2020 and 2023 of revolving door island flap reconstruction of auricular conchal and external auditory canal defects caused by tumour removal.

In all the cases, tumour-free margins and total reconstruction of the defect were achieved through the revolving door island flap intervention, with optimal aesthetic and functional results.

Revolving door island flap reconstruction is a viable surgical option for the reconstruction of auricular conchal and external auditory canal defects because of its versatility, reproducibility, low post-operative morbidity and optimal results.

To appraise clinical practice guidelines for anaplastic thyroid carcinoma treatment and management using the Appraisal of Guidelines for Research and Evaluation II tool.

A literature search was performed using MEDLINE/PubMed, Embase, Scopus, Cochrane, and Google Scholar. Four reviewers evaluated clinical practice guidelines utilising Appraisal of Guidelines for Research and Evaluation II, with domain scores requiring a threshold of greater than 60 per cent. Inter-reviewer agreement was evaluated using intraclass correlation coefficients.

Twelve clinical practice guidelines were evaluated after application of inclusion and exclusion criteria. There were two “high-”, four “average-”, and six “low-” quality clinical practice guidelines. The domains with the highest scores were “clarity of presentation” (69.44 ± 16.75) and “scope and purpose” (68.87 ± 20.88), while “applicability” (7.12 ± 6.17) and “rigor of development” (50.26 ± 20.77) had the lowest scores. Intraclass correlation coefficients showed a high level of inter-reviewer agreement (0.689–0.924; good–excellent).

These results showcased wide variability in quality amongst guidelines for the treatment and management of anaplastic thyroid carcinoma. These findings necessitate greater standardisation among clinical practice guidelines and greater focus on the applicability of recommended practices.

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.

We conducted a prospective observational study over a six-month period. All patients who underwent tonsillectomy were included. The instruments used during the procedure and their frequency of use were counted, with the operating surgeon being unaware of the study.

During the 6-month timeframe, 46 tonsillectomies were performed. From the standard tonsillectomy tray containing 38 pieces, 9 pieces were never used. The removal of unused reusable instruments resulted in an estimated total reduction of 594 g of carbon dioxide equivalents and a saving of €9.63 per operation.

Rationalising the contents of the surgical instrument tray can have a positive environmental impact by reducing greenhouse gas emissions. There are also pecuniary benefits for the National Health Service because of the potential for cost savings.

The purpose of this study is to investigate whether sex plays a role in donor-site dysfunction after head and neck reconstruction.

In this retrospective case series, 76 patients were assessed for donor-site morbidity using the Short Form 36, Short Musculoskeletal Function Assessment, disabilities of the arm, shoulder, and hand, and lower-limb core scale. Differences by sex were compared using t-tests. Multivariable linear regression analysis was conducted to adjust for potential confounders.

Females observed significantly greater disability for the SF-36 mental component summary score with a mean of 45.9 (standard deviation 10.5) compared to males, with a mean of 51.8 (standard deviation 10.2), p = 0.02. Sex is significantly related to SF-36 mental component summary score after controlling for neuropsychiatric disease and tracheostomy status.

Females reported significantly worse mental component scores compared to males undergoing free flap reconstruction of the head and neck.

To compare perioperative and oncological outcomes between stapler and manual closure in patients undergoing total laryngectomy for advanced endolaryngeal squamous cell carcinoma.

Patients with advanced endolaryngeal tumours operated between July 2017 and July 2023 were retrospectively dichotomised into stapler closure and manual closure cohorts and compared.

Seventy-one patients with a median age of 57 years were included in our study. The median surgical duration was 270 minutes for the manual closure cohort and 245 minutes for the stapler closure cohort. The pharyngo-cutaneous salivary fistula rate was 6 per cent less in the stapler closure cohort. The estimated mean survival was not significantly different 54.5 months (95 per cent, confidence interval 46.3–62.71) in the manual closure cohort versus 28.12 months (95 per cent, confidence interval 23.6–32.63) in the stapler closure cohort (p = 0.79).

Stapler closure can be used in endolaryngeal tumours, and it reduces operating time, thus facilitating efficient utilisation of operation time with non-inferior oncological outcomes as compared to traditional manual closure.