To evaluate the experiences and perspectives of otolaryngology residents regarding current parental leave (PL) practices, incorporating insights from both male and female trainees to assess institutional policies and support mechanisms.

A 43-item anonymous survey was distributed to 125 ACGME-accredited otolaryngology residency programs, yielding responses from 105 residents (response rate: 29%). Data were analyzed using descriptive statistics and thematic analysis to evaluate perceptions of PL policies, barriers to leave, and postpartum support.

Most respondents were female (57%) and married (77%), with an average age of 30 years. Only 26% were aware of the American Board of Otolaryngology’s 8-week PL policy. Female residents typically took 4-6 weeks of leave, while male residents took none. Concerns about program strain (29%) and lack of lactation support (60%) were significant barriers. Despite this, most respondents felt supported by co-residents and faculty.

Otolaryngology residents reported dissatisfaction with PL policies, inadequate lactation support, and poor awareness of institutional guidelines. Addressing these issues is critical to fostering a supportive environment for residents pursuing parenthood during training.

In recent years, there has been a significant disparity between workforce capacity and clinical demand in surgical specialities, including head and neck surgery (HNS). Our objective was to assess final-year medical student interest in pursuing a career in HNS.

An online survey was distributed via social media and was completed by 633 final-year medical students across seven United Kingdom (UK) universities.

A total of 66.7 per cent (n = 422) had 1–7 days of exposure to HNS. Complex surgery (24.2 per cent), interesting patient population (20.2 per cent) and complex pathology (16.7 per cent) were the main motivators to consider HNS. Work–life balance (23.8 per cent), lack of exposure (31.3 per cent) and length of training (6.5 per cent) were the most common deterrants. A total of 67.1 per cent of students reported inadequate exposure to the field during undergraduate training.

The undergraduate curriculum must place more emphasis on HNS to accommodate increasing disease burden amid a limited workforce capacity within the National Health Service.

Oncological and functional outcomes for T1-2 N0-1 (TNMv8) p16-positive oropharyngeal squamous cell carcinoma patients were analysed according to treatment: either transoral robotic surgery (TORS) (Surgery group – TORS and neck dissection ± adjuvant radiotherapy/chemoradiotherapy) or primary radiotherapy/chemoradiotherapy (Oncology group).

Single-centre retrospective observational study.

The two-year disease-free survival rate was 88 per cent for the Oncology group (n = 42) and 95 per cent for the Surgery group (n = 44). The two-year overall survival rate was 98 per cent for the Oncology group and 100 per cent for the Surgery group. The functional swallowing outcome at two years post-treatment was similar in both groups. Subgroup analysis showed patients treated with surgery-only with no adjuvant treatment had the best functional outcome whilst patients treated with surgery and post-operative chemoradiotherapy had the worst functional outcome.

The overall oncological and functional outcomes at two years were similar in both groups. Patients treated with surgery-only had the best functional outcome without compromised oncological outcome.

Head and neck cancer has a 5 per cent incidence of synchronous primary cancer. Synchronous primary cancers are commonly detected with imaging and flexible nasoendoscopy. Routine panendoscopy is still being used to screen for synchronous primary cancers. The aim was to establish the method of detection of synchronous primary cancer.

A retrospective cohort study of newly diagnosed head and neck cancer patients with a synchronous primary cancer, presented at the West of Scotland Head and Neck Multidisciplinary Team from December 2020 to August 2022. This study is Level 3 evidence.

A total of 2325 patients were presented to the Multi-Disciplinary Team with head and neck cancer and 54 (2.3 per cent) had SPC; 63.8 per cent (30) of patients had a panendoscopy. All patients with comprehensive out-patient assessment had their synchronous primary cancer detected on examination or imaging, without the need for panendoscopy.

Panendoscopy did not detect any new synchronous primary cancer in patients assessed with flexible nasoendoscopy and imaging. With modern high-resolution imaging and fibreoptics, panendoscopy does not play a role in the detection of synchronous primary cancers.

The adipofascial anterolateral thigh (AF-ALT) free flap represents a versatile technique in head and neck reconstructions, with its applications increasingly broadening. The objective was to detail the novel utilization of the AF-ALT flap in orbital and skull base reconstruction, along with salvage laryngectomy onlay in our case series.

We conducted a retrospective analysis at Roswell Park Comprehensive Cancer Center, spanning from July 2019 to June 2023, focusing on patient demographics and reconstructive parameters data.

The AF-ALT flap was successfully employed in eight patients (average age 59, body mass index [BMI] 32.0) to repair various defects. Noteworthy outcomes were observed in skull base reconstructions, with no flap failures or major complications over an average 12-month follow-up. Donor sites typically healed well with minimal interventions.

Our series is the first to report the AF-ALT flap's efficacy in anterior skull base and orbital reconstructions, demonstrating an additional innovation in complex head and neck surgeries.

Our centre (Freeman Hospital, Newcatle Upon Tyne NHS Trust) has favoured primary surgery over chemoradiotherapy for specific advanced laryngeal cancer patients (e.g. large-volume tumours, airway compromise, significant dysphagia, T4 disease). This study reports the survival outcomes for a modern, high-volume head and neck centre favouring surgical management to determine whether this approach improves survival.

Retrospective analysis of patient data over a seven-year period from a tertiary cancer centre.

In total, 121 patients were identified with T3 (n = 76) or T4 (n = 45) laryngeal cancer (mean follow up 2.9 years). In the cohort treated with curative intent (n = 104, 86.0 per cent), the 2- and 5-year estimated disease-specific survival rates were 77.9 and 64.1 per cent. chemoradiotherapy had the highest 2-year disease-specific survival (92.5 per cent), followed by surgery with adjuvant therapy (81.8 per cent), radiotherapy alone (75 per cent) and surgery alone (72.4 per cent).

For a centre favouring primary surgery for certain advanced laryngeal cancers, the disease-specific survival appears no higher than that found in the published literature. To enhance survival, future research should focus on precision medicine to define treatment pathways in this disease.

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.

A pathological communication between the trachea and oesophagus – a tracheoesophageal fistula – may be congenital or acquired, benign or malignant, necessitating a multidisciplinary approach. Conservative attempts at closure of this abnormal connection are ineffective; the interposition of healthy vascular tissue offers the least chance of recurrence.

Outcomes of an islanded fasciocutaneous internal mammary artery perforator flap applied for tracheoesophageal fistula management were assessed in four radiated patients with laryngeal carcinoma using retrospective records.

Four male patients, with an average age of 60.75 years, underwent tracheoesophageal fistula closure between September 2017 and February 2021. A left-sided second internal mammary artery perforator flap was used in all cases, with an average dimension of 10.5 × 4.5 cm. There were no complications of tracheoesophageal leak, flap issues or donor site morbidity on follow up.

Recent advances in angiosomal territory mapping and microvascular dissection techniques, combined with an understanding of tracheoesophageal fistula pathology, have changed management perspectives in these difficult-to-treat patients.

To study the safety and efficacy of Artiss fibrin sealant in lateral neck dissection, focusing on drain retention time, length of hospital stay and post-operative complications.

A retrospective review was conducted of patients who underwent neck dissection in a UK hospital over a 12-month period.

Twenty-three patients were identified; 13 patients had Artiss and a drain, 10 patients had Artiss only. All drains were removed by post-operative day 2. No post-operative fluid collections or complications were recorded. Patients who had Artiss only without a drain were discharged on post-operative day 1.

The use of Artiss reduced the drain retention time and hospital stay, with no post-operative complications. Neck dissection can be safely undertaken with no drain, and can potentially be carried out as a day-case procedure, with the application of Artiss. These findings benefit patients and the National Health Service by improving the patient journey and reducing overall costs.

The coronavirus disease 2019 pandemic created challenges in surgical education that expedited the development of virtual learning. Virtual rotations have been one such solution. However, they require co-ordination and technological equipment to create a meaningful, interactive experience for students.

Various otolaryngology surgical procedures were live-streamed during a two-week virtual rotation for medical students. A mobile audiovisual cart comprising a computer mounted with a webcam and microphone/speaker were utilised to live-stream from four sources: video-assisted telescope operating monitor (‘VITOM’) exoscope, microscope, endoscope and room camera. A dedicated faculty member, who was not the operating surgeon, was present to facilitate students’ understanding of the procedure.

A wide breadth of otolaryngology surgical procedures were live-streamed via a mobile audiovisual computer, including views of the room, endoscopic views, microscopic views and open views via an exoscope (video-assisted telescope operating monitor). This virtual rotation set-up, along with the dedicated faculty facilitator, reduced the burden on the operating surgeon and enhanced students’ learning experience.

To investigate whether the possible pressure produced by a haematoma in the neck would be sufficient to directly compress the trachea to the point of airway obstruction.

In vitro study.

Varying pressures were applied over the second and third cartilaginous rings of 10 pig tracheas in vitro and the anterior–posterior compression was measured.

At pressures of 257 mmHg, equivalent to the maximum possible pressure in the neck (i.e. systolic blood pressure), there was an average compression of 20.8 per cent of the original anterior–posterior tracheal diameter.

This study suggests that the pressures in haematomas observed after neck surgery would not be sufficient to cause airway obstruction due to direct pressure on the trachea. Therefore, the most likely cause of airway obstruction would be supraglottic oedema secondary to venous obstruction.