Clinical OtolaryngologyVolume 34, Issue 2 p. 161-164 Surgical management of advanced differentiated thyroid cancer – introducing the concept of wide field total thyroidectomy: how we do it J.-P. Jeannon, J.-P. Jeannon Departments of Otolaryngology – Head & Neck SurgerySearch for more papers by this authorR. Simo, R. Simo Departments of Otolaryngology – Head & Neck SurgerySearch for more papers by this authorB. Wallwork, B. Wallwork Departments of Otolaryngology – Head & Neck SurgerySearch for more papers by this authorG. Bruch, G. Bruch Departments of Otolaryngology – Head & Neck SurgerySearch for more papers by this authorS. Clarke, S. Clarke Nuclear MedicineSearch for more papers by this authorM. O’Connell, M. O’Connell Clinical Oncology, Guys & St Thomas NHS Foundation Trust, London, UKSearch for more papers by this author J.-P. Jeannon, J.-P. Jeannon Departments of Otolaryngology – Head & Neck SurgerySearch for more papers by this authorR. Simo, R. Simo Departments of Otolaryngology – Head & Neck SurgerySearch for more papers by this authorB. Wallwork, B. Wallwork Departments of Otolaryngology – Head & Neck SurgerySearch for more papers by this authorG. Bruch, G. Bruch Departments of Otolaryngology – Head & Neck SurgerySearch for more papers by this authorS. Clarke, S. Clarke Nuclear MedicineSearch for more papers by this authorM. O’Connell, M. O’Connell Clinical Oncology, Guys & St Thomas NHS Foundation Trust, London, UKSearch for more papers by this author First published: 08 April 2009 https://doi.org/10.1111/j.1749-4486.2009.01881.xCitations: 4 Jean-Pierre Jeannon, Department of Otolaryngology – Head & Neck Surgery, Guys & St Thomas NHS Foundation Trust, London SE1 9RT, UK. Tel.: +44 207 188 2213; fax: +44 207 188 2206; e-mail: [email protected] Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat References 1 Mazzaferri E.L. & Jhiang S.M. (1994) Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am. J. Med. 97, 418–428 10.1016/0002-9343(94)90321-2 CASPubMedWeb of Science®Google Scholar 2 Tovi F., Noyek A.M., Chapnik J.S. et al. (1989) Safety of total thyroidectomy: review of 100 consecutive cases. Laryngoscope 99, 1233–1237 10.1288/00005537-198912000-00005 CASPubMedWeb of Science®Google Scholar 3 Steurer M., Passler C., Denk D.M. et al. (2002) Advantages of recurrent laryngeal nerve identification in thyroidectomy and parathyroidectomy and the importance of preoperative and postoperative laryngoscopic examination in more than 1000 nerves at risk. Laryngoscope 112, 124–133 10.1097/00005537-200201000-00022 PubMedWeb of Science®Google Scholar Citing Literature Volume34, Issue2April 2009Pages 161-164 ReferencesRelatedInformation

Background: The current management of thyroid lymphomas (TL) includes the combined use of chemotherapy and radiotherapy, with surgery mainly confined to diagnosis through an open biopsy following ultrasound-guided fine-needle aspiration cytology (US-FNAC). Aims: To analyse the clinical presentation and methods of diagnosis of TL, its pitfalls and the management of these tumours presenting with compression symptoms and airway obstruction. Methods: A retrospective review of nine patients diagnosed with TL at Guy’s and St Thomas Hospital NHS Foundation Trust in London over the past 5 years. Results: Nine consecutive patients were identified with the diagnosis of TL, and seven (78%) of them being women and with a mean age of 65 years. All patients presented with an anterior neck mass while four (44.4%) presented with stridor and vocal cord palsy. Two (22.2%) presented with a hoarse voice, dysphagia, and only one patient had a B symptom of weight loss. FNAC was diagnostic in three patients (33.3%) and a report of multi-nodular goitre in one patient. There was clinical suspicion of TL in three patients (33.3%). Of the three patients presenting with stridor, two had an open biopsy followed by the initiation of dexamethasone therapy and resolution of symptoms within 48 h. One patient had a partial thyroidectomy following a suspected diagnosis of multi-nodular goitre from US-FNAC. One patient required tracheostomy for airway management. Conclusion: Diagnosis of TL may be difficult. However, US-FNAC is useful in raising the suspicion of a TL. Open biopsy is still the definitive diagnostic tool of choice. In the emergency setting of airway obstruction, once definitive diagnosis is achieved, dexamethasone therapy and endotracheal intubation for airway management are all that is required for optimal management strategy. Surgical intervention has no role except for providing tissue for diagnosis.

Introduction: Feeding gastrostomies (FG) are well established as a method of providing satisfactory nutritional support in patients undergoing treatment for head and neck cancer (HNC). These FG can be inserted percutaneously (PEG), under radiological guidance (RIG) or surgically (OG). With PEG, abdominal wall metastasis (AWM) and airway obstruction (AO) are two of the most devastating complications. The aims of this paper is to review our experience of systematically assessing the airway in patients undergoing FG insertion, demonstrate the advantages of this approach to prevent AO and determine the indications for FG insertion under general anaesthesia (GA) or RIG.

In a south London department of otorhinolaryngology and head and neck surgery, 33 cases of tuberculosis were diagnosed in 4 years. The most common presentation was cervical adenitis (58%) and in some cases the initial investigations suggested malignant disease. Most of the patients were of non-British origin but none proved to be HIV seropositive. Fine-needle aspiration was positive for tuberculosis in 7 of 19 patients. 21 patients required a surgical procedure for diagnosis.