Abstract Aim Audit incidence of Surgical Site Infection (SSI) and early post-operative infection in open head and neck surgery in a tertiary centre and identify opportunities for improvement. Method We performed two 6-month audit cycles of rates of post-operative infection in elective open head and neck surgery against national rates. Cycle 1 was from August 2021-January 2022, and Cycle 2 from March-September 2022. Between cycles we introduced a flow-chart antibiotics prophylaxis protocol as an improvement measure and presented findings at a local meeting. Results 172 open head and neck operations were performed in Cycle 1. 7 patients developed SSIs. 169 open head and neck operations were performed in Cycle 2. 6 patients developed SSIs. Cycle 1 included 14 diabetic patients, of whom 7 received prophylactic antibiotics. Cycle 2 included 19 diabetic patients, of whom 16 received prophylactic antibiotics. In Cycle 1, 2 diabetic patients developed early post-operative infections, one of which was an SSI, compared with 0 in Cycle 2. SSI was more likely in patients who had surgical drains placed (8 out of 94 patients with drains, p = 0.008498*) and prophylactic antibiotic practice in this group was inconsistent in both cycles. Conclusion Our tertiary centre had comparable rates of SSI to national standards. We identified low rates of prophylactic antibiotic prescription for patients with diabetes and introduced a prophylaxis protocol which, despite not reaching statistical significance, appears to have improved rates of infection in diabetic patients. Additional changes should be introduced to reduce rates of infection in patients with surgical drains.

Intrathyroidal parathyroid adenomas (IPAs) are a rare cause of primary hyperparathyroidism. They are often difficult to localize preoperatively and intraoperatively, making diagnosis and treatment challenging. Current data on IPAs are sparse and fragmented in the literature. This makes it difficult to compare the effectiveness of different imaging and surgical techniques. To address this issue, this scoping review maps the literature on IPAs, focusing on four domains: clinical presentation, current localization methods, different surgical techniques, and histopathological features. A search of MEDLINE, Embase, and the Cochrane Library was conducted, with 19 studies meeting the inclusion criteria. The characteristics of IPAs on ultrasound, fine-needle aspiration, CT, MRI, sestamibi-based techniques, and selective venous sampling are summarized. Emerging imaging modalities, including autofluorescence, are introduced. Surgical methods and intraoperative factors that correlate with high success rates for removal are highlighted. This review also identifies gaps in knowledge to guide further research into this area.

The peer review history for this article is available at https://publons.com/publon/10.1111/coa.13896. The data that support this study are available from the corresponding author upon reasonable request.

Malignant thyroid teratoma in adults is a rare tumour with less than 40 cases reported worldwide. Our case is of a 29-year-old man who presented with a thyroid lump and compressive symptoms. He underwent multiple investigations before being diagnosed with a malignant thyroid teratoma. There are no established guidelines in the management of this tumour yet. In this case report, we discuss the diagnosis, treatment and follow-up of the patient and reflect on the published literature on this tumour.

Since publishing our article, Custom designing laryngoplasty implant using actual size CT scan images on a mobile device,1 we have refined our technique to improve the accuracy and time required for the procedure using smart phones with a stylus that allows direct sketching on the screen. The published technique starts with taking a screenshot of the image after adjusting it to the actual size.

Heterotopic Salivary Gland Tissue (HSGT) of the larynx is an extremely rare pathology, with only 8 cases reported in English literature. We are reporting 2 cases of HSGT in the larynx which we encountered in our practice. The first one is a unique presentation of a 45 year old female with HSGT in bilateral false vocal cords. While the second case is 50-year-old male patient with HSGT in the left false vocal cord and subglottic region. With these 2 cases, we would be discussing about the clinical presentation of this rare anomaly and add to the literature.