{"title":"Disorders of swallowing","authors":"Paul R Counter, Jen H Ong","doi":"10.1016/j.mpsur.2024.05.022","DOIUrl":"10.1016/j.mpsur.2024.05.022","url":null,"abstract":"<div><p><span>Disorders of swallowing are very common and, when looked for, occur regularly in most branches of surgery. Dysphagia<span><span><span> is often not the patient's presenting complaint and can be easily missed. The consequences of missed or delayed diagnosis of dysphagia can be insidious but profound and, in some cases, fatal. The investigation and treatment of these patients is normally highly multidisciplinary, potentially involving gastroenterology, general surgery, </span>otolaryngology, acute medicine, stroke medicine, </span>paediatrics, </span></span>speech and language therapy<span> (SLT) and dietitians. While this article is aimed at surgeons and will thus concentrate mostly on those conditions seen by surgeons, it must be remembered that the most common cause of dysphagia is a neurological disturbance and is managed by physicians and SLT. That said, the incidence of these conditions rises with age, as does the incidence of many surgically treatable conditions. It is therefore common to assess a patient with a known neurological condition for the presence of a second pathology affecting their swallow. A basic knowledge of non-surgical conditions is therefore useful.</span></p></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 9","pages":"Pages 644-651"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142117406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Investigation and management of the neck lump","authors":"Katharine Davies, David Hamilton","doi":"10.1016/j.mpsur.2024.05.018","DOIUrl":"10.1016/j.mpsur.2024.05.018","url":null,"abstract":"<div><p>A neck lump is a common presenting sign in both the paediatric and adult population and may represent a broad range of benign or malignant diagnoses. The appropriate initial assessment, investigation and management is key to delivering appropriate treatments and to avoid missing potentially serious diagnoses. There is a range of imaging modalities available to the treating clinician and huge variability in the appropriate surgical or non-surgical management of disease. In this article we discuss the approach to the assessment of patients with a neck lump, including the history and examinations which should take place. We discuss the imaging modalities which are most appropriate for each condition and the range of management options available. Both common and rarer diagnoses are discussed through the course of the review.</p></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 9","pages":"Pages 684-693"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142117396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Physiology of swallowing","authors":"Jenny Walton, Priyamal Silva","doi":"10.1016/j.mpsur.2024.05.015","DOIUrl":"10.1016/j.mpsur.2024.05.015","url":null,"abstract":"<div><p>The mechanism behind normal swallowing is complex and multifactorial. Due to the close proximity of the pathways of swallowing and respiration, precise coordination between these functions is vital in order to avoid entry of material into the airway and to ensure optimal health and nutrition in general. Swallowing can be divided into three stages: oral, pharyngeal and oesophageal, and although initiation of the swallow is often under voluntary control, swallowing is also triggered frequently throughout the day as a reflex action due to the presence of saliva in the oropharynx. Dysphagia is a symptom frequently encountered by clinicians and its causes are vast and varied. A thorough understanding of the physiology of swallowing remains necessary to conduct a full assessment and instigate appropriate treatment for these patients in whom dysphagia is often debilitating and may significantly affect their quality of life. We present an account of the physiology of swallowing, illustrated with clinical examples.</p></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 9","pages":"Pages 638-643"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142117405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Blunt and penetrating cervical trauma","authors":"Zaid Awad, Thomas Jacques, Dave Sharma","doi":"10.1016/j.mpsur.2024.07.011","DOIUrl":"10.1016/j.mpsur.2024.07.011","url":null,"abstract":"<div><p>Trauma to the cervical region may result in critical injury to the airway, the neck vasculature, and the pharynx or oesophagus. These three systems should be systematically assessed, alongside ATLS protocols, in all patients presenting with blunt or penetrating trauma to the head and neck region. The majority of trauma centres now have a policy of selective neck exploration based on clinical and radiological findings. It is therefore essential to be aware of the symptoms and clinical signs of injury of key neck structures, so that neck exploration can be performed promptly in patients who require it.</p></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 9","pages":"Pages 702-706"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142117399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Test yourself: MCQ and Single Best Answer","authors":"Adrian Ben Cresswell","doi":"10.1016/j.mpsur.2024.06.003","DOIUrl":"10.1016/j.mpsur.2024.06.003","url":null,"abstract":"","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 8","pages":"Pages 628-629"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The diagnosis and management of discitis and spinal infection","authors":"David A. Samy, Surya Gandham, Marcus DeMatas","doi":"10.1016/j.mpsur.2024.06.001","DOIUrl":"10.1016/j.mpsur.2024.06.001","url":null,"abstract":"<div><p><span>Discitis and spinal infections are both common presentations within the field of spinal surgery, but the diagnosis and management can be challenging. When identified and treated early, the patient outcomes are very good and often do not require surgical intervention. Conversely, delayed presentations with neurological compromise are a surgical emergency requiring aggressive treatment to prevent irreversible spinal cord and </span>spinal deformity<span>. A multidisciplinary approach involving surgeons and microbiologists prevent the need for surgical intervention. In this review article, we highlight the key aspects of diagnosing and treating discitis and spinal infections based on the current literature and evidence base.</span></p></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 8","pages":"Pages 615-620"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cerebral vascular anatomy and physiology","authors":"Rahul S. Shah, Deva S. Jeyaretna","doi":"10.1016/j.mpsur.2024.05.009","DOIUrl":"10.1016/j.mpsur.2024.05.009","url":null,"abstract":"<div><p>Knowledge of normal cerebral vascular anatomy and physiology is critical for both recognizing and safely managing a range of neurosurgical conditions through either open or endovascular techniques. In this article we summarize the key features of the arterial supply and venous drainage of the brain along with their main clinical significance.</p></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 8","pages":"Pages 536-542"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Neurosurgery of epilepsy, movement disorders and pain","authors":"Jonathan R Ellenbogen, Keyoumars Ashkan","doi":"10.1016/j.mpsur.2024.05.005","DOIUrl":"10.1016/j.mpsur.2024.05.005","url":null,"abstract":"<div><p>Functional neurosurgery involves the surgical management of a wide range of neurological diseases with the aim of treating conditions such as movement disorders, spasticity, epilepsy and intractable pain. Functional neurosurgery began with ablative surgical techniques involving destruction of neural structures responsible for the aberrant neural pathways/networks causing pathology. In more recent years there has been a move away from the creation of permanent destructive lesions towards modulation of the neural networks utilizing neuro-modulation. Neuromodulation therapies include invasive (e.g. deep brain stimulators, cortical stimulators, vagal nerve stimulators and spinal cord stimulators) and non-invasive (e.g. transcranial magnetic stimulation) approaches that involve the application of electrical stimulation to drive or inhibit neural function within a circuit. Most implantable neuromodulation systems include three primary components: stimulating electrode(s) with contacts at the tip through which electricity is delivered, an implantable pulse generator (IPG) that serves as a signal generator/battery pack, and the extension cable(s) to subcutaneously connect the electrode(s) to the IPG. In this article we primarily focus on the current role of neuromodulation in treating movement disorders, epilepsy and pain, and also consider emerging and evolving applications.</p></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 8","pages":"Pages 570-579"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The management of radiculopathy, neurogenic claudication and cauda equina syndrome","authors":"Nick Carleton-Bland","doi":"10.1016/j.mpsur.2024.05.006","DOIUrl":"10.1016/j.mpsur.2024.05.006","url":null,"abstract":"<div><p><span><span>Radiculopathy<span><span> is a commonly encountered symptom in neurosurgical practice. This article discusses the clinical presentation, anatomy, </span>pathophysiology and treatment of radiculopathy, neurogenic </span></span>claudication and </span>cauda equina syndrome.</p></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 8","pages":"Pages 599-603"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Neurovascular neurosurgery","authors":"Samir Adil Matloob, Umang Jash Patel","doi":"10.1016/j.mpsur.2024.06.002","DOIUrl":"10.1016/j.mpsur.2024.06.002","url":null,"abstract":"<div><p><span><span>Neurovascular disorders including brain aneurysms, </span>arteriovenous malformations (AVMs) and intracranial atherosclerotic disease with its associated morbidity have a significant health and economic toll on our population. They form a major part of the neurosurgical workload. Neurovascular </span>neurosurgery<span><span> covers a wide variety of pathologies affecting the brain and spinal cord, all of which can result in intracerebral or subarachnoid haemorrhage, stroke, direct compression from mass effect and subsequent neurological deficits. Neurovascular </span>neurosurgery is increasingly being managed in subspecialist teams. The aim of this article is to outline the more commonly encountered neurovascular conditions, their diagnosis and management, to better equip those looking after patients with neurovascular conditions.</span></p></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 8","pages":"Pages 561-569"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141695152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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