The edition · ENT & Head and Neck Surgery
Most head and neck cancer patients stayed on opioids months after radiation
Plus coffee's opposite effects on throat versus voice-box cancer, a cheap adjunct for tonsillectomy pain, and why adding a pharyngeal procedure to children's sleep-apnoea surgery did not help.
The edition in brief
Today's ENT edition leads on opioid stewardship after head and neck cancer. In a cohort of 789 patients treated with radiation or chemoradiation, 70% were still taking prescription opioids three months after treatment and 47% at six months, with prior opioid use, former smoking and palliative-care referral predicting continued use — an argument for structured stewardship that balances analgesia against dependency. A dose-response meta-analysis found higher coffee intake associated with lower overall head and neck cancer risk, with reduced oral and pharyngeal cancer but, strikingly, a higher risk of laryngeal cancer — an observational signal, not a dietary recommendation. A meta-analysis suggested perioperative intraoral sucralfate eases post-tonsillectomy pain and speeds recovery without raising bleeding. A pearl reiterates the red flags that should trigger urgent two-week referral for head and neck cancer. The practice-changer: adding pharyngoplasty or pillar suturing to adenotonsillectomy for paediatric obstructive sleep apnoea gave no measurable benefit over tonsillectomy alone, so it should not be routine.
Most head and neck cancer patients were still on opioids months after radiation
Anticipate long-term opioid use after head and neck radiation and build a review-and-taper plan for high-risk patients, without undertreating acute pain.
Coffee linked with lower throat cancer risk — but higher laryngeal cancer risk
Higher coffee intake was associated with lower oral and pharyngeal but higher laryngeal cancer risk — an observational signal, not a dietary recommendation.
Intraoral sucralfate eased post-tonsillectomy pain in pooled trials
Consider perioperative intraoral sucralfate as a cheap, low-risk adjunct for post-tonsillectomy pain within a multimodal analgesic plan.
Know the head and neck cancer red flags that mean urgent referral
Refer urgently and scope for persistent unilateral head and neck symptoms — hoarseness, neck lump, non-healing ulcer, or otalgia with a normal ear exam.
Adding a pharyngeal procedure to children's sleep-apnoea surgery did not help
Do not routinely add pharyngoplasty or pillar suturing to adenotonsillectomy for paediatric obstructive sleep apnoea — it gives no measurable benefit over tonsillectomy alone.
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