This publication offers modern, state‐of‐the‐art International Neural Monitoring Study Group (INMSG) guidelines based on a detailed review of the recent monitoring literature. The guidelines outline evidence‐based definitions of adverse electrophysiologic events, especially loss of signal, and their incorporation in surgical strategy. These recommendations are designed to reduce technique variations, enhance the quality of neural monitoring, and assist surgeons in the clinical decision‐making process involved in surgical management of recurrent laryngeal nerve. The guidelines are published in conjunction with the INMSG Guidelines Part II, Optimal Recurrent Laryngeal Nerve Management for Invasive Thyroid Cancer–Incorporation of Surgical, Laryngeal, and Neural Electrophysiologic Data. Laryngoscope, 128:S1–S17, 2018

The purpose of this publication was to inform surgeons as to the modern state‐of‐the‐art evidence‐based guidelines for management of the recurrent laryngeal nerve invaded by malignancy through blending the domains of 1) surgical intraoperative information, 2) preoperative glottic function, and 3) intraoperative real‐time electrophysiologic information. These guidelines generated by the International Neural Monitoring Study Group (INMSG) are envisioned to assist the clinical decision‐making process involved in recurrent laryngeal nerve management during thyroid surgery by incorporating the important information domains of not only gross surgical findings but also intraoperative recurrent laryngeal nerve functional status and preoperative laryngoscopy findings. These guidelines are presented mainly through algorithmic workflow diagrams for convenience and the ease of application. These guidelines are published in conjunction with the INMSG Guidelines Part I: Staging Bilateral Thyroid Surgery With Monitoring Loss of Signal. Level of Evidence: 5 Laryngoscope, 128:S18–S27, 2018

Background Little is known about the epidemiology of pain in head and neck cancer, the effects of curative treatment on this pain, and the impact that pain experience may have on patients' quality of life (QL). Method The prevalence and severity of pain was studied in 93 patients who were first seen with a diagnosis of head and neck cancer, were treated, and remained disease free at two years. QL assessment utilised the life‐satisfaction scale and the General Health Questionnaire as specific measures. Pain was assessed by a linear analogue scale anchored by words and numbers. Results Forty‐eight percent had head and neck pain when first seen, whereas only 25% and 26% had such pain at 12 and 24 months. Approximately 8% of patients rated the pain as “severe” when first seen, whereas 3% had severe pain at 12 months and 4% at 2 years. The prevalence of shoulder and arm pain increased from 14% at diagnosis to 37% at a year and 26% at 24 months, but the percentage of patients with severe pain at any stage postoperatively was only 5% and 2%, respectively. Any pain (pain in either in the head and neck or shoulder and arm or both) at 2 years was strongly predicted by earlier posttreatment pain (at 3 months or at 12 months.) Shoulder and arm pain at 2 years was strongly correlated with surgical treatment of the neck, although no difference in pain experience was noted between those who had radical neck dissections and those who had more conservative procedures. There was no correlation between radiotherapy to the neck and subsequent shoulder and arm pain. Pain had an adverse effect on the general well‐being and psychological distress of head and neck cancer patients who were free of disease. Conclusions Pain is common among those presenting with curable head and neck cancer. Pain can be reduced by curative treatment but neck dissection may cause increased shoulder and arm pain. Ongoing pain is predictable and impacts adversely on patients QL. © 1999 John Wiley & Sons, Inc. Head Neck 21: 531–537, 1999.

Fifty-four surfers and 38 surf life savers were examined and questioned in order to determine the prevalence of exostoses. Seventy-three per cent had evidence of body exostoses in the external auditory meatus. Forty per cent had their ear canals narrowed by 50% or more. The relationship between the number of years spent surfing or life saving and the extent of canal stenosis was highly significant (P < 0.00001). Left and right ears were affected equally in this series and the obstruction appears to begin after approximately 7 years and is further aggravated by continued surfing. Over 90% of subjects who had participated for longer than 10 years had some evidence of exostoses. There was no significant association between the number of days per year or the number of hours per day spent surfing and the development of surfer's ear in this sample. Those who participated in their water sport over winter had significantly more exostoses than those who did not (P < 0.0001). Those who lived in the South Island (colder water) had more surfer's ear than those in the North Island (warmer water).

One hundred and seventy patients were identified. The 5-year disease-specific survival rate was 69%, and the loco-regional recurrence rate was 36%. The presence of parotid (P < 0.01) or neck (P = 0.01) disease, immunosuppression (P < 0.01) and the uptake of radiotherapy (P < 0.01) impacted significantly on survival. Increasing P or N category worsened the prognosis significantly.