Neil Sharma

Neil Sharma
University of Birmingham · Institute of Cancer and Genomic Sciences

MBChB PhD DOHNS FRCS (ORL HNS)

About

119
Publications
13,012
Reads
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1,221
Citations
Introduction
Clinical Scientist at University of Birmingham and Honorary Consultant Head and Neck Surgeon at University Hospitals Birmingham NHS Trust.
Additional affiliations
August 2018 - September 2018
University of Birmingham
Position
  • Consultant

Publications

Publications (119)
Article
Full-text available
To explore laryngeal function of tracheostomised patients with COVID-19 in the acute phase, to identify ways teams may facilitate and expedite tracheostomy weaning and rehabilitation of upper airway function. Consecutive tracheostomised patients underwent laryngeal examination during mechanical ventilation weaning. Primary outcomes included prevale...
Preprint
Key Points • CRP reduction at day five of more than 35% from the previous highest concentration post-laryngectomy or laryngopharyngectomy has been proposed to positively predict healing without pharyngocutaneous fistula • Retrospective cohort analysis of 163 patients has not been able to externally validate these findings. • ROC curves and subset a...
Article
Full-text available
Background Thyroid cancer recurrence is associated with increased mortality and adverse outcomes. Recurrence risk is currently predicted using clinical tools, often restaging patients after treatment. Detailed understanding of recurrence risk at disease-onset could lead to personalised and improved patient care. Objective To perform a comprehensiv...
Article
Objectives Nodal metastasis is an important prognosticator in primary parotid cancers. The management of the clinically node-negative neck is an area lacking consensus. This study investigates the occult nodal metastasis rate, and prognostic indicators in primary parotid cancers. Materials and methods We performed a multicentre retrospective case...
Article
Full-text available
The infiltration of T‐lymphocytes in the stroma and tumour is an indication of an effective immune response against the tumour, resulting in better survival. In this study, our aim is to explore the prognostic significance of tumour‐associated stroma infiltrating lymphocytes (TASILs) in head and neck squamous cell carcinoma (HNSCC) through an AI ba...
Article
Background This study aims to develop and validate a new classification system that better predicts combined risk of neurological and neurovascular complications following CBT surgery, crucial for treatment decision-making. Methods Multinational retrospective cohort study with 199 consecutive cases. A cohort of 132 CBT cases was used to develop th...
Article
Full-text available
Background: Remote triage for suspected head and neck cancer (HNC) referrals was adopted by many institutions during the initial peak of the coronavirus disease 2019 pandemic. Its safety in this population has not been established. Methods: A 16-week, prospective, multicenter national service evaluation was started on March 23, 2020. Suspected H...
Article
Full-text available
Objectives To report the experience of civilian penetrating neck trauma (PNT) at a UK level I trauma centre, propose an initial management algorithm and assess the degree of correlation between clinical signs of injury, operative findings, and radiological reports. Design Retrospective case note review Setting UK level I trauma centre April 2012-...
Article
Full-text available
Predictive tools, utilising biomarkers, aim to objectively assess the potential response to a particular clinical intervention in order to direct treatment. Conventional cancer therapy remains poorly served by predictive biomarkers, despite being the mainstay of treatment for most patients. In contrast, targeted therapy benefits from a clearly defi...
Preprint
Full-text available
The infiltration of T-lymphocytes in the stroma and tumour is an indication of an effective immune response against the tumour, resulting in better survival. In this study, our aim is to explore the prognostic significance of tumour-associated stroma infiltrating lymphocytes (TASILs) in head and neck squamous cell carcinoma (HNSCC) through an AI ba...
Preprint
Full-text available
Purpose COVIDTrach is a UK multi-centre prospective cohort study project evaluating the outcomes of tracheostomy in patients with COVID-19 receiving mechanical ventilation. It also examines the incidence of SARS-CoV-2 infection among healthcare workers involved in the procedure. Method An invitation to participate was sent to all UK NHS department...
Article
Full-text available
Objectives As the pathophysiology of COVID-19 emerges, this paper describes dysphagia as a sequela of the disease, including its diagnosis and management, hypothesised causes, symptomatology in relation to viral progression, and concurrent variables such as intubation, tracheostomy and delirium, at a tertiary UK hospital. Results During the first...
Article
Full-text available
Background The role of tracheostomy in COVID-19 is unclear, with several consensus guidelines advising against this practice. We developed both a dedicated airway team and coordinated education programme to facilitate ward management of tracheostomised COVID-19 patients. Here, we report outcomes in the first 100 COVID-19 patients that underwent tra...
Article
Full-text available
PurposeThe objectives of this study were (1) to systematically review current definitions of head and neck squamous cell carcinoma (HNSCC) recurrence and (2) to propose a definition of locally recurrent HNSCC.MethodsA systematic literature review was performed according to the ‘Preferred Reporting Items for Systematic Reviews and Meta-Analyses’ sta...
Article
Full-text available
Background Impaction of a soft food bolus in the oesophagus causes dysphagia and regurgitation. If the bolus does not pass spontaneously, then the patient is at risk of aspiration, dehydration, perforation, and death. Definitive management is with endoscopic intervention, recommended within 24 hours. Prior to endoscopy, many patients undergo a peri...
Article
This paper explores the concept of advocacy in head and neck cancer. We define inherent challenges in the development and success of advocacy within this context, and offer ways to embed it within clinical practice. We outline what advocacy is, ways in which it may benefit people with head and neck cancer and the engagement required from health car...
Article
Introduction: Warthin's tumor (WT) is a common benign salivary gland neoplasm with a negligible risk of malignant transformation. However, there is a risk of malignant tumors being misdiagnosed as WT on cytology and inappropriately managed conservatively. Methods: Patients from nine centers in Italy and the United Kingdom undergoing parotid surg...
Article
Background Blunt neck trauma can cause serious morbidity and mortality rates of up to 40 per cent, but there is a paucity of literature on the topic. Method A retrospective case note review was performed for all blunt neck trauma cases managed at the Queen Elizabeth Hospital Birmingham between 1st January 2011 and 31st December 2017. Results Seve...
Article
Full-text available
Background: The use of transoral robotic surgery (TORS) and laser microsurgery (TLM) in the diagnosis and identification of the site of the unknown primary has become increasingly common. This systematic review and meta-analysis aims to assess the use and efficacy of TORS and TLM for this indication. Method: Systematic review and meta-analysis of...
Article
Full-text available
Objective: Presentation of a case of cervical hibernoma. Methods: Case report and review literature. Subject: A 16-year-old woman with a right posterior triangle neck mass. Results: Hibernoma is a rare, benign tumour of brown fat. The cervical area is an unusual localization. The presented case posed difficulties in the differential diagnosis of ce...
Article
Full-text available
Background The incidence of human papillomavirus (HPV)-positive oropharyngeal cancer, a disease affecting younger patients, is rapidly increasing. Cetuximab, an epidermal growth factor receptor inhibitor, has been proposed for treatment de-escalation in this setting to reduce the toxicity of standard cisplatin treatment, but no randomised evidence...
Article
Full-text available
Background Cell-free DNA (cfDNA) can be detected in the circulation of healthy individuals, but is found in higher concentrations in cancer patients. Furthermore, mutations in tumor cells can be identified in circulating DNA fragments. This has been the subject of significant interest in the field of cancer research, but little has been published i...
Article
Full-text available
The use of circulating biochemical molecular markers in head and neck cancer holds the promise of improved diagnostics, treatment planning, and posttreatment surveillance. In this review, we provide an introduction for the head and neck surgeon of the basic science, current evidence, and future applications of circulating tumor DNA (ctDNA) as a bio...
Article
Objective: Epistaxis is a common ENT emergency in the UK; however, despite the high incidence, there are currently no nationally accepted guidelines for its management. This paper seeks to recommend evidence-based best practice for the hospital management of epistaxis in adults. Methods: Recommendations were developed using an Appraisal of Guide...
Article
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To evaluate the efficacy of non-procedural interventions in the management of soft food boluses impacted within the oesophagus.
Article
Full-text available
Objectives: To access 1) the value of further surgical resection (completion surgery) in cases with a positive intraoperative margin analysis, and 2) whether cancers that undergo completion surgery following positive intraoperative margin analysis with subsequent negative margins should be considered true margin-negative (R0) resections in terms o...
Article
Full-text available
Background Epistaxis is a common condition that can be associated with significant morbidity, and it places a considerable burden on our healthcare system. This national audit of management sought to assess current practice against newly created consensus recommendations and to expand our current evidence base. Methods The management of epistaxis...
Article
Full-text available
Objective To investigate the feasibility of a national audit of epistaxis management led and delivered by a multi-region trainee collaborative using a web-based interface to capture patient data. Methods Six trainee collaboratives across England nominated one site each and worked together to carry out this pilot. An encrypted data capture tool was...
Article
Full-text available
Traditionally few students have had the opportunity to contribute to high-quality clinical research. Over the last five years, collaborative networks have empowered students and trainees to participate in high-impact multicentre studies that have potential to change clinical practice and improve patient care. The UK Foundation Programme Application...
Article
Despite extensive genomic profiling a better understanding of the contributory factors that promote aggressive thyroid cancer is urgently needed. The proto-oncogenes PBF and PTTG have been implicated in thyroid cancer but there is a lack of information regarding their co-expression and specific roles in tumour progression. Separate studies have pre...
Article
Full-text available
Context: Metastatic disease is responsible for the majority of endocrine cancer deaths. New therapeutic targets are urgently needed to improve patient survival rates. Objective: The proto-oncogene PTTG1-Binding Factor (PBF/PTTG1IP) is overexpressed in multiple endocrine cancers and circumstantially associated with tumour aggressiveness. This stu...
Article
Background: Current surgical standard of care in sporadic medullary thyroid carcinoma (sMTC) consists of a minimum of total thyroidectomy with central neck dissection. Some have suggested thyroid lobectomy with isthmusectomy and central neck dissection for patients with sMTC given their lower frequency of bilateral disease, although this topic has...
Article
The presentation of salivary gland pathology to general practice is relatively infrequent. As a result, GPs often only experience limited exposure to salivary gland disorders; thus, their knowledge of the topic is often patchy. This article aims to provide an overview of the topic to help GPs manage these conditions and identify cases requiring urg...
Article
Full-text available
The PTTG1-binding factor (PBF) is a transforming gene capable of eliciting tumor formation in xenograft models. However, the precise role of PBF in tumorigenesis and its prognostic value as a cancer biomarker remain largely uncharacterised, particularly in malignancies outside the thyroid. Here, we provide the first evidence that PBF represents a p...
Article
15th International Thyroid Congress & 85th Annual Meeting of the American Thyroid Association (Oral Presentation)
Chapter
Enlargement of the thyroid beyond the thoracic inlet occurs in between 5 and 20 % of goiters. The terminology varies between retrosternal, substernal, intrathoracic, and mediastinal
Chapter
The thyroid has a dense network of intraglandular lymphatics which joins collecting and draining lymphatic trunks and leaves the gland with the vascular supply. This results in early multifocal disease and significant locoregional spread
Article
Full-text available
Re-operative thyroid surgery is a relatively uncommon procedure complicated by distorted anatomy and post-operative tissue changes. Surgery may follow initial benign or malignant pathology. Published outcomes vary widely in the literature. This study aims to report our outcomes from re-operative thyroid surgery. Patient demographics and complicatio...
Article
The seventh edition tumor, node metastasis (TNM) classifies tumors <10 mm as T1a and tumors between 10 mm and 20 mm as T1b. Previous editions of the TNM staging system did not differentiate these lesions. We compare new classification in terms of presentation and outcome. Early thyroid cancers that were previously staged under the TNM sixth edition...
Article
Full-text available
The PTTG1-Binding Factor (PBF/PTTG1IP) has an emerging repertoire of roles, especially in thyroid biology, and functions as a proto-oncogene. High PBF expression is independently associated with poor prognosis and lower disease-specific survival in human thyroid cancer. However, the precise role of PBF in thyroid tumorigenesis is unclear. Here, we...
Chapter
Always check the patient’s recent thyroid function tests (especially important for the toxic patient)
Book
This book provides a concise summary across all aspects of endocrine surgery, covering the major endocrine organs and discussing aspects of surgical care. It comprises five sections covering the major endocrine organs/systems, each with a specialist section editor. Within each section there are a number of brief (2-3 page) chapters, written in a co...
Article
83rd Annual Meeting of the American Thyroid Association (ATA) meeting. 16th-20th October, San Juan, Puerto Rico (Poster)
Article
Full-text available
Human Pituitary Tumor Transforming Gene (hPTTG) is a multifunctional proto-oncogene implicated in the initiation and progression of several tumors. Phosphorylation of hPTTG is mediated by cyclin-dependent kinase 2 (CDC2), whilst cellular expression is regulated by specificity protein 1 (SP1). The mechanisms underlying hPTTG propagation of aberrant...
Article
Full-text available
Objectives: To evaluate the diagnostic accuracy of fine-needle aspiration biopsy (FNAB) to preoperatively diagnose medullary thyroid cancer (MTC) among multiple international centers and evaluate how the cytological diagnosis alone could impact patient management. Methods: We performed a retrospective chart review of sporadic MTC (sMTC) patients...
Article
Full-text available
Context: The clinical effectiveness of ablative radioiodine treatment of thyroid tumors is limited by the availability of the sodium iodide symporter (NIS) at the plasma membrane (PM) for uptake of 131I. A significant proportion of well-differentiated thyroid tumors are unable to concentrate sufficient radioiodine for effective therapy, and in othe...
Article
Full-text available
CONTEXT: The clinical effectiveness of ablative radioiodine treatment of thyroid tumors is limited by the availability of the sodium iodide symporter (NIS) at the plasma membrane (PM) for uptake of ¹³¹I. A significant proportion of well-differentiated thyroid tumors are unable to concentrate sufficient radioiodine for effective therapy, and in othe...
Article
Full-text available
Tandem mass spectrometry (MS/MS) permits the detection of femtomolar quantities of protein from a wide variety of tissue sources. As endocrine cancers are frequently aetiologically complex, they are particularly amenable to mass spectrometry. The most widely studied aspect is the search for novel reliable biomarkers that would allow cancers to be d...