Mr Neil Tolley
Mr Tolley is an consultant ENT – Head and Neck Surgeon. He graduated from the Welsh National School of Medicine in Cardiff in 1982. He was awarded a Masters Degree in Nasal Physiology, before undertaking specialist training at the Royal National Throat, Nose & Ear Hosital, Great Ormond Street Hospital and the Royal Sussex County Hospital, Brighton. He has undertaken specialist overseas fellowships in America, South Africa and Austrailia. He has been awarded a Fellowship of the Royal College of Surgeons Edinburgh (1988) and England (1989). In 1994, he was appointed as a Consultant ENT surgeon at St Mary’s Hospital and has been lead clinical for eight years. He is the Education Director for ENT training in North Thames and a Regional Advisor to the Royal College of Surgeons (England). His research interest is in the applications of telerobotics to thyroid and parathyroid surgery.
UK first – robotic neck surgery
4th January 2010
In a UK-first, Imperial College Healthcare NHS Trust clinicians have performed robotic-assisted neck surgery.
A team at St Mary’s Hospital has pioneered the use of the da Vinci robot to remove overactive parathyroid glands.
There are four pea-sized parathyroid glands in the neck that control the level of calcium in the blood.
When the glands become overactive, calcium levels rise causing complications such as weaker bones, high blood pressure and kidney stones.
Conventional treatment involves open or laparoscopic surgery to remove the abnormal glands, both of which leave a scar on the neck.
The Trust’s pioneering use of telerobotic surgery, however, avoids a neck scar because one small incision is made below the collarbone and three near the armpit, through which instruments and a camera are fed.
The surgeon manoeuvres the instruments from a console that provides a magnified, three-dimensional image of the patient’s anatomy and allows the surgeon to operate with greater dexterity and improved precision.
Ear, nose and throat (ENT) consultant Mr Neil Tolley, who led the team, said: "Robotic-assisted surgery has been used for several years in heart and prostate operations in specialist centres such as St Mary’s. Now we’re the first to use this technique in parathyroid surgery too.
“At Imperial College Healthcare we’re proud to offer our patients the latest treatments and surgical technologies to ensure they receive the very best care."
ENT research registrar, Mr Asit Arora, added: "We’ve had excellent feedback from patients who’ve had this procedure. In all cases, the abnormal gland was removed successfully, with virtually no blood loss, and patients returned home the next day."
Mr Tolley thanked other members of the team from endocrinology, radiology and anaesthesia, as well as Professor Darzi and the Imperial College Healthcare Charity, for their involvement and support in this work.
1. Serum phosphate predicts temporary hypocalcaemia following thyroidectomy. Sam AH, Dhillo WS, Donaldson M, Moolla A, Meeran K, Tolley NS, Palazzo FF. Clin Endocrinol (Oxf). 2010 Dec 10.
2. Multinodular goitre in lingual thyroid: case report. Zackaria M, Chisholm EJ, Tolley NS, Rice A, Chhatwani A. J Laryngol Otol. 2010 Mar;124(3):349-51. Epub 2009 Oct 20.
3. Computational modeling of flow and gas exchange in models of the human maxillary sinus. Hood CM, Schroter RC, Doorly DJ, Blenke EJ, Tolley NS. J Appl Physiol. 2009 Oct;107(4):1195-203.
4. Evaluation of 18fluoro-2-deoxyglucose positron emission tomography in iodine scan negative, differentiated thyroid cancer recurrence. Chisholm EJ, Tolley NS. J Laryngol Otol. 2009 Oct;123(10):1145-9.
5. Systematic review and meta-analysis of the adverse effects of thyroidectomy combined with central neck dissection as compared with thyroidectomy alone. Chisholm EJ, Kulinskaya E, Tolley NS. Laryngoscope. 2009 Jun;119(6):1135-9. Review.
6. New presentation of familial medullary thyroid carcinoma in 87-year-old patient with high-risk RET proto-oncogene codon 620 mutation. Jaggard MK, MacRae C, Ifeacho S, Robinson S, Tolley NS. J Laryngol Otol. 2009 Jul;123(7):796-800. Epub 2008 Sep 4. Review.
7. A new classification system for retrosternal goitre based on a systematic review of its complications and management. Huins CT, Georgalas C, Mehrzad H, Tolley NS. Int J Surg. 2008 Feb;6(1):71-6. Epub 2007 Feb 16. Review.
8. A combined third and fourth branchial arch anomaly: clinical and embryological implications. Mehrzad H, Georgalas C, Huins C, Tolley NS. Eur Arch Otorhinolaryngol. 2007 Aug;264(8):913-6. Epub 2007 Mar 15.
9. A randomised controlled trial of routine suction drainage after elective thyroid and parathyroid surgery with ultrasound evaluation of fluid collection. Ahluwalia S, Hannan SA, Mehrzad H, Crofton M, Tolley NS. Clin Otolaryngol. 2007 Feb;32(1):28-31.
10. Recurrent throat infections (tonsillitis). Georgalas CC, Tolley NS, Narula A. Clin Evid (Online). 2007 Jun 1;2007. pii: 0503.
11. Stem cells. Vats A, Bielby RC, Tolley NS, Nerem R, Polak JM. Lancet. 2005 Aug 13-19;366(9485):592-602. Review.
12. Embryonic stem cells and tissue engineering: delivering stem cells to the clinic. Vats A, Tolley NS, Bishop AE, Polak JM. J R Soc Med. 2005 Aug;98(8):346-50. Review.
13. The stem cell in orthopaedic surgery. Vats A, Tolley NS, Buttery LD, Polak JM. J Bone Joint Surg Br. 2004 Mar;86(2):159-64. Review. No abstract available.
14. Scaffolds and biomaterials for tissue engineering: a review of clinical applications. Vats A, Tolley NS, Polak JM, Gough JE. Clin Otolaryngol Allied Sci. 2003 Jun;28(3):165-72. Review.
15. The disinfection of flexible fibre-optic nasendoscopes out-of-hours: confidential telephone survey of ENT units in England. Kanagalingam J, Zainal A, Georgalas C, Paun S, Tolley NS. J Laryngol Otol. 2002 Oct;116(10):817-22.
16. Gene expression: a review of clinical applications in otorhinolaryngology-head and neck surgery. Vats A, Tolley NS, Polak JM, Knight BC. Clin Otolaryngol Allied Sci. 2002 Oct;27(5):291-5. Review.
17. Stem cells: sources and applications. Vats A, Tolley NS, Polak JM, Buttery LD. Clin Otolaryngol Allied Sci. 2002 Aug;27(4):227-32. Review.
18. Regulation of human eotaxin-3/CCL26 expression: modulation by cytokines and glucocorticoids. Banwell ME, Tolley NS, Williams TJ, Mitchell TJ. Cytokine. 2002 Mar 21;17(6):317-23.
19. Tissue engineering and ENT surgery. Patel NN, Butler PE, Buttery L, Polak JM, Tolley NS. J Laryngol Otol. 2002 Mar;116(3):165-9. Review.
20. Superficial parotidectomy under local anaesthesia. Reece PH, Papesch ME, Tolley NS. J Laryngol Otol. 2000 Dec;114(12):983-4.
21. The laryngeal mask airway in tonsillectomy: the surgeon's perspective. Hern JD, Jayaraj SM, Sidhu VS, Almeyda JS, O'Neill G, Tolley NS. Clin Otolaryngol Allied Sci. 1999 Apr;24(2):122-5.
22. Fibrous dysplasia and ossifying fibroma of the paranasal sinuses. Commins DJ, Tolley NS, Milford CA. J Laryngol Otol. 1998 Oct;112(10):964-8.
23. Subglottic stenosis secondary to tuberculosis. Almeyda J, Tolley NS, Ghufoor K, Mochoulis G. Int J Clin Pract. 1997 Sep;51(6):402-3.
24. Characterization of nasal airflow. Newcombe RG, O'Neill G, Tolley NS, Montgomery P. Clin Otolaryngol Allied Sci. 1997 Oct;22(5):414-8.
25. Laparoscopically-assisted total pharyngolaryngo-oesophagectomy. Willson P, Montgomery P, Mochloulis G, Tolley NS, Rosin RD. Br J Surg. 1997 Jun;84(6):870-1.
26. Infectious pseudomonas subglottic stenosis occurring in a patient with acquired immunodeficiency syndrome. Ghufoor K, Almeyda J, Mochloulis G, Montgomery PQ, Tolley NS. J Laryngol Otol. 1997 Jan;111(1):70-2.
27. Nuclear DNA content using computerized image cytometry of squamous cell carcinomas of the head and neck. Sarker SK, Ghufoor K, Patel KS, Tolley NS, Coleman DV. J Laryngol Otol. 1997 Jan;111(1):43-7.
28. Analysis of rhinomanometric data based upon a model of nasal airflow and logarithmic transformation of the data. O'Neill G, Tolley NS, Hollis LJ, Hern JD, Almeyda JS. Clin Otolaryngol Allied Sci. 1996 Dec;21(6):524-7.
29. Laparoscopically assisted total laryngopharyngoesophagectomy with gastric transposition. Montgomery P, Willson PD, Mochloulis G, Tolley NS, Rosin RD. J Laryngol Otol. 1996 Nov;110(11):1072-4.
30. Iatrogenic accessory nerve injury. Almeyda JS, Montgomery PQ, Tolley NS. Ann R Coll Surg Engl. 1996 Sep;78(5):479.
31. Invasive candidiasis of a late presentation laryngeal chondroradionecrosis. Hollis LJ, Montgomery PQ, Hern JD, Mahadeva U, Tolley NS. J Laryngol Otol. 1996 Aug;110(8):789-92.
32. Maxillary antral lavage using inferior meatal cannula anaesthesia. Mochloulis G, Hern JD, Hollis LJ, Tolley NS. J Laryngol Otol. 1996 Aug;110(8):763-4.
33. Early diagnosis of Wegener's granulomatosis presenting with facial nerve palsy. Hern JD, Hollis LJ, Mochloulis G, Montgomery PQ, Tolley NS. J Laryngol Otol. 1996 May;110(5):459-61.
34. Clinico-pathological correlation of T3 glottic carcinomas. Fagan JJ, Tolley NS. Clin Otolaryngol Allied Sci. 1994 Dec;19(6):532-6.
35. The management of neonatal rhinitis. Tolley NS, Ford G, Commins D. Int J Pediatr Otorhinolaryngol. 1992 Nov;24(3):253-60.
36. Experimental studies on the acoustic properties of mastoid cavities. Tolley NS, Ison K, Mirza A. J Laryngol Otol. 1992 Jul;106(7):597-9.
37. Bilateral acute mastoiditis complicated by lateral sinus thrombosis. Oyarzabal MF, Patel KS, Tolley NS. J Laryngol Otol. 1992 Jun;106(6):535-7.
38. Surgical management of cerebrospinal fluid rhinorrhoea. Tolley NS, Brookes GB. J R Coll Surg Edinb. 1992 Feb;37(1):12-5.
39. A clinical study of spontaneous CSF rhinorrhoea. Tolley NS. Rhinology. 1991 Sep;29(3):223-30.
40. Radiological study of primary spontaneous CSF rhinorrhoea. Tolley NS, Lloyd GA, Williams HO. J Laryngol Otol. 1991 Apr;105(4):274-7.
41. Further studies on nasal sensation of airflow. Aldren C, Tolley NS. Rhinology. 1991 Mar;29(1):49-55.
42. Nose-blowing and CSF rhinorrhoea. Tolley NS, Schwartz P. Lancet. 1991 Feb 2;337(8736):302.
43. Dislocated arytenoid: an intubation-induced injury. Tolley NS, Cheesman TD, Morgan D, Brookes GB. Ann R Coll Surg Engl. 1990 Nov;72(6):353-6.
44. Patulous eustachian tube: a radiological perspective. Tolley NS, Phelps P. J Laryngol Otol. 1990 Apr;104(4):291-3.
45. Theoretical considerations of nasal airflow mechanics and surgical implications. O'Neill G, Tolley NS. Clin Otolaryngol Allied Sci. 1988 Aug;13(4):273-7.
46. The effects of nasal anaesthesia upon nasal sensation of airflow. Eccles R, Morris S, Tolley NS. Acta Otolaryngol. 1988 Jul-Aug;106(1-2):152-5.
47. The effects of D and L isomers of menthol upon nasal sensation of airflow. Eccles R, Griffiths DH, Newton CG, Tolley NS. J Laryngol Otol. 1988 Jun;102(6):506-8.
48. The effects of menthol isomers on nasal sensation of airflow. Eccles R, Griffiths DH, Newton CG, Tolley NS. Clin Otolaryngol Allied Sci. 1988 Feb;13(1):25-9.
49. The effect of alcohol ingestion upon nasal airway resistance. Eccles R, Tolley NS. Rhinology. 1987 Dec;25(4):245-8.
50. Experimental studies on nasal sensation of airflow. Eccles R, Lancashire B, Tolley NS. Acta Otolaryngol. 1987 Mar-Apr;103(3-4):303-6.
51. The effect of aromatics on inspiratory and expiratory nasal resistance to airflow. Eccles R, Lancashire B, Tolley NS. Clin Otolaryngol Allied Sci. 1987 Feb;12(1):11-4.