Journal of Otolaryngology - Head & Neck Surgery最新文献

{"title":"A Descriptive Study of Quality of Life Following Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma.","authors":"Alina Diaconescu, Jennifer A Silver, Thava Subramaniam, Maida J Sewitch, Marco A Mascarella, Jose Ramirez-Garcia Luna, Nahid Golabi, Keith Richardson, Nathaniel Bouganim, Reza Forghani, Alex Marcin Mlynarek, Michael P Hier, Nader Sadeghi","doi":"10.1177/19160216241248670","DOIUrl":"10.1177/19160216241248670","url":null,"abstract":"<p><strong>Background: </strong>Patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with radiation-based therapy suffer from short- and long-term toxicities that affect quality of life (QOL). Transoral robotic surgery (TORS) has an established role in the management of early OPSCC but adjuvant treatment is often indicated postoperatively due to the high incidence of nodal metastasis associated with advanced human papillomavirus (HPV)-related OPSCC. To overcome the need for adjuvant radiation therapy (RT), neoadjuvant chemotherapy followed by TORS and neck dissection (ND) is proposed. This study aimed to assess if QOL in HPV-associated OPSCC receiving neoadjuvant chemotherapy followed by TORS and ND returns to baseline within 12 months of completing treatment.</p><p><strong>Methods: </strong>A 12 month longitudinal study was carried out at McGill University Health Centre in Montreal, Canada, among a convenience sample of patients with American Joint Committee on Cancer Seventh Edition stage III and IVa HPV-related OPSCC who were treated with neoadjuvant chemotherapy followed by TORS and ND. QOL data were obtained pretreatment and at 1, 3, 6, and 12 months following treatment completion using the European Organisation for Research and Treatment of Cancer Core and Head and Neck extension modules. Paired <i>t</i> tests and mixed models for repeated measures analysis were used to assess changes in QOL from baseline to 12 months postoperatively and over time, respectively.</p><p><strong>Results: </strong>Nineteen of 23 patients (median age 58 years) who received the study treatment fulfilled the eligibility criteria. OPSCC subsites were palatine tonsil (n = 12) and base of tongue (n = 7). All 19 patients were treated per protocol and none required adjuvant RT as per pathology review and protocol requirements at a postoperative multidisciplinary team tumor board discussion. No significant differences were found when comparing 12 month QOL follow-up scores to pretreatment scores in measures that would likely be affected by RT [eg, swallowing (<i>P</i> = .7), social eating (<i>P</i> = .8), xerostomia (<i>P</i> = .9)].</p><p><strong>Conclusion: </strong>In HPV-related OPSCC, neoadjuvant chemotherapy followed by TORS and ND as definitive treatment is associated with excellent QOL outcomes. Postoperative QOL scores returned to baseline by 3 months and were maintained for all measures, indicating a return to normal function.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"53 ","pages":"19160216241248670"},"PeriodicalIF":3.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preservation of Residual Hearing: Long-Term Results With a Mid-Scala Electrode.","authors":"Martin Gerbert, Arne Ernst, Rainer Seidl, Lars Decker, Sandra Scholz, Gina Lauer, Philipp Mittmann","doi":"10.1177/19160216241250351","DOIUrl":"10.1177/19160216241250351","url":null,"abstract":"<p><strong>Objective: </strong>The long-term preservation of residual hearing after cochlear implantation has become a major goal over the past few years. The aim of the present study was to evaluate residual hearing in the long-term follow-up using mid-scala electrodes.</p><p><strong>Methods: </strong>In this retrospective, single-center study, we collected data from 27 patients who were implanted between 2014 and 2015 with residual hearing in the low-frequency range using a mid-scala electrode. Measurements of the hearing thresholds were carried out directly postoperatively (day 1 after surgery) and in the long-term follow-up 43.7 ± 6.9 months. The calculation of the extent of audiological hearing preservation was determined using the HEARRING group formula by Skarsynski.</p><p><strong>Results: </strong>Postoperative preservation of residual hearing was achieved in 69.2% of the cases in the low-frequency range between 250 Hz and 1 kHz, of which 89.5% of the patients had frequencies that suggested using electroacoustic stimulation (EAS). In the long-term follow-up, 30.8% of the patients showed residual hearing; however, 57.1% had apparently benefited from EAS.</p><p><strong>Conclusion: </strong>Preservation of residual hearing is feasible in the long term using mid-scala electrodes. Postoperatively, there is over the half of patients who benefit from an EAS strategy. The long-term follow-up shows a certain decrease in residual hearing. However, these results are comparable to studies relating to other types of electrodes. Further research should be conducted in future to better evaluate hearing loss in long-term follow-up, compared to direct postoperative audiological results.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"53 ","pages":"19160216241250351"},"PeriodicalIF":3.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life After Head and Neck Cancer Surgery and Free Flap Reconstruction: A Systematic Review.","authors":"Laura-Elisabeth Gosselin, Noémie Villemure-Poliquin, Nathalie Audet","doi":"10.1177/19160216241248666","DOIUrl":"10.1177/19160216241248666","url":null,"abstract":"<p><strong>Background: </strong>Different factors can affect the quality of life of patients treated for head and neck cancer undergoing major surgical intervention. However, it remains unclear which specific factors and what possible interventions could have the greatest influence on quality of life postoperatively for patients undergoing surgical resection with free flap reconstruction. The objective of our systematic review was to identify which factors, at the time of surgical treatment, are associated with a worse postoperative quality of life for patients undergoing surgical resection with free flap reconstruction for head and neck cancer.</p><p><strong>Methods: </strong>We performed a systematic review of MEDLINE, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL), from their inception through November 2021. We included peer reviewed studies that evaluated the impact of specific factors on quality of life for adult patients who underwent surgery with free flap reconstruction for head and neck cancer. Two reviewers independently screened citations for eligibility and extracted data. Risk of bias of each study was evaluated using the New-Castle Ottawa Scale. Vote counting and qualitative review were used to synthesize results. All relevant findings were reported.</p><p><strong>Results: </strong>We initially identified 1971 articles. We included 22 articles in our systematic review, totaling 1398 patients. There was a high level of variability for factors evaluated throughout studies and many studies presented small sample sizes. However, some factors were associated with worse long-term quality of life, including older age, radiotherapy, higher tumor stage, dysphagia, anxiety as well as depressive symptoms. Very few articles analyzed their data for specific tumor subsites and the impact of psychosocial factors was rarely evaluated throughout studies.</p><p><strong>Conclusions: </strong>For patients with head and neck cancer requiring free flap reconstruction, some specific factors may correlate with changes in quality of life. However, these findings are based on very few and mostly underpowered studies. A better understanding of factors affecting quality of life could allow a more personalized and overall better quality of care for patients.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"53 ","pages":"19160216241248666"},"PeriodicalIF":3.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reasonable Risk Ratio of Palate Surgery: A New Critical Analysis.","authors":"Kenny P Pang,Joon Wei Lim,Kathleen A Pang,Claudio Vicini,Filippo Montevecchi,Ryan C T Cheong,Edward B Pang,Jin Keat Siow,Yiong Huak Chan,Brian Rotenberg","doi":"10.1177/19160216241279074","DOIUrl":"https://doi.org/10.1177/19160216241279074","url":null,"abstract":"OBJECTIVE.A new critical complication risk analysis, the reasonable risk ratio (RRR or R3) for palate surgeries in obstructive sleep apnea patients.METHODS.Analysis from published meta-analyses, systematic reviews on success rates, and complications encountered for 3 palate surgeries, expansion sphincter pharyngoplasty (ESP), barbed repositioning pharyngoplasty (BRP) and modified uvulopalatopharyngoplasty (mUPPP), over 20 years. The RRR is derived from a ratio of the percentage of each respective complication over the success rate of that particular surgical procedure. The benchmark RRR of tonsillectomy is set at 0.035 to 0.078. An RRR below this benchmark value is more favorable as tonsillectomy is a widely accepted ENT procedure with risks to benefit well accepted.RESULTS.The RRR for foreign body (FB) sensation (BRP) ranged from 0.03 to 0.23 (mean RRR of 0.14), FB sensation (ESP) 0.01, FB sensation (mUPPP) ranged from 0.33 to 0.55 (mean RRR of 0.44). The RRR for swallowing difficulties (BRP) ranged from 0.04 to 0.23 (mean RRR of 0.11), mUPPP, was 0.37; no reported swallowing difficulties with the ESP. The RRR for velopharyngeal insufficiency (VPI) (BRP) ranged from 0.009 to 0.18 (mean RRR of 0.07), and RRR VPI (mUPPP) was 0.14. The RRR (BRP) for dry throat was 0.06 and the mUPPP was 0.35, with no reported VPI or dry throat for ESP. The overall RRR for the BRP was 0.09, ESP was 0.01 and mUPPP was 0.29.CONCLUSION.RRR provides a summarized data-driven, statistical guide to aid decision-making, and helps in patient counseling. BRP and ESP have been shown to have less complications compared to mUPPP.Level of evidence: IV.","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"13 1","pages":"19160216241279074"},"PeriodicalIF":3.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions to Reduce Psychosocial Burden in Head and Neck Cancer Patients: A Narrative Review.","authors":"Tanya Chen,Elysia Grose,Christopher W Noel,Noemie Villemure-Poliquin,Antoine Eskander","doi":"10.1177/19160216241251701","DOIUrl":"https://doi.org/10.1177/19160216241251701","url":null,"abstract":"BACKGROUNDThe diagnosis and treatment of head and neck cancer (HNC) is associated with several life-altering morbidities including change in appearance, speech, and swallowing, all of which can significantly affect quality of life and cause psychosocial stress.COMMENTARYThe aim of this narrative review is to provide an overview of the evidence on psychosocial interventions for patients with HNC. Evidence regarding screening tools, psychological interventions, smoking and alcohol cessation, and antidepressant therapy in the HNC population is reviewed.CONCLUSIONThere is a large body of evidence describing various psychosocial interventions and several of these interventions have shown promise in the literature to improve psychosocial and health outcomes in the HNC population. Psychosocial interventions should be integrated into HNC care pathways and formal recommendations should be developed.","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"47 1","pages":"19160216241251701"},"PeriodicalIF":3.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Safety of the Laryngeal Mask Airway in Adenotonsillectomy: A Systematic Review and Meta-Analysis.","authors":"Sami Khoury, Dorsa Zabihi-Pour, Jacob Davidson, Raju Poolacherla, Gopakumar Nair, Abhijit Biswas, Peng You, Julie E Strychowsky","doi":"10.1177/19160216241263851","DOIUrl":"10.1177/19160216241263851","url":null,"abstract":"<p><strong>Background: </strong>Adenotonsillectomy is one of the most common surgical procedures worldwide. The current standard for securing the airway in patients undergoing adenotonsillectomy is endotracheal tube (ETT) intubation. Several studies have investigated the use of the laryngeal mask airway (LMA) in this procedure. We conducted a systematic review and meta-analysis to compare the safety and efficacy of the LMA versus ETT in adenotonsillectomy.</p><p><strong>Method: </strong>Databases were searched from inception to 2022 for randomized controlled trials and comparative studies. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The primary outcome is the rate of perioperative respiratory adverse events (PRAEs). Secondary outcomes included the rate of conversion to ETT, desaturations, nausea/vomiting, and surgical time. A subgroup analysis, risk of bias, publication bias, and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessments were also performed.</p><p><strong>Results: </strong>Twelve studies were included in the analysis (4176 patients). The mean overall conversion to ETT was 8.36% [95% confidence interval (CI) = 8.17, 8.54], and for the pediatric group 8.27% (95% CI = 8.08, 8.47). The mean rate of conversion to ETT secondary to complications was 2.89% (95% CI = 2.76, 3.03) while the rest was from poor surgical access. Overall, there was no significant difference in PRAEs [odds ratio (OR) 1.16, 95% CI = 0.60, 2.22], desaturations (OR 0.79, 95% CI = 0.38, 1.64), or minor complications (OR 0.89, 95% CI = 0.50, 1.55). The use of LMA yielded significantly shorter operative time (mean difference -4.38 minutes, 95% CI = -8.28, -0.49) and emergence time (mean difference -4.15 minutes, 95% CI = -5.63, -2.67).</p><p><strong>Conclusion: </strong>For adenotonsillectomy surgery, LMA is a safe alternative to ETT and requires less operative time. Careful patient selection and judgment of the surgeon and anesthesiologist are necessary, especially given the 8% conversion to ETT rate.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"53 ","pages":"19160216241263851"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Single Intratympanic Triamcinolone Acetonide Administration Elicits Long-Term Reduction in Impedances Following Cochlear Implantation.","authors":"Michael Nieratschker, Rudolfs Liepins, Clemens Honeder, Alice Barbara Auinger, Julia Clara Gausterer, Wolf-Dieter Baumgartner, Dominik Riss, Christoph Arnoldner, Valerie Dahm","doi":"10.1177/19160216241288819","DOIUrl":"10.1177/19160216241288819","url":null,"abstract":"<p><strong>Background: </strong>Intracochlear fibrosis and inflammation remain important limitations in cochlear implantation (CI). Glucocorticoids are routinely used to ameliorate the inflammatory response following CI. This study investigates the long-term effects of an intratympanically-applied triamcinolone-acetonide suspension on intracochlear impedance changes in CI recipients and investigates differences in drug concentrations and timepoints of injection.</p><p><strong>Methods: </strong>A total of 87 patients were included in the study, of whom 39 received an intratympanically-applied triamcinolone-acetonide suspension at either 10 or 40 mg/ml, 1 hour or 24 hours prior to cochlear implantation, while 48 patients served as an untreated control group. Electrode impedances were measured and compared over a period of 3 years following cochlear implantation.</p><p><strong>Results: </strong>The preoperative intratympanic application of a triamcinolone-acetonide suspension resulted in significantly lower mean impedances following cochlear implantation compared with an untreated control group at first fitting (4.66 ± 1.3 kΩ to 5.90 ± 1.4 kΩ, <i>P</i> = .0001), with sustained reduction observed over 3 months. A sustained reduction was observed after spatial grouping of the electrode contacts, with significant improvements in both the middle cochlear region over a 24 month period (from 3.97 ± 1.3 kΩ to 5.85 ± 1.3 kΩ, <i>P</i> = .049) and the basal region over a 6 month period (from 5.02 ± 1.3 kΩ to 5.85 ± 1.3 kΩ, <i>P</i> = .008). The injection of 10 mg/ml of triamcinolone-acetonide 1 hour prior to cochlear implantation resulted in higher impedances compared with 40 mg/ml and 24 hour time interval until surgery.</p><p><strong>Conclusion: </strong>A single preoperative intratympanic injection of triamcinolone-acetonide significantly reduces electrode impedances across the entire cochlea. This effect is sustained for up to 2 years, after which impedances gradually equalize between the groups. A preoperative triamcinolone-acetonide injection could therefore be a favorable approach to attenuate the immediate tissue response following cochlear implantation.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"53 ","pages":"19160216241288819"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Radiofrequency Tuboplasty and Cartilage Underlay Myringoplasty for Repairing Chronic Large Perforation with Eustachian Tube Dysfunction.","authors":"Zhengcai Lou, Zihan Lou, Tian Lv, Zhengnong Chen","doi":"10.1177/19160216241291822","DOIUrl":"10.1177/19160216241291822","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to compare the outcomes of endoscopic cartilage myringoplasty (ECM) with or without plasma radiofrequency (RF) tuboplasty (PRT) for repairing chronic large perforation with Eustachian tube dysfunction (ETD).</p><p><strong>Materials and methods: </strong>Chronic large perforations with ETD were randomly divided into receiving ECM or ECM plus PRT. During the 24 months follow-up, the Eustachian tube score (ETS), Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7), ET inflammation scale, hearing results, and graft success rate of the patients were analyzed.</p><p><strong>Results: </strong>A total of 61 subjects were included in the study. Difference of ETS was significant before and after surgery in the ECM + PRT group (<i>P</i> < .05) but the ECM group was not (<i>P</i> > .05). Also, significant between-group difference was found regardless of post-24 months ETS and improvement value. Postoperative ETDQ-7 scores were significantly reduced compared with preoperative ETDQ-7 scores in both groups (<i>P</i> < .05), also, significant between-group difference was found regardless of post-24 months ETDQ-7 scores and improvement value. The graft success rate was 86.7% in the ECM group and 96.8% in the ECM + PRT group at postoperative 24 months (<i>P</i> > .05). In addition, although the ECM + PRT group showed a better air-bone gap improvement than the ECM group, the difference was not significant (13.01 ± 2.97 vs 10.92 ± 0.69 dB; <i>P</i> > .05). No PRT procedure-related serious adverse events were reported during the follow-up process. No patients developed atelectasis or otitis media with effusion in either group.</p><p><strong>Conclusion: </strong>ECM combined with low-temperature PRT did not affect the graft success rate but showed a better long-term improvement in ETS and ETDQ-7 than cartilage myringoplasty for the treatment of chronic perforation with ETD. In addition, although PRT showed a better hearing improvement, the difference was not significant between the 2 groups.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"53 ","pages":"19160216241291822"},"PeriodicalIF":4.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fine Needle Aspirate Flow Cytometry's Ancillary Utility in Diagnosing Non-Hodgkin Lymphoma in the Head and Neck.","authors":"Saruchi Bandargal, Livia Florianova, Svetlana Dmitrienko, Tina Haliotis, Marc Philippe Pusztaszeri, Michael P Hier, Alex M Mlynarek, Marco A Mascarella, Richard J Payne, Sabrina Daniela da Silva, Nathalie Johnson, Véronique-Isabelle Forest","doi":"10.1177/19160216241296127","DOIUrl":"10.1177/19160216241296127","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;While ultrasound-guided fine-needle aspiration cell block (FNACB) is a cost-effective, expeditious, and reliable procedure used routinely in the initial evaluation of head and neck masses, it has limited efficacy in diagnosing lymphoproliferative disorders such as non-Hodgkin lymphoma (NHL). Flow cytometry performed on an fine-needle aspiration (FNA) sample [ultrasound-guided fine-needle aspirate flow cytometry or flow cytometry performed on an FNA sample (FNAFC)], has been shown to be a valuable adjunct to FNACB in the diagnosis of lymphoproliferative disorders of the spleen, kidney, and thyroid. The objective of this study was to appraise FNAFC's utility as an ancillary tool to detect NHL arising in the head and neck region in adult patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a retrospective study involving 52 adult patients with head and neck lymphadenopathies and masses suspicious for lymphoproliferative disorders, who underwent ultrasound-guided FNACB and ultrasound-guided FNAFC between January 2017 and November 2022. Patient demographics, FNACB histopathological and immunophenotypic results, postoperative histopathology results (when available), and follow-up information until May 2023 were reviewed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 52 FNACB samples, 23 samples (44.2%) yielded a diagnosis negative for carcinoma, 20 samples (38.5%) were nondiagnostic on account of scant cellularity, 8 samples (15.4%) were suspicious for malignancy, and a single sample (1.9%) was compatible with malignancy. Regarding FNAFC samples, 37 samples (71.2%) were diagnosed as showing no evidence for a lymphoproliferative disorder, 4 samples (7.7%) as nondiagnostic because of insufficient cell count, 4 samples (7.7%) as suspicious for a lymphoproliferative neoplasm, and 7 samples (13.5%) as compatible with a lymphoproliferative neoplasm, most frequently a B-cell lymphoma. 7 of the 11 patients (63.6%) with a suspicious/positive FNAFC result underwent excisional biopsy for additional work up. Postoperative histopathology reports corroborated FNAFC's findings in 6 patients (85.7%), while the remaining patient's (14.3%) suspicious FNAFC result was discordant with postoperative histopathology results. The other 4 patients (36.4%) did not require excisional biopsy as the hemato-oncologist deemed the information provided by the FNAFC as sufficient for the diagnosis and treatment of an NHL in the specific clinical contexts of those patients. All patients with nondiagnostic (due to insufficient cell count), inconclusive, or negative FNAFC (ie, nondiagnostic of a lymphoproliferative disorder) were followed up for a mean follow-up period of 11.9 months (range: 61.2 months; SD: 10.2 months), during which no new lymphadenopathies/masses nor progression was observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;FNAFC is a useful and practical supplementary tool in the diagnosis of lymphoproliferative disorders in the head and neck region, principa","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"53 ","pages":"19160216241296127"},"PeriodicalIF":4.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Margin Definition and Assessment in Head and Neck Oncology: A Cross-Sectional Survey of Canadian Head and Neck Surgeons.","authors":"Ryan C Daniel, Bernie Yan, Shamir Chandarana, Anthony C Nichols, Antoine Eskander, Danny Enepekides, Kevin Higgins","doi":"10.1177/19160216241296121","DOIUrl":"10.1177/19160216241296121","url":null,"abstract":"<p><strong>Importance: </strong>Head and neck squamous cell carcinomas (HNSCC) are responsible for a significant amount of morbidity and mortality in Canada. Surgical margins are one of the most important factors used to guide treatment; however, currently there is a lack of consensus on the ideal surgical margin definition, sampling, and assessment method.</p><p><strong>Objective: </strong>To understand the current perspectives and practice patterns of Canadian head and neck surgeons with respect to surgical margin: (1) definition, (2) sampling, (3) pathological assessment.</p><p><strong>Design: </strong>A 24-question cross-sectional survey was sent via email through the Canadian Society of Otolaryngology-Head & Neck Surgery (CSOHNS), and responses were gathered from December 19, 2023, to March 12, 2024. Responses were aggregated and reported using descriptive statistics.</p><p><strong>Setting/participants: </strong>The survey was conducted in Canada among self-reported staff head and neck oncology surgeons with membership in the CSOHNS.</p><p><strong>Results: </strong>A total of 36 staff head and neck oncology surgeons responded from across Canada. The most common (58.3%) definition of a negative surgical margin for oral cavity HNSCC was \">5 mm formalin fixed paraffin embedded distance.\" To obtain surgical margins, surgeons were split with 44.1% using only a tumor bed approach and 32.4% using only a specimen-driven approach. A dedicated head and neck pathologist is always available more commonly for final pathological assessment (63.6%) versus intraoperative frozen section assessment (15.5%). Finally, most surgeons reported having a synoptic standardized reporting system for annotating margin status (78.8%).</p><p><strong>Conclusions/relevance: </strong>The results of this survey provide a current-state analysis of head and neck surgeons across Canada and set the stage for future efforts to be directed toward standardizing the collection method and reporting criteria for surgical margins in HNSCC.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"53 ","pages":"19160216241296121"},"PeriodicalIF":4.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}