Journal of Head & Neck Physicians and Surgeons最新文献

{"title":"Inequality in the use of microvascular versus pedicled flaps in oral cancer reconstruction across India: Can we bridge the gap?","authors":"A. Vaidya","doi":"10.4103/jhnps.jhnps_80_22","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_80_22","url":null,"abstract":"","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42916581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous dilatational tracheostomy: an observational study at tertiary level teaching hospital","authors":"R. Shah, Bipin Koirala, Lalit Rajbansi, Batsalya Arjyal","doi":"10.4103/jhnps.jhnps_62_22","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_62_22","url":null,"abstract":"Introduction: Tracheostomy is the most commonly performed procedure worldwide. It is mainly done in critically ill patients requiring long-term ventilation, facial trauma, laryngeal fractures, laryngeal malignancy, etc., Converting from endotracheal intubation to tracheostomy has many benefits in terms of maintaining laryngeal function, feeding, and safety, it is more comfortable than endotracheal intubation. Tracheostomized patients require less analgesics and sedatives. It also helps in easier and early weaning from the mechanical ventilator, possibility of speech, and initiation of oral intake of medication. Percutaneous dilatational tracheostomy (PDT) is a safe and feasible procedure performed at bedside with minimal invasive technique in the intensive care unit (ICU). This all contributes to shorter ICU stay and hospital stay which becomes more cost-effective. Methods: This is a prospective observational study that was conducted in the 22-bedded neurointensive care and medical ICU of Birat Medical College and Teaching Hospital. The data were collected from August 01, 2021, to February 28, 2022. All patients needing tracheostomy for prolonged intubation, protection of airway, and to maintain tracheobronchial toileting was taking under study. Results: Our study was a prospective observational regarding PDT. A total of 71 patients were included in the study. Out of which, 39 (54.9%) were male and 32 (45.1%) were female with the ratio of (1.2:1). The age of the patients ranged from 18 to 82 years with the mean age of 53.25 years. The most common indication of PDT was prolonged intubation and that accounted for 29 (40.8%) of the patients which was followed by airway protection in 27 (38%) patients and to maintain pulmonary hygiene was seen in 15 (21.1%) patients. Conclusion: Tracheostomy is among the most frequently performed procedures in critically ill patients. PDT is a safe and feasible procedure performed at bedside with minimal invasive techniques in ICU.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41761495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of human epidermal growth factor receptor 2/Neu in oral leukoplakia","authors":"A. Jha, Vansh Verma, K. Patiri, N. Arora","doi":"10.4103/jhnps.jhnps_41_22","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_41_22","url":null,"abstract":"Background: Molecular alterations in premalignant lesions of the oral cavity are not well known. Many reports have found increased human epidermal growth factor receptor 2 (HER-2) expression in oral cancer. Overexpression of HER-2 in premalignant lesions may denote its positive contribution in the malignant transformation of these lesions. Materials and Methods: Twenty-three samples of leukoplakia were stained by routine H and E to assess any dysplasia; five samples of normal mucosa were used as control. Immunohistochemical staining for HER-2 was done. ASCO/CAP 2018 guidelines were used for reporting the results. The percentage of lesions expressing cytoplasmic or membranous expression was calculated. Results: One sample of leukoplakia with severe dysplasia expressed focal membranous staining. Cytoplasmic staining was observed in 3/9 (33.33%) dysplastic leukoplakia. Only one nondysplastic leukoplakia expressed cytoplasmic HER-2 staining. Conclusions: Membranous expression in severe dysplasia and higher expression in oral cancer are in concordance with the multistep theory of carcinogenesis.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42007559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of sclerostin levels in gingival crevicular fluid of periodontal health and disease before and after nonsurgical periodontal therapy","authors":"Ankita Mathur, D. Gopalakrishnan, S. Shetty, Vini Mehta, Shreya Bagwe","doi":"10.4103/jhnps.jhnps_48_22","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_48_22","url":null,"abstract":"Aim: The purpose of this study was to measure the concentration of sclerostin in the gingival crevicular fluid (GCF) before and after 1, 3, and 6 weeks of nonsurgical periodontal therapy (NSPT) in subjects with and without chronic periodontitis. Materials and Methods: An interventional study was conducted among 35 subjects of age groups 30–50 years. Subjects were divided into three groups: Group I (10 healthy individuals), Group II (10 gingivitis), and Group III (15 chronic periodontitis only). Clinical parameters assessed were gingival index (GI), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL). The GCF samples were collected from all the groups at baseline and in Group III at baseline and 1, 3, and 6 weeks after NSPT using micropipettes. Results: Table 1 shows age and gender details. Although the mean sclerostin concentration in GCF (ng/ml) was highest in Group III at baseline (5.41 ± 0.68) and lowest in Group 1 (4.98 ± 0.46), there was no statistically significant difference (P < 0.05) when intergroup comparison was done [Tables 2 and 3]. PPD and CAL measured for Group III were 6.93 + 1.2 and 7.67 + 1.2, respectively. PI (2.52 + 0.25) and GI (2.52 + 0.17) were measured highest in Group III [Table 4]. Conclusion: There was a substantial decrease in the concentration of sclerostin in the GCF of chronic periodontitis patients after 1, 3, and 6 weeks after NSPT. This proves sclerostin to be a responsive measure of inflammation in periodontal destruction.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43335713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic role of galectin-3 immunohistochemistry in thyroid lesions","authors":"K. Sarin, R. Bhagat, R. S. Punia, Arjun Das, U. Handa","doi":"10.4103/jhnps.jhnps_37_22","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_37_22","url":null,"abstract":"Background: Galectin-3 (Gal-3) is a good diagnostic marker for thyroid cancer. Evaluation of diagnostic accuracy of this marker complements the morphological assessment of a particular thyroid lesion. The aim of this study was to evaluate the immunohistochemical expression and diagnostic role of Gal-3 in various surgically resected thyroid lesions. Materials and Methods: Surgically resected thyroid specimens from 50 patients with hematoxylin and eosin (H and E)- and Gal-3-stained sections were studied. Results: The age of the patients ranged from 14 to 64 years. Of the 50 patients, 12 (24%) were male and 38 (76%) were females. Various histopathological diagnoses included were inflammatory lesions 8 (16%), hyperplastic lesions 15 (30%), and benign 2 (4%) and malignant 25 (50%) lesions. On quantitative analysis of Gal-3 immunostaining, 16/16 (100%) of the papillary thyroid carcinoma (PTC) cases showed a positive expression. In the rest of the malignant cases, 5 (20%) of follicular thyroid carcinoma, 3 (12%) of medullary thyroid carcinoma, and 1 (4%) of anaplastic thyroid carcinoma showed a negative expression. The PTC cases showed a statistically significant difference from the rest of the benign lesions (P = 0.000). In PTC cases, the sensitivity of Gal-3 came out to be 100%, specificity was 64%, positive predictive value was 75.3%, negative predictive value was 100%, and accuracy was 82%. Conclusion: The data thus obtained indicate that Gal-3 is a valuable marker for differentiating classical PTC and its common variants (follicular variant and microcarcinoma in our study) from the other benign and malignant lesions. Gal-3 as a diagnostic marker for thyroid cancer can lead to improved outcomes for individuals diagnosed with equivocal or suspicious lesions.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43803732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contralateral neck dissection in oral cavity cancers crossing midline: A look in the mirror","authors":"Sachin V Wani, Nishith R. Modi, M. Srinitya, R. Bhatt, Shishir Shah, A. Shah, Nikita Choksi","doi":"10.4103/jhnps.jhnps_35_22","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_35_22","url":null,"abstract":"Introduction: Oral cavity cancer is the most common cancer in our country. In patients with oral cavity squamous cell carcinoma (OCSCC) elective neck dissection results in higher rates of overall survival and disease-free survival. Nodal metastasis in OCSCC is related to poor prognosis. Elective ipsilateral node dissection is recommended in all patients. Contralateral nodal metastasis is associated with poorer prognosis. The purpose of our study is to identify the predictors and factors associated with bilateral or contralateral nodal metastasis in oral cavity cancers reaching or crossing the midline. Materials and Methods: All patients of oral cavity cancer where the primary cancer was reaching or crossing the midline, operated during 3 years in a single institute were taken up for the study. All patients underwent surgery of primary cancer and bilateral neck dissection. Patients with truly lateral disease not approaching midline, history of any previous oncologic treatment, and recurrent cancers, and patients with two or more primaries were excluded from the study. Results: Out of 93 patients, 43% of the buccal mucosa – gingivobuccal sulcus region and 57% of the tongue – floor of mouth region. Out of 46 patients having nodal metastasis (50%), 26.8% of patients had bilateral nodal metastasis, but none had isolated contralateral nodal metastasis. On univariate and bivariate analysis, we found tumor grade, stage, site of ENE, and presence of multiple ipsilateral positive nodes were significant factors predicting contralateral nodal metastasis. Conclusion: Surgical management of the contralateral neck in oral cavity cancer is a complex issue. The simplistic approach of doing contralateral neck dissection in all oral cavity cancers when disease crosses midline is not sufficient. The presence of contralateral neck node metastasis in the absence of positive ipsilateral neck is very rare (0% in our study). There are other important clinic radiological factors such as DOI >10 mm, involvement of skin and bone, and presence of extranodal extension and location of primary tumor which also need to be considered in decision-making algorithm.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44908870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preservation of eye in carcinoma of the nose and paranasal sinuses – A critical review","authors":"S. Bahadur, Amit Kumar Sharma, J. Malik, S. Monga","doi":"10.4103/jhnps.jhnps_21_22","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_21_22","url":null,"abstract":"Background: Tumor invasion into the orbit by carcinoma is well known and its negative impact on the survival and quality of life has been discussed in the literature. Methods: This article is a narrative review on the preservation of eye in the management of cancers of the nose and paranasal region. Conclusions: The clinical features and modern imaging can help in preoperative planning, aided by the intraoperative assessment in decision-making to preserve the eye or not. Unlike in the past, when even orbital periosteum involvement was considered for orbital sacrifice, more conservative approach has been advocated in recent years in view of anatomic, radiological, and histological studies. Limited involvement of the periorbita or even the small part of intraorbital fat may still be considered for the preservation of the eye in selected patients with frozen section control and without affecting the oncologic outcome.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45452833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facial nerve anatomy revisited – A surgeon's perspective","authors":"Riju Ramachandran, A. Pillai","doi":"10.4103/jhnps.jhnps_30_22","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_30_22","url":null,"abstract":"Facial nerve (FN) anatomy is an enigma and its knowledge helps in safe and adequate parotidectomy without compromising the nerve. A review of the literature was done by searching the databases in PubMed, Embase, Scopus, and Google Scholar using the keywords “Parotid,” “FNT,” “Anatomy,” “Surgery,” and “Parotidectomy” and retrieving about 433 manuscripts fulfilling our requirements. FNT anatomy has been described in detail dividing the extracranial FNT under “Exit,” “Trunk,” “Pes Anserinus,” “Divisions,” “Branches,” “Communications,” “Relationships,” and “Termination.” Normal anatomy and variations including classification of the variation have been done. Knowledge of FNT anatomy helps in performing a safe parotidectomy. It is possible to preempt the course of the nerve and dissect the gland in a precise and rapid fashion, especially in surgery for a recurrence.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44213270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infrahyoid flap: Myocutaneous pedicled flap for reconstrcution of tongue carcinomas","authors":"H. Saluja, Seemit Shah, Shivani Sachdeva, A. Dadhich","doi":"10.4103/jhnps.jhnps_3_22","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_3_22","url":null,"abstract":"The infrahyoid flap (IHF) is a myocutaneous pedicled flap which is mostly supplied by the superior thyroid vessels through the infrahyoid muscles perforators. The flap is thin and it could be transferred as a pedicle of superior thyroid artery along with the vein for the reconstruction of medium-sized defects of head and neck surgeries. The added advantage of this flap is that it is pliable and provides a skin island which is approximately seven by four centimeters from the central part of the anterior neck. The best substitute for reconstruction of oral defects is IHF. It can be carried out for the moderate defects of mouth along with that of pharynx carcinomas. The flap can be either unilateral or bilateral superior thyroid pedicle flaps but the main limitations are restricted arc of rotation and small flap volume. The IHF is contraindicated in cases with prior irradiation as well as cases of neck metastasis. The flap is most trusted and can be easily yielded during dissections of the head and neck; oncologically, it is safe and it carries least morbidity of the donor site.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49070998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Papillary carcinoma thyroid – Histological subtypes and clinical significance","authors":"H. Ravindran","doi":"10.4103/jhnps.jhnps_32_22","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_32_22","url":null,"abstract":"Papillary carcinoma thyroid is a very common malignancy of the thyroid having a very good overall prognosis. Among the subtypes of this tumor certain histological subtypes identified are more aggressive than the ones with classic histology. The purpose of this review is to stratify the prognosis concerning papillary thyroid carcinoma patients with different histopathological patterns, their features of identification, and molecular differences. This is a narrative review of various published articles including meta-analysis results. This does not contain any studies with human participants by the author. A general outline of each subtype with histologic descriptions, relevant differential diagnosis, immunohistochemical as well as ancillary studies is discussed in this article. The rarity of the aggressive subtypes of papillary carcinoma and poor understanding of tumor biology can lead to inadequate treatment, and hence, the correct diagnosis is very important, and equally important is the awareness of these entities among the treating physicians.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47304632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}