Head & Neck最新文献

{"title":"Free flap failure in head and neck reconstruction.","authors":"Christian Corbitt,&nbsp;Roman J Skoracki,&nbsp;Peirong Yu,&nbsp;Matthew M Hanasono","doi":"10.1002/hed.23471","DOIUrl":"https://doi.org/10.1002/hed.23471","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to determine the causes of head and neck free flap loss and to evaluate outcomes after subsequent microvascular and non-microvascular reconstruction.</p><p><strong>Methods: </strong>Patients who experienced free flap loss between 2000 and 2012 were reviewed.</p><p><strong>Results: </strong>There were 40 flap losses out of 3090 free flaps (1.3%). Twenty-eight patients underwent subsequent free flap reconstruction of which 27 free flaps were successful (96.4%), which was not significantly different from our initial flap success rate (p = .81). Of patients who underwent subsequent free flap reconstruction for oral/pharyngeal defects, 100% had >80% speech intelligibility and 87.5% were tube feed independent. By comparison, 42.9% of patients who underwent subsequent pectoralis major flap reconstruction had intelligible speech (p = .01) and 25.0% were independent of tube feeds (p = 0.02).</p><p><strong>Conclusion: </strong>Subsequent free flaps after initial free flap losses can be successful in selected patients. Functional outcomes after subsequent free flap reconstruction are favorable compared to pedicled flap reconstruction.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"1440-5"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23471","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31735014","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":"Multi-institutional investigation of the prognostic value of lymph nodel yield in advanced-stage oral cavity squamous cell carcinoma.","authors":"James J Jaber,&nbsp;Chad A Zender,&nbsp;Vikas Mehta,&nbsp;Kara Davis,&nbsp;Robert L Ferris,&nbsp;Pierre Lavertu,&nbsp;Rod Rezaee,&nbsp;Paul J Feustel,&nbsp;Jonas T Johnson","doi":"10.1002/hed.23475","DOIUrl":"https://doi.org/10.1002/hed.23475","url":null,"abstract":"<p><strong>Background: </strong>Although existing literature provides surgical recommendations for treating occult disease (cN0) in early-stage oral cavity squamous cell carcinoma (SCC), a focus on late-stage oral cavity SCC is less pervasive.</p><p><strong>Methods: </strong>The medical records of 162 patients with late-stage oral cavity SCC pN0 who underwent primary neck dissections were reviewed. Lymph node yield as a prognosticator was examined.</p><p><strong>Results: </strong>Despite being staged pN0, patients that had a higher lymph node yield had an improved regional/distant control rates, disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS). Lymph node yield consistently outperformed all other standard variables as being the single best prognostic factor with a tight risk ratio range (RR = 0.95-0.98) even when correcting for the number of lymph nodes examined.</p><p><strong>Conclusion: </strong>The results of this study showed that lower regional recurrence rates and improved survival outcomes were seen as lymph node yield increased for advanced T classification oral cavity SCC pN0. This suggests that increasing lymph node yield with an extended cervical lymphadenectomy may result in lower recurrence rates and improved survival outcomes for this advanced stage group.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"1446-52"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23475","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31735992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solitary dural metastasis at presentation in a patient with untreated human papillomavirus-associated squamous cell carcinoma of the oropharynx.","authors":"Samer Al-Khudari,&nbsp;Susan Guo,&nbsp;Yunwei Chen,&nbsp;Tobenna Nwizu,&nbsp;John F Greskovich,&nbsp;Robert Lorenz,&nbsp;Brian B Burkey,&nbsp;David J Adelstein,&nbsp;Shlomo A Koyfman","doi":"10.1002/hed.23589","DOIUrl":"https://doi.org/10.1002/hed.23589","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (SCC) is associated with high cure rates and distant metastases are rare.</p><p><strong>Methods and results: </strong>We report a case of a 61-year-old man presenting with acute left-sided weakness. An enhancing dural mass was noted and resected. Histology revealed p16-positive SCC. Further workup revealed a p16-positive right tonsillar primary with ipsilateral nodal disease and was classified as T2N2bM1. The patient underwent whole brain irradiation and definitive chemoradiation with curative intent. Complete clinical response was achieved and the patient continues to be disease-free 6 months posttreatment.</p><p><strong>Conclusion: </strong>HPV-associated oligometastatic oropharyngeal SCC is a rare entity that may have a unique natural history and behavior. Given the excellent treatment response and prognosis of HPV-positive disease in general, these patients may be appropriate for definitive treatment approaches.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"E103-5"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23589","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31986344","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":"Investigating laryngeal basaloid squamous cell carcinoma prognosis.","authors":"Gino Marioni","doi":"10.1002/hed.23768","DOIUrl":"https://doi.org/10.1002/hed.23768","url":null,"abstract":"To the Editor: I read with great interest the recent article by Fritsch and Lentsch, who investigated laryngeal basaloid squamous cell carcinoma (BSCC) prognosis using the populationbased cancer registries of the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. Although the study by Fritsch and Lentsch is inevitably characterized by a potential bias relating to the fact that the cases of BSCC were diagnosed and treated by different teams and in different ways, the numerosity of the cases considered is remarkable. These studies are important, particularly those comparing the prognosis for head and neck BSCC as opposed to conventional squamous cell carcinoma (SCC) in site-matched and stage-matched settings, because numerous—but not all—investigators currently believe that head and neck BSCC is a significantly more aggressive lesion and carries a worse prognosis than the more commonly encountered SCC. Confirmation of the greater aggressiveness of head and neck BSCC visa-vis conventional SCC could rationally justify a more aggressive approach to their locoregional treatment and possibly the use of adjuvant chemotherapy in head and neck BSCC. However, because the mistakes made (and reiterated) in citations eventually have a significant impact on the international medical literature, I have to point out that, in their reference number 22, Fritsch and Lentsch misquote the content of a study conducted by our group in this field. In the investigation concerned, the 9 BSCCs considered did not all arise in the larynx (but 5 in the larynx, 3 in the tongue, and 1 in the tonsil), whereas another study by our group analyzed the prognostic role of the apoptosis inhibitor protein survivin in 9 consecutive cases of laryngeal BSCC, and, in this latter series, the diseasespecific survival (DSS) was 55.6%. In speaking about the prognosis for BSCC of the head and neck, it is extremely important to be accurate about the site involved by the primary lesion. In fact, a more recent study by Fritsch and Lentsch concluded that the DSS of patients treated for laryngeal BSCC was significantly lower than for patients with conventional SCC on multivariate analysis, but patients with oropharyngeal BSCC had a higher DSS than those with oropharyngeal conventional SCC (reported data source: Surveillance, Epidemiology, and End Results Program of the National Cancer Institute, September 2005; size of the populations considered: 1083 head and neck BSCCs, 66,929 conventional SCC).","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"1527"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23768","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32351973","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":"Desmoid tumors of the head and neck: a therapeutic challenge.","authors":"Eelco de Bree,&nbsp;Odysseas Zoras,&nbsp;Jennifer L Hunt,&nbsp;Robert P Takes,&nbsp;Carlos Suárez,&nbsp;William M Mendenhall,&nbsp;Michael L Hinni,&nbsp;Juan P Rodrigo,&nbsp;Ashok R Shaha,&nbsp;Alessandra Rinaldo,&nbsp;Alfio Ferlito,&nbsp;Remco de Bree","doi":"10.1002/hed.23496","DOIUrl":"https://doi.org/10.1002/hed.23496","url":null,"abstract":"<p><p>Desmoid tumor, or aggressive fibromatosis, is a rare, histologically benign, fibroblastic lesion that infrequently presents in the head and neck. Desmoid tumors often grow locally, invasively, and may, in rare instances, be fatal secondary to invasion into critical structures, such as airway or major vessels. The most common treatment is surgery, but desmoid tumors are characteristically associated with a high local recurrence rate after resection. Although the margin status seems to be of importance, operations that avoid function loss and esthetic disfigurement should be the primary goal. The efficacy of postoperative radiotherapy is controversial. Its potential benefit should be carefully balanced against possible radiation-induced adverse effects. Alternative treatment modalities, such as primary radiotherapy and medical treatment or a wait-and-see policy, may be preferable to mutilating surgery. Considering all the aforementioned, it seems obvious that desmoid tumors of the head and neck present a therapeutic challenge and require an individualized approach.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"1517-26"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23496","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32025445","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":"Hereditary paraganglioma-pheochromocytoma syndromes associated with SDHD and RET mutations.","authors":"Joseph Do Woong Choi,&nbsp;Katherine M Tucker,&nbsp;Tack Tsiew Lee,&nbsp;Guan C Chong","doi":"10.1002/hed.23598","DOIUrl":"https://doi.org/10.1002/hed.23598","url":null,"abstract":"<p><strong>Background: </strong>Hereditary paraganglioma-pheochromocytoma syndromes (PGL/PCC) are rare tumors arising from neuroendocrine cells.</p><p><strong>Methods and results: </strong>The proband, a 59-year-old white man and his 42-year-old elder son had a medical history of bilateral carotid body PGL and both presented for treatment of abdominal PGLs. His 36-year-old daughter had excision of recurrent malignant carotid body PGL and vertebral metastasis. His 33-year-old youngest son presented for excision of a unilateral carotid body PGL. All 4 members had succinate dehydrogenase subunit D (SDHD) mutations, whereas the proband and youngest son also had concurrent rearranged during transfection (RET) mutation.</p><p><strong>Conclusion: </strong>This is the first report of PGL/PCC with SDHD and RET mutations. The role of the RET gene as a modifier remains speculative. Additionally, the family pedigree suggests maternal inheritance of disease from the probands' paternal grandmother. Clinicians should refer PGL/PCC families for mutation analysis as well as being alert to changes in the classification of mutations.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"E99-E102"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23598","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31988313","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":"Evaluation of shoulder disability questionnaires used for the assessment of shoulder disability after neck dissection for head and neck cancer.","authors":"David P Goldstein,&nbsp;Jolie Ringash,&nbsp;Eric Bissada,&nbsp;Yves Jaquet,&nbsp;Jonathan Irish,&nbsp;Douglas Chepeha,&nbsp;Aileen M Davis","doi":"10.1002/hed.23490","DOIUrl":"https://doi.org/10.1002/hed.23490","url":null,"abstract":"<p><strong>Background: </strong>Several questionnaires have been used to evaluate shoulder disability after neck dissection. The purpose of this study was to review these measures and highlight their strengths and weaknesses.</p><p><strong>Methods: </strong>A literature review was performed to identify measures of shoulder disability after head and neck cancer surgery. These measures were evaluated in terms of their methods of development and assessment of their psychometric properties.</p><p><strong>Results: </strong>Seven questionnaires were identified. Several of the other questionnaires have been well developed but have not had their psychometric properties assessed in the head and neck cancer population. Each questionnaire has its strengths and weaknesses.</p><p><strong>Conclusion: </strong>The strengths and weaknesses of the shoulder disability questionnaires should be considered when deciding which questionnaire to use. Efforts should be focused on using well-designed questionnaires that have been assessed in this patient population rather than developing or using other questionnaires.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"1453-8"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23490","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31699950","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":"Outcomes and xerostomia after postoperative radiotherapy for oral and oropharyngeal carcinoma.","authors":"Zhong-He Wang,&nbsp;Chao Yan,&nbsp;Zhi-Yuan Zhang,&nbsp;Chen-Ping Zhang,&nbsp;Hai-Sheng Hu,&nbsp;Wen-Yong Tu,&nbsp;Jessica Kirwan,&nbsp;William M Mendenhall","doi":"10.1002/hed.23488","DOIUrl":"https://doi.org/10.1002/hed.23488","url":null,"abstract":"<p><strong>Background: </strong>We compared outcomes and xerostomia grade after postoperative intensity-modulated radiation therapy (IMRT) and conventional radiotherapy (RT) in patients with oral and oropharyngeal carcinoma.</p><p><strong>Methods: </strong>Eighty-eight patients with oral cavity (n = 77) and oropharyngeal (n = 11) carcinoma underwent postoperative IMRT (n = 44) or conventional RT (n = 44). Outcomes, failure patterns, volume, doses, salivary gland V30, and xerostomia grade were evaluated. The median follow-up was 53 months (range, 48-58 months). The median interval from surgery to RT was 4 weeks (range, 3-6 weeks).</p><p><strong>Results: </strong>Twenty-one patients (7 and 14 for the IMRT and conventional RT groups, respectively) experienced local-regional failure. For the IMRT group, all 7 local-regional failures occurred in the high-dose target volumes. For the conventional RT group, there were 12 in-field failures, 1 at the margin, and 1 out-of-field. Nine patients experienced distant failure (5 and 4 for the IMRT and conventional RT groups, respectively). The 4-year local-regional control, disease-free survival (DFS), overall survival (OS), and distant-metastasis rates for the IMRT and conventional RT groups were 84.1% versus 68.2% (p = .055), 68.2% versus 52.3% (p = .091), 70.5% versus 56.8% (p = .124), and 11.4% versus 9.1% (p = .927), respectively. Xerostomia grade after RT was lower for IMRT compared to conventional RT (p < .001).</p><p><strong>Conclusion: </strong>Postoperative IMRT for oral and oropharyngeal carcinoma significantly improves mean dose, salivary gland V30, and xerostomia grade when compared to conventional RT. The predominant failure pattern was local. No differences were found in survival outcomes between both groups. There was a marginal difference in local-regional control.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"1467-73"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23488","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31699756","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":"Intraoperative near-infrared fluorescence imaging of parathyroid adenomas with use of low-dose methylene blue.","authors":"Joost R van der Vorst,&nbsp;Boudewijn E Schaafsma,&nbsp;Floris P R Verbeek,&nbsp;Rutger-Jan Swijnenburg,&nbsp;Quirijn R J G Tummers,&nbsp;Merlijn Hutteman,&nbsp;Jaap F Hamming,&nbsp;Job Kievit,&nbsp;John V Frangioni,&nbsp;Cornelis J H van de Velde,&nbsp;Alexander L Vahrmeijer","doi":"10.1002/hed.23384","DOIUrl":"https://doi.org/10.1002/hed.23384","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative identification of parathyroid adenomas can be challenging. We hypothesized that low-doses methylene blue (MB) and near-infrared fluorescence (NIRF) imaging could be used to identify parathyroid adenomas intraoperatively.</p><p><strong>Methods: </strong>MB was injected intravenously after exploration at a dose of 0.5 mg/kg into 12 patients who underwent parathyroid surgery. NIRF imaging was performed using the Mini-FLARE imaging system.</p><p><strong>Results: </strong>In 10 of 12 patients, histology confirmed a parathyroid adenoma. In 9 of these patients, NIRF could clearly identify the parathyroid adenoma during surgery. Seven of these 9 patients had a positive preoperative (99m) Tc-sestamibi single photon emission CT (SPECT) scan. Importantly, in 2 patients, parathyroid adenomas could be identified only using NIRF.</p><p><strong>Conclusion: </strong>This is the first study to show that low-dose MB can be used as NIRF tracer for identification of parathyroid adenomas, and suggests a correlation with preoperative (99m) Tc-sestamibi SPECT scanning.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"853-8"},"PeriodicalIF":2.9,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23384","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31559174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor location-dependent skip lateral cervical lymph node metastasis in papillary thyroid cancer.","authors":"Yoon Se Lee,&nbsp;Sung-Chan Shin,&nbsp;Yun-Sung Lim,&nbsp;Jin-Choon Lee,&nbsp;Soo-Geun Wang,&nbsp;Seok-Man Son,&nbsp;In-Ju Kim,&nbsp;Byung-Joo Lee","doi":"10.1002/hed.23391","DOIUrl":"https://doi.org/10.1002/hed.23391","url":null,"abstract":"<p><strong>Background: </strong>Lateral cervical lymph node metastasis without central lymph node (CLN) metastasis is not infrequent in papillary thyroid cancer (PTC). This study was designed to investigate the frequency and pattern of skip metastasis in PTC.</p><p><strong>Methods: </strong>We reviewed 131 patients who underwent total thyroidectomy with CLN dissection and selective lymph node dissection. Tumor location was classified in 3 areas (upper, middle, and lower third) based on preoperative ultrasonographic findings.</p><p><strong>Results: </strong>All skip metastases occurred in patients whose tumors had been on the upper part of the thyroid (p < .001). Among 9 patients with skip metastasis, level III lymph nodes (66.7%) were the lymph nodes that were most frequently involved in skip metastasis.</p><p><strong>Conclusion: </strong>Primary tumors in the upper portion of the thyroid are closely linked to skip metastasis. Careful preoperative evaluation of lateral cervical lymph nodes is suggested when a tumor is in the upper portion.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"887-91"},"PeriodicalIF":2.9,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23391","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31570753","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}