Head & Neck最新文献

{"title":"Esophageal-subarachnoid fistula: a case of spontaneous tension pneumocephalus in the setting of esophageal cancer.","authors":"Mihir R Patel,&nbsp;Winslo Idicula,&nbsp;Ricardo L Carrau,&nbsp;Daniel M Prevedello","doi":"10.1002/hed.23459","DOIUrl":"https://doi.org/10.1002/hed.23459","url":null,"abstract":"<p><strong>Background: </strong>Pneumocephalus occurs as a result of traumatic or iatrogenic violation of the dura. Tension pneumocephalus, whereby air continues to accumulate with no mechanism for escape, can cause significant morbidity and mortality.</p><p><strong>Methods: </strong>This case report reviews the underlying pathophysiology, clinical presentation, diagnosis, and management of tension pneumocephalus.</p><p><strong>Results: </strong>We present the case of a 68-year-old man who presented to the Emergency Department with headache thought to be the result of a newfound intracranial mass. After admission, he became obtunded and was found to have tension pneumocephalus requiring emergent evacuation. A cervical esophagus carcinoma caused an esophageal-subarachnoid fistula that resulted in tension pneumocephalus after a retching episode.</p><p><strong>Conclusion: </strong>This case illustrates the importance of considering alternative sources of pneumocephalus in the absence of more typical differential diagnosis.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"E52-6"},"PeriodicalIF":2.9,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23459","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31735669","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":"Genetics of hereditary head and neck paragangliomas.","authors":"Carsten C Boedeker,&nbsp;Erik F Hensen,&nbsp;Hartmut P H Neumann,&nbsp;Wolfgang Maier,&nbsp;Francien H van Nederveen,&nbsp;Carlos Suárez,&nbsp;Henricus P Kunst,&nbsp;Juan P Rodrigo,&nbsp;Robert P Takes,&nbsp;Phillip K Pellitteri,&nbsp;Alessandra Rinaldo,&nbsp;Alfio Ferlito","doi":"10.1002/hed.23436","DOIUrl":"https://doi.org/10.1002/hed.23436","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to give an overview on hereditary syndromes associated with head and neck paragangliomas (HNPGs).</p><p><strong>Methods: </strong>Our methods were the review and discussion of the pertinent literature.</p><p><strong>Results: </strong>About one third of all patients with HNPGs are carriers of germline mutations. Hereditary HNPGs have been described in association with mutations of 10 different genes. Mutations of the genes succinate dehydrogenase subunit D (SDHD), succinate dehydrogenase complex assembly factor 2 gene (SDHAF2), succinate dehydrogenase subunit C (SDHC), and succinate dehydrogenase subunit B (SDHB) are the cause of paraganglioma syndromes (PGLs) 1, 2, 3, and 4. Succinate dehydrogenase subunit A (SDHA), von Hippel-Lindau (VHL), and transmembrane protein 127 (TMEM127) gene mutations also harbor the risk for HNPG development. HNPGs in patients with rearranged during transfection (RET), neurofibromatosis type 1 (NF1), and MYC-associated factor X (MAX) gene mutations have been described very infrequently.</p><p><strong>Conclusion: </strong>All patients with HNPGs should be offered a molecular genetic screening. This screening may usually be restricted to mutations of the genes SDHD, SDHB, and SDHC. Certain clinical parameters can help to set up the order in which those genes should be tested.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"907-16"},"PeriodicalIF":2.9,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23436","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31631265","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":"Supraglottic immunoglobulin-G4 related plasma cell granuloma: case report and literature review.","authors":"Jeremy F Khoo,&nbsp;Michael Batt,&nbsp;Paul Stimpson,&nbsp;Adnan Safdar","doi":"10.1002/hed.23519","DOIUrl":"https://doi.org/10.1002/hed.23519","url":null,"abstract":"<p><strong>Background: </strong>Granuloma of the upper aerodigestive tract is a rare presentation of immunoglobulin-G4 (IgG4)-related disease. Since the disease process was defined in 2003, only 2 cases affecting the laryngopharynx have been reported in the literature.</p><p><strong>Methods and results: </strong>A 62-year-old white man presented with persistent productive cough of brown sputum, globus symptoms, dysphagia, odynophagia, dysphonia, otalgia, and general malaise over a period of 2 months. Investigations revealed IgG4-positive plasma cell granuloma of the supraglottic region. This was successfully treated with oral corticosteroids.</p><p><strong>Conclusion: </strong>Because IgG4 testing is not performed routinely, management recommendations have been poorly defined. We reviewed the literature and discuss herein the clinical characteristics, pathology, diagnosis, and management. The authors theorize that IgG4-related disease involving the larynx and pharynx may be more common than suggested by the paucity of reported cases.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"E57-9"},"PeriodicalIF":2.9,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23519","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31798805","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":"Conclusions about human papillomavirus-related malignancies.","authors":"Wendell G Yarbrough,&nbsp;Eben Rosenthal","doi":"10.1002/hed.23378","DOIUrl":"https://doi.org/10.1002/hed.23378","url":null,"abstract":"Although cancer death rates and overall cancer incidence in the United States have recently declined, human papillomavirus (HPV)-associated cancers of the oropharynx and anus have the ominous distinction of increasing in incidence. The article by Skinner et al therefore addresses an important topic — what is the relationship between multiple HPV-related malignancies in a single individual? This question has previously been addressed using epidemiological approaches, but not in a comprehensive chart review. Skinner and Beadle present a retrospective review of patients treated at their institution over a 60-year period starting in 1949 with the intent of understanding which patients are at risk for HPV-related malignancies, specifically, are patients with one HPV-related malignancy more likely to have additional HPV-related malignancies. It is logical to assume that HPV exposure may predispose to a phenotype of multiple cancers in susceptible organs. Using administrative data, others have shown that patients with a history of cervical cancer are at risk for a head and neck cancer primary (1.7 incidence ratio). Conversely, patients with oropharyngeal cancer are at increased risk for cervical cancer. Skinner et al have investigated additional tumor sites and determined latency and associated clinical characteristics. Among other findings, the authors identify significant differences in latency periods between first and second HPV-related cancers depending on the initial cancer site. Related to methodological problems, the authors acknowledge that the results “should be interpreted as hypothesis-generating” and recognize some other deficiencies in the discussion; however, these shortcomings and potential interpretations warrant additional comment. Although this article addresses an important topic, there are several methodological issues that should be recognized in the data collection. The head and neck cancer population included all sites rather than the oropharynx and, as a result, probably significantly overestimates the number of HPV-related cancers. Elimination of patients with disease outside the oropharynx or preferably some method of HPV testing tissue (p16 immunohistochemistry or HPV in situ hybridization) of archival tumor specimens, would significantly improve identification of HPVrelated malignancies. It is fair to say that many patients with oropharyngeal disease get primary medical therapy and, as a result, there is often limited tissue available for laboratory analysis. However, limiting the study to patients with oropharyngeal disease and eliminating patients with laryngeal or oral cavity disease, especially over the time frame of the study, would be very appropriate although it would also shrink the overall study numbers. Because HPV-related head and neck malignancies have trended upward over time, it is likely that, over the 60-year study period, the incidence of HPV-related oropharyngeal cancer has significantly increased just as t","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"826-7"},"PeriodicalIF":2.9,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23378","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31448344","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":"Prospective quality of life assessment between treatment groups for oral cavity squamous cell carcinoma.","authors":"Sydney Ch'ng,&nbsp;Justine Oates,&nbsp;Kan Gao,&nbsp;Kerwyn Foo,&nbsp;Sarah Davies,&nbsp;Markus Brunner,&nbsp;Jonathan R Clark","doi":"10.1002/hed.23387","DOIUrl":"https://doi.org/10.1002/hed.23387","url":null,"abstract":"<p><strong>Background: </strong>Postoperative radiation therapy (PORT) is frequently recommended to improve survival outcome. The effect of PORT-associated morbidity on patients' quality of life (QOL) is, however, not well established. This study assessed the effect of PORT on medium-term (ie, at 6 months) QOL in patients with oral cavity squamous cell carcinoma (SCC).</p><p><strong>Methods: </strong>Patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Quality of Life Questionnaire Core Head and Neck 35 (QLQ-HN35) at initial presentation, and at 3-, 6-, and 12-month follow-up. Baseline QOL scores were adjusted for using analysis of covariance (ANCOVA).</p><p><strong>Results: </strong>Global health status (mean difference = 13.3; p = .042) and xerostomia (mean difference = 35.4; p = .003) were significantly worse at 6 months in patients who received PORT compared to those treated with surgery alone.</p><p><strong>Conclusion: </strong>The survival advantage needs to be balanced against increased treatment toxicity. PORT is associated with reduced global health status, increased xerostomia, and marginally increased levels of fatigue at 6 months posttreatment for oral cavity cancer.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"834-40"},"PeriodicalIF":2.9,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23387","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31467013","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":"Transoral laser microsurgery in treatment of pT2 and pT3 glottic laryngeal squamous cell carcinoma - results of 391 patients.","authors":"Martin Canis,&nbsp;Alexios Martin,&nbsp;Friedrich Ihler,&nbsp;Hendrik A Wolff,&nbsp;Martina Kron,&nbsp;Christoph Matthias,&nbsp;Wolfgang Steiner","doi":"10.1002/hed.23389","DOIUrl":"https://doi.org/10.1002/hed.23389","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to evaluate oncological and functional results of transoral laser microsurgery (TLM) in patients with T2 and T3 glottic laryngeal squamous cell carcinoma (SCC).</p><p><strong>Methods: </strong>A retrospective chart analysis was carried out. Cases were classified into categories pT2a, pT2b, and pT3. Treatment was exclusively TLM ± selective neck dissection and adjuvant (chemo)radiotherapy.</p><p><strong>Results: </strong>Three hundred ninety-one patients were treated by TLM; 142 cases were category pT2a, 127 were pT2b, and 122 were pT3. Median follow-up was 71 months. Five-year overall, recurrence-free, and disease specific survival rates were 72.2%, 76.4%, and 93.2% for pT2a tumors, 64.9%, 57.3%, and 83.9% for pT2b tumors, and 58.6%, 57.8%, and 84.1% for pT3 tumors, respectively. Larynx preservation was achieved in 93% (pT2a) and 83% (pT2b and pT3).</p><p><strong>Conclusion: </strong>Results are comparable to open partial or total laryngectomy and superior to primary (chemo)radiotherapy. TLM results in a lower morbidity and superior function compared to standard treatment.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"859-66"},"PeriodicalIF":2.9,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23389","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31467026","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":"Clival chordomas: A pathological, surgical, and radiotherapeutic review.","authors":"Juan C Fernandez-Miranda,&nbsp;Paul A Gardner,&nbsp;Carl H Snyderman,&nbsp;Kenneth O Devaney,&nbsp;William M Mendenhall,&nbsp;Carlos Suárez,&nbsp;Alessandra Rinaldo,&nbsp;Alfio Ferlito","doi":"10.1002/hed.23415","DOIUrl":"https://doi.org/10.1002/hed.23415","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to discuss the optimal management of patients with clival chordomas and provide an up-to-date review of the field.</p><p><strong>Methods: </strong>A schematic description of the anatomy of the clivus and its surrounding structures is provided based on the modular classification of the surgical corridors used in endoscopic skull base surgery. Postoperative radiotherapy (RT) techniques are described.</p><p><strong>Results: </strong>The optimal treatment is gross total resection. Recent advances in endoscopic endonasal skull base surgery have allowed very high rates of macroscopic and radiographic complete tumor resection in spite of the challenging location of these lesions. When the tumor location or extension is too lateral or inferior to be effectively resected with an endoscopic approach, an open approach or a combination of endoscopic and open approaches in stages should be considered. Postoperative RT is usually indicated because the likelihood of recurrence is high in spite of complete surgical resection. The main site of recurrence is local and late recurrences are relatively common. The probability of cure is approximately 50% at 10 years and significantly increases when complete tumor resection has been achieved.</p><p><strong>Conclusion: </strong>The preferred treatment for patients with clival chordoma is gross total resection (via endoscopic endonasal surgery when possible) followed by postoperative RT. Treatment at experienced multidisciplinary cranial base centers is key to minimize complications and to enhance the probability of total removal of the tumors.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"892-906"},"PeriodicalIF":2.9,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31537244","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":"Transoral robotic approach to carcinoma of unknown primary.","authors":"Kasim Durmus,&nbsp;Sanjeet V Rangarajan,&nbsp;Matthew O Old,&nbsp;Amit Agrawal,&nbsp;Theodoros N Teknos,&nbsp;Enver Ozer","doi":"10.1002/hed.23385","DOIUrl":"https://doi.org/10.1002/hed.23385","url":null,"abstract":"<p><strong>Background: </strong>The management of carcinoma of unknown primary (CUP) is one of the challenging conditions in head and neck oncologic surgery. Despite various diagnostic tools, the primary tumor site in more than half of cases remains unidentified. The purpose of this study was to assess the feasibility and efficiency of utilizing transoral robotic surgery (TORS) for the diagnosis and treatment of CUP in the head and neck.</p><p><strong>Methods: </strong>In this prospective, single-institutional, clinical TORS trial, 22 of 181 patients were treated for CUP between 2008 and 2012.</p><p><strong>Results: </strong>Among all those 22 patients, primary tumor site identification and complete tumor removal was achieved in 17 patients (77.3%) with TORS. Tonsil (59.1%) and base of tongue (18.1%) were identified as the most common tumor locations.</p><p><strong>Conclusion: </strong>Together with panendoscopy, directed biopsies, and positron emission tomography (PET)/CT, TORS is a valuable option in the identification and treatment of primary tumor sites.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"848-52"},"PeriodicalIF":2.9,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23385","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31466663","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":"Laryngeal electromyography findings of vocal fold immobility in patients after radiotherapy for nasopharyngeal carcinoma.","authors":"Yi-Ling Hsieh,&nbsp;Ming-Hong Chang,&nbsp;Chen-Chi Wang","doi":"10.1002/hed.23388","DOIUrl":"https://doi.org/10.1002/hed.23388","url":null,"abstract":"<p><strong>Background: </strong>The clinical features of vocal fold immobility (VFI) after radiotherapy for nasopharyngeal carcinoma (NPC) have seldom been reported.</p><p><strong>Methods: </strong>We retrospectively reviewed laryngeal electromyography (LEMG) and tumor study findings to elucidate the common clinical features of patients who presented with VFI after radiotherapy for NPC. The LEMG signals obtained from the cricothyroid and thyroarytenoid muscles were used to confirm superior laryngeal nerve (SLN) and recurrent laryngeal nerve (RLN) injury.</p><p><strong>Results: </strong>The medical records of 13 patients were reviewed and 11 of them had evidence of RLN injury. Six of the 11 patients also had SLN injury, indicating possible vagus nerve (VN) injury. Two patients had cricoarytenoid joint fixation without evidence of nerve injury. None of the nerve injuries were caused by skull base recurrence or tumor metastasis.</p><p><strong>Conclusion: </strong>VFI is usually caused by nerve injury, but it is not a malignant sign of tumor recurrence or metastasis.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"867-72"},"PeriodicalIF":2.9,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23388","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31467670","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":"Clinical outcomes for early-stage nasopharyngeal carcinoma with predominantly WHO II histology treated by intensity-modulated radiation therapy with or without chemotherapy in nonendemic region of China.","authors":"Shanquan Luo,&nbsp;Lina Zhao,&nbsp;Jianhua Wang,&nbsp;Man Xu,&nbsp;Jianping Li,&nbsp;Bin Zhou,&nbsp;Feng Xiao,&nbsp;Xiaoli Long,&nbsp;Mei Shi","doi":"10.1002/hed.23386","DOIUrl":"https://doi.org/10.1002/hed.23386","url":null,"abstract":"<p><strong>Background: </strong>The clinical outcomes for early-stage nasopharyngeal carcinoma (NPC) in northwest China were evaluated.</p><p><strong>Methods: </strong>A retrospective study was performed from 69 patients with NPC patients treated with intensity-modulated radiation therapy (IMRT) with or without chemotherapy.</p><p><strong>Results: </strong>Median follow-up was 34 months. World Health Organization (WHO) type II was the predominant histology (71%). All treatment failures occurred in T2N1 NPCs (14.5%), with metastasis the major reason. The 3-year overall survival (OS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were 93.3%, 94.1%, and 94.8% respectively. The 3-year survival rate for T2N1 and IMRT alone group were both significantly poorer than the T1N0, T2N0, and T1N1 groups and the chemoradiation group, respectively (p < .05). N1 classification, T2N1 classification, and addition of chemoradiation were significant independent predictors (p < .05). No grade IV toxicities were observed.</p><p><strong>Conclusion: </strong>T2N1 classification is a unique subgroup with higher risk of distant metastasis. Improved outcomes of T2N1 NPC with predominantly WHO II histology after chemoradiation has not been reported.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"841-7"},"PeriodicalIF":2.9,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23386","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31468569","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}