Head & Neck最新文献

{"title":"Postoperative radiotherapy for advanced medullary thyroid cancer--local disease control in the modern era.","authors":"David L Schwartz,&nbsp;Vishal Rana,&nbsp;Stephanie Shaw,&nbsp;Cynthia Yazbeck,&nbsp;Kie-Kian Ang,&nbsp;William H Morrison,&nbsp;David I Rosenthal,&nbsp;Ana Hoff,&nbsp;Douglas B Evans,&nbsp;Gary L Clayman,&nbsp;Adam S Garden,&nbsp;Steven I Sherman","doi":"10.1002/hed.20791","DOIUrl":"https://doi.org/10.1002/hed.20791","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study is to catalog modern-era postoperative radiotherapy (external beam radiotherapy [EBRT]) outcomes for advanced medullary thyroid cancer.</p><p><strong>Methods: </strong>Thirty-four consecutive patients with stage IVa-c disease were evaluated. Ten patients had recurrent disease, 16 had mediastinal involvement, and 10 had distant metastasis. Positive surgical margins were present in 12 cases. Median pre-EBRT serum calcitonin was 556. All patients received conformal EBRT or intensity-modulated radiotherapy. Median EBRT dose was 60 Gy and median follow-up was 46.5 months.</p><p><strong>Results: </strong>Kaplan-Meier estimates of locoregional relapse-free survival, disease-specific survival, and overall survival at 5 years were 87%, 62%, and 56%, respectively. Disease in 3 patients with gross residual disease was controlled locoregionally. Distant disease at the time of EBRT did not predict survival. Two (9%) patients reported symptomatic chronic morbidity.</p><p><strong>Conclusion: </strong>Surgery followed by EBRT provided durable locoregional disease control with limited morbidity. Postoperative EBRT merits consideration in cases of advanced disease at high risk for locoregional recurrence.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"883-8"},"PeriodicalIF":2.9,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.20791","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40412694","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":"Systematic review: accuracy of imaging tests in the diagnosis of recurrent laryngeal carcinoma after radiotherapy.","authors":"Jolijn Brouwer, Lotty Hooft, Otto S Hoekstra, Ingrid I Riphagen, Jonas A Castelijns, Remco de Bree, C René Leemans","doi":"10.1002/hed.20790","DOIUrl":"10.1002/hed.20790","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing recurrent laryngeal tumor after radiotherapy is challenging. The most reliable method is direct laryngoscopy under general anesthesia. However, many futile laryngoscopies are performed in disease-free patients. Imaging tests selecting patients for this invasive procedure would be useful. The aim of this systematic review was summarizing the available evidence and determining the diagnostic accuracy of CT, MRI, thallium-201 (201Tl) scintigraphy, and F-18-fluorodeoxyglucose positron emission tomography (18FDG-PET).</p><p><strong>Methods: </strong>A systematic review was performed according to the guidelines of the Cochrane Collaboration. Two reviewers scored the articles according to A-, B-, and C-items. Statistical meta-analysis was performed producing summary pooled estimates of sensitivity and specificity.</p><p><strong>Results: </strong>There were 8 eligible studies on 18FDG-PET. The validity of the 18FDG-PET studies was reasonable; the pooled estimates (95% CI) for sensitivity and specificity were 89% and 74%.</p><p><strong>Conclusion: </strong>The diagnostic accuracy of 18FDG-PET is promising and warrants a randomized trial comparing a strategy based on conventional diagnostic work-up to one based on 18FDG-PET.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"889-97"},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40527474","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":"Malignant paraganglioma caused by a novel germline mutation of the succinate dehydrogenase D-gene--a case report.","authors":"Konstantinos Papaspyrou,&nbsp;Heidi Rossmann,&nbsp;Christian Fottner,&nbsp;Matthias M Weber,&nbsp;Wolf Mann,&nbsp;Karl J Lackner,&nbsp;Kai Helling","doi":"10.1002/hed.20746","DOIUrl":"https://doi.org/10.1002/hed.20746","url":null,"abstract":"<p><strong>Background: </strong>Paragangliomas of the head and neck are rare, mostly benign tumors. Approximately 10% to 15% of paragangliomas are caused by mutations in the succinate dehydrogenase (SDH) genes B, C, or D. These are often multifocal as part of paraganglioma syndromes and hormone secreting, and malignant particularly associated with mutations in SDHB.</p><p><strong>Methods and results: </strong>A 29-year-old man was seen with recurrent paraganglioma. The patient's father reportedly suffered from bilateral carotid body tumors. Imaging studies showed metastases in both lungs and the liver. There was no increased hormone production by the tumor. Sequence analysis of the SDH genes revealed a novel C to T nonsense mutation in the first exon of the SDHD gene (R17X).</p><p><strong>Conclusions: </strong>A novel mutation in the SDHD gene associated with malignant paraganglioma is reported. This case underscores the relevance of family history and genetic analysis, thus permitting early detection of unaffected carriers. These have to be monitored clinically, biochemically and by imaging techniques.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"964-9"},"PeriodicalIF":2.9,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.20746","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40412696","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":"Phase II study of gefitinib for the treatment of recurrent and metastatic nasopharyngeal carcinoma.","authors":"Daniel T T Chua,&nbsp;William I Wei,&nbsp;Maria P Wong,&nbsp;Jonathan S T Sham,&nbsp;John Nicholls,&nbsp;Gordon K H Au","doi":"10.1002/hed.20792","DOIUrl":"https://doi.org/10.1002/hed.20792","url":null,"abstract":"<p><strong>Background: </strong>This single-center, phase II study assessed the safety/tolerability and initial efficacy of gefitinib in patients with nasopharyngeal carcinoma (NPC) pretreated with platinum-based chemotherapy.</p><p><strong>Methods: </strong>Patients with recurrent and metastatic NPC who had treatment failure with at least 2 lines of chemotherapy including platinum were given gefitinib at a fixed dose of 250 mg daily. Treatment was continued until the patient experienced unacceptable side effects or disease progression.</p><p><strong>Results: </strong>Nineteen patients were enrolled, having had treatment failure with a median of 2 chemotherapy regimens. Treatment was well tolerated, and only grades 1 to 2 adverse events were observed. None of the patients achieved partial or complete response. Median time-to-progression was 4 months, and median overall survival was 16 months.</p><p><strong>Conclusion: </strong>Gefitinib was well tolerated, but the response rate was poor in this heavily pretreated study population, and its use in NPC is not recommended outside the context of clinical trial.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"863-7"},"PeriodicalIF":2.9,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.20792","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40413260","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":"Increased midsagittal tongue velocity as indication of articulatory compensation in patients with lateral partial glossectomies.","authors":"Orchid Rastadmehr,&nbsp;Tim Bressmann,&nbsp;Ron Smyth,&nbsp;Jonathan C Irish","doi":"10.1002/hed.20772","DOIUrl":"https://doi.org/10.1002/hed.20772","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to describe the impact of partial lateral glossectomy on midsagittal tongue movement during speech.</p><p><strong>Methods: </strong>Using B-mode ultrasound, the midsagittal tongue movement of 10 patients with lateral partial glossectomy during a standardized reading passage was analyzed before and after surgery. Six normal adults served as control speakers. The main outcome measure was the tongue velocity during speech. The technique of defect reconstruction (local vs flap) was included as a covariate in the analysis.</p><p><strong>Results: </strong>Following the surgery, all patients significantly increased the velocity of the midsagittal tongue movements during the reading passage.</p><p><strong>Conclusion: </strong>The results demonstrated that the patients with partial glossectomy compensated for the lateral tongue resections by increasing the velocity of the residual tongue during speech. The study provides first insights into the biomechanical aspects of spontaneous articulatory compensation following lateral tongue resections.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"718-26; discussion 726-7"},"PeriodicalIF":2.9,"publicationDate":"2008-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.20772","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40413258","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":"Response to paclitaxel in adenoid cystic carcinoma of the salivary glands.","authors":"Brian G Till,&nbsp;Renato G Martins","doi":"10.1002/hed.20731","DOIUrl":"https://doi.org/10.1002/hed.20731","url":null,"abstract":"<p><strong>Background: </strong>Paclitaxel is not considered to be an active drug in adenoid cystic carcinoma (ACC) of the salivary glands. We report 2 consecutive cases of patients with ACC who responded to paclitaxel.</p><p><strong>Methods: </strong>The patients were: (1) a 58-year-old man with recurrent ACC who developed pulmonary metastases, had progressive disease after a good response to first-line chemotherapy, and then achieved a partial response to weekly single- agent paclitaxel; and (2) a 46-year-old woman with extensive thoracic ACC metastases who achieved a significant response after 2 cycles of paclitaxel chemotherapy.</p><p><strong>Results: </strong>The first patient died of progressive disease approximately 4 months after completing paclitaxel therapy, and the second patient had disease control after 6 cycles of paclitaxel.</p><p><strong>Conclusions: </strong>Systemic weekly paclitaxel produced a significant response in 2 patients with ACC of the head and neck, and its use in this disease merits further study.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"810-4"},"PeriodicalIF":2.9,"publicationDate":"2008-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.20731","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40724877","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":"Aggressive angiomyxoma of supraclavicular fossa: a case report.","authors":"Chien-Yu Pai,&nbsp;Shin Nieh,&nbsp;Jih-Chin Lee,&nbsp;Chung-Ping Lo,&nbsp;Herng-Sheng Lee","doi":"10.1002/hed.20747","DOIUrl":"https://doi.org/10.1002/hed.20747","url":null,"abstract":"<p><strong>Background: </strong>Aggressive angiomyxoma (AAM) is a rare myxoid mesenchymal tumor that occurs almost exclusively in the adult pelvic-perineal region and predominantly in females. Only 1 case of AAM occurring outside this region has been reported. Here we report another such case.</p><p><strong>Methods: </strong>The patient was referred for evaluation of a firm nonmovable mass of the supraclavicular fossa that had progressively enlarged within the previous year. MRI showed an infiltrative growth pattern with adhesion to adjacent anatomic structures. Wide excision was attempted, but a clear margin could not be achieved.</p><p><strong>Results: </strong>The histopathology revealed characteristic features of AAM, including stellate to spindle-shaped tumor cells set in a myxoid background, with hyalinizing thick-walled vessels and characteristic immunophenotype.</p><p><strong>Conclusion: </strong>Accurate diagnosis and a definite surgical margin are crucial because AAM is locally aggressive and easily recurrent. Our case deserves attention because it shows that AAM may exist in the head and neck.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"821-4"},"PeriodicalIF":2.9,"publicationDate":"2008-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.20747","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40527476","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":"Cytogenetic analysis of 101 skull base tumors.","authors":"Ziv Gil,&nbsp;Avi Orr-Urtreger,&nbsp;Nadia Voskoboinik,&nbsp;Leonor Trejo-Leider,&nbsp;Ruth Shomrat,&nbsp;Dan M Fliss","doi":"10.1002/hed.20741","DOIUrl":"https://doi.org/10.1002/hed.20741","url":null,"abstract":"<p><strong>Background: </strong>Skull base tumors are rare neoplasms and the cytogenetic data on these tumors are limited. The authors cytogenetically analyzed a large series of tumors and compared the findings with patients' pathologic data.</p><p><strong>Methods: </strong>The karyotypes of pathologically confirmed samples of 101 patients, who were operated for oncological extirpation of tumors, were analyzed using G-banding and spectral-karyotyping techniques.</p><p><strong>Results: </strong>Of the 67 malignant tumors, 32 (48%) had chromosomal aberrations, some with complex numerical and structural chromosomal anomalies. Recurrent chromosomal breakpoints were identified in squamous cell carcinomas, adenoid cystic carcinomas (ACCs), sinonasal undifferentiated carcinomas, chordomas, and sarcomas. Specific breakpoints established the diagnosis of various soft tissue sarcomas. Novel chromosomal aberrations were found in various other malignant and benign tumors.</p><p><strong>Conclusion: </strong>This study highlights the value of cytogenetic analysis for diagnosis of skull base tumors. The data add further information on the biological behavior of these rare neoplasms.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"567-81"},"PeriodicalIF":2.9,"publicationDate":"2008-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.20741","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27133659","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":"Lower airway humidification in spontaneously breathing tracheostomized patients: comparative study of trachea spray versus heated humidifier.","authors":"Tilman Keck,&nbsp;Ajnacska Rozsasi,&nbsp;Richard Leiacker,&nbsp;Marc Oliver Scheithauer","doi":"10.1002/hed.20742","DOIUrl":"https://doi.org/10.1002/hed.20742","url":null,"abstract":"<p><strong>Background: </strong>Our aim was to compare inhalation with molecular water (vaporizing humidifier) and particulate water (trachea spray) in spontaneously breathing tracheostomized patients.</p><p><strong>Methods: </strong>We performed a randomized, 2-way crossover study and a prospective, comparative, nonblinded study. Tracheal humidity and temperature were measured before and after use of a humidifier and spray for 1 week.</p><p><strong>Results: </strong>After both inhalation and spray, the tracheal temperature and total water content increased significantly (study 1). The temperature gradient between ambient and tracheal air was significantly higher after spray, but not after inhalation (study 2). The water gradient increased nonsignificantly after spray and inhalation. The water gradient after inhalation or spray did not differ significantly.</p><p><strong>Conclusions: </strong>Molecular water is not superior to particulate water because of temperature and humidity increase after both forms of water delivery. Because of its easy use, portability, and moisturizing effect, a trachea spray may offer additional options in postoperative tracheostomy care.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"582-8"},"PeriodicalIF":2.9,"publicationDate":"2008-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.20742","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41055340","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":"Evolution of a paradigm for free tissue transfer reconstruction of lateral temporal bone defects.","authors":"Eben L Rosenthal,&nbsp;Teresa King,&nbsp;Benjamin M McGrew,&nbsp;William Carroll,&nbsp;J Scott Magnuson,&nbsp;Mark K Wax","doi":"10.1002/hed.20744","DOIUrl":"https://doi.org/10.1002/hed.20744","url":null,"abstract":"<p><strong>Background: </strong>Tumors of the lateral skull base are best treated with surgery plus or minus radiation therapy. Surgical ablation may involve cutaneous structures, the auricle, the parotid, and the lateral temporal bone. These composite soft tissue defects are best reconstructed with composite tissue. Multiple pedicled flaps have been used to reconstruct these defects. Free flaps have been shown to provide the best tissue for these reconstructions. We review our experience and present an algorithm for their reconstruction.</p><p><strong>Methods: </strong>A case series of consecutive patients treated between 1999 and 2006 at 2 tertiary care institutions, Oregon Health and Science University and University of Alabama at Birmingham were reviewed. There were 73 patients who had periauricular defects requiring 74 free tissue transfers in this retrospective chart review. All defects had extensive cutaneous loss and underwent some form of parotidectomy. There were 57 lateral temporal bone defects and 16 periauricular defects where the external auditory canal was preserved. The majority of patients had nonmelanoma skin malignancies (65%). Eighty percent of patients had undergone previous treatment (radiation therapy, surgery, or a combination therof).</p><p><strong>Results: </strong>Early on, reconstruction was performed using a radial forearm (RFFF, n=29), evolving to lateral arm (n=6), rectus (n=11), and finally an anterolateral thigh (ALT, n=28) free flap. The average hospital stay was 6 days, and the overall complication rate was 22%. The rectus flap needed debulking in 34% of patients, and the anterolateral thigh in 9%. Periauricular defects were classified based on preservation of the external auditory canal (class I), lateral temporal bone resection with preservation of the auricle (class II), or lateral temporal bone with total auriculectomy (class III).</p><p><strong>Conclusion: </strong>Class I defects were best managed by RFFF reconstruction, class II defects were managed well with the ALT flap, and class III defects required the ALT or rectus flap.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"589-94"},"PeriodicalIF":2.9,"publicationDate":"2008-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.20744","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40412692","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}