Head and Neck-Journal for the Sciences and Specialties of the Head and Neck最新文献

{"title":"Radiation-Induced Pharyngeal Necrosis and Cervical Spine Osteoradionecrosis in Patients With Oropharyngeal Squamous Cell Carcinoma.","authors":"Diana S Shaari, Danielle A Kapustin, Michelle Yoon, Samuel J Rubin, Azita Khorsandi, Ricardo J Ramirez, Michael Schiff, Mark L Urken","doi":"10.1002/hed.27991","DOIUrl":"https://doi.org/10.1002/hed.27991","url":null,"abstract":"<p><strong>Background: </strong>Radiation therapy with or without chemotherapy is commonly used as an adjunct or alternative to surgery for treating head and neck cancer (HNC). In rare cases, radiation-induced side effects such as posterior pharyngeal wall necrosis, fistula formation, and osteoradionecrosis (ORN) can lead to dangerous complications of the cervical spine (C-spine).</p><p><strong>Methods: </strong>We conducted a literature review on C-spine ORN in HNC, and we reported four additional cases following the treatment of oropharyngeal carcinoma.</p><p><strong>Results: </strong>We identified 26 reported cases of C-spine ORN following radiation for HNC. Of the four cases from our institution, two were treated with surgical management and two with conservative measures. Two patients were able to resume oral intake. The median time to diagnosis was 121.5 (range: 22-194) months after completion of radiation.</p><p><strong>Conclusion: </strong>Late complications of radiation can be devastating, severely limiting functional status and quality of life. C-spine ORN is related to total radiation dose and should be discussed with patients as a rare but serious side-effect.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607509","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":"Anatomy and Histology of Sensorimotor Connections Between the Facial and Trigeminal Nerve in the Buccinator Muscle.","authors":"Ahneesh J Mohanty, Joep A F van Rooij, Renée M L Miseré, Arno Lataster, Shai M Rozen, René R W J van der Hulst, Stefania M H Tuinder","doi":"10.1002/hed.27990","DOIUrl":"https://doi.org/10.1002/hed.27990","url":null,"abstract":"<p><strong>Background: </strong>Despite indications of a close interaction between the trigeminal (CN V) and facial nerve (CN VII) within the buccinator muscle, a combination of anatomical dissection and histological analysis has not been reported.</p><p><strong>Methods: </strong>Five formalin-fixed and fresh-frozen hemifaces were dissected to reveal the buccal fat pad, the buccinator muscle, and anastomotic connections between CN V and CN VII within it. Samples were taken for histological processing and immunostaining.</p><p><strong>Results: </strong>Branches of CN V and CN VII formed pronounced sensorimotor anastomotic connections in and surrounding the buccinator muscle. These findings were histologically evident with close intramuscular coupling of sensory and motor fibers. There was an evident but gradual shift from motor to sensory fibers in the interconnections when analyzing them from the side of CN V toward the side of CN VII and vice versa.</p><p><strong>Conclusions: </strong>These results further elucidate connections between CN V and CN VII and their possible role in proprioception of the facial muscles.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607508","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":"A Review of Contemporary Image Guidance Techniques in Head and Neck Cancer.","authors":"Adebayo Alade, Melissa Persad, George Bitar, Alina Dragan, Nicos Fotiadis, Joshua Shur, Kee Howe Wong, Brian Ng-Cheng-Hin, Vinidh Paleri, Kevin Harrington, Derfel Ap Dafydd","doi":"10.1002/hed.27968","DOIUrl":"https://doi.org/10.1002/hed.27968","url":null,"abstract":"<p><strong>Background: </strong>Traditional head and neck cancer treatment involves open surgery, cytotoxic chemotherapy, and conventional radiotherapy planning. Emerging techniques aim to improve precision and reduce associated toxicity and functional impairment in current practice. This review article describes four such adaptations in image guidance, tailored to next generation therapies.</p><p><strong>Methods: </strong>This is a review of current literature, including feasibility studies from our cancer center, relating to: saline-aided intra-oral ultrasound-guided retropharyngeal biopsy; intra-oral ultrasound guided trans-oral robotic surgery (TORS); ultrasound-guided injection of \"directly injected therapies\"; and magnetic resonance imaging-guided radiotherapy.</p><p><strong>Results: </strong>Presented within the context of the wider literature, initial local experience and data indicate good technical outcomes and patient tolerance, and low technical complications in all four image guidance techniques.</p><p><strong>Conclusion: </strong>Initial findings suggest a potentially important future role for these four image guidance techniques, on which next generation therapies are reliant. The broader implications on cross-disciplinary collaboration are also explored herein.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584909","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":"Recurrent Patterns in Patients With Nasopharyngeal Caricinoma and Risks Leading to Inaccurate Delineation in Marginal Failure in the Era of Intensity-Modulated Radiotherapy.","authors":"Shu Zhang, Ni Zeng, Jiangping Yang, Jiaqi Han, Jinlan He, Baofeng Duan, Xiaoqiang Chen, Xiaofang Gou, Fubin Zhu, Huizhen Liu, Ming Zeng, Di Yan, Nianyong Chen","doi":"10.1002/hed.27987","DOIUrl":"https://doi.org/10.1002/hed.27987","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the failure patterns of recurrent nasopharyngeal carcinoma (NPC), especially to identify the relationship between the recurrent-prone anatomic structures and the tumor regression sites after the introduction of chemotherapy (IC).</p><p><strong>Method: </strong>A cohort of 1121 non-metastatic patients with NPC was retrospectively enrolled. The pretreatment and recurrent images of each patient were registered to the planning CT. Tumor regression sites after IC (Vicr) overlapped with recurrent tumor (rGTV) were evaluated for the delineation accuracy and dose sufficiency in marginal failure patients.</p><p><strong>Results: </strong>A total of 126 (11.24%) experienced tumor recurrence. Re-evaluation of 12 patients with local marginal recurrence, their rGTV within Vicr predominantly located at choanae, sphenoidal sinus, and cavernous sinus. The regression sites did not receive the full 70 Gy but over half receiving with 60Gy.</p><p><strong>Conclusion: </strong>Analysis from marginal failure that exempts tumor regression sites from GTV or an insufficient prescription dose of less than 70 Gy may contribute to marginal failure.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584911","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":"Impact of Transoral Robotic Surgery Versus Radiation on Swallowing Function in Oropharyngeal Cancer Patients: A Sub-Study From a Randomized Trial.","authors":"Julie A Theurer, Rosemary Martino, Nedeljko Jovanovic, John R de Almeida, David P Goldstein, Kevin Fung, John Yoo, S Danielle MacNeil, Eric Winquist, J Alex Hammond, Varagur Venkatesan, Nancy Read, Sarah Kuruvilla, Andrew Warner, Philip C Doyle, Ian Ross, Colleen Dreyer, Sarah Hawkins, Kendra Thouless, Courtney McCallum, David A Palma, Anthony C Nichols","doi":"10.1002/hed.27986","DOIUrl":"https://doi.org/10.1002/hed.27986","url":null,"abstract":"<p><strong>Background: </strong>This ORATOR sub-study evaluated swallowing physiology in patients treated with transoral robotic surgery (TORS) versus radiotherapy (RT) for early-stage oropharynx cancer.</p><p><strong>Methods: </strong>Swallowing physiology was evaluated using videofluoroscopy and outcomes were compared across treatment arms and correlated with MDADI scores.</p><p><strong>Results: </strong>Of the 68 patients in the ORATOR trial, 21 participated in this sub-study (30.8%), including 15 RT Arm and six TORS Arm patients. Swallowing profiles were not significantly different between the arms. MBSImP pharyngeal scores for RT Arm versus TORS Arm patients were 4.8 (±2.1) versus 4.3 (±1.5) at baseline, 6.2 (±1.2) versus 9.6 (±4.8) at 6 months and 5.9 (±1.8) versus 8.0 (±4.7) at 12 months. MBSImP pharyngeal scores demonstrated weak associations with several MDADI subscales and PAS scores.</p><p><strong>Conclusions: </strong>To best describe swallowing outcomes in studies of RT and/or surgery, instrumental swallowing assessments should be strongly considered in addition to quality of life measures.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568191","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 Prognostic Importance of Radiologic Extranodal Extension in Hypopharyngeal Carcinoma.","authors":"Yu-Hao Liao, Ya-Fang Chen, Min-Shu Hsieh, Mei-Chun Lin, Chun-Wei Wang, Cheng-Ping Wang, Pei-Jen Lou, Tseng-Cheng Chen","doi":"10.1002/hed.27978","DOIUrl":"https://doi.org/10.1002/hed.27978","url":null,"abstract":"<p><strong>Background: </strong>Extranodal extension (ENE) had been included in the latest cancer staging system in hypopharyngeal squamous cell carcinoma (HypoSCC). However, the impact of ENE on HypoSCC survival and treatment outcomes are still unclear.</p><p><strong>Methods: </strong>Records from all HypoSCC patients diagnosed at the National Taiwan University Hospital from January 2007 to December 2018 were reviewed. All patients were divided into two groups, with or without ENE. Clinical features, pathological factors, and survival rates between the two groups were reviewed.</p><p><strong>Results: </strong>We analyzed data from 388 HypoSCC patients, 125 (32.22%) with and 263 (67.78%) without ENE. The 5-year overall survival of the HypoSCC patients with radiological ENE, pathological ENE, and without ENE were 22.9%, 40.3%, and 55.5%. From the multivariate analysis, primary T3/T4 classification (p = 0.001) and radiological ENE (p < 0.001) were independent risk factors for disease-free and overall survival (OS). Finally, upfront neck dissection may significantly benefit disease-free survival (DFS) and neck nodal control in ENE+ (p = 0.002 and p = 0.007, respectively) or ENE- patients (p = 0.003 and p = 0.02, respectively).</p><p><strong>Conclusion: </strong>More than one-third of HypoSCC patients have ENE, with significantly lower OS and DFS. The upfront neck dissection could provide better DFS and neck nodal control.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577111","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":"Thyroid Malignancies With Thymic Differentiation: Outcomes of Rare SETTLE and CASTLE Tumors.","authors":"Iulia Tapescu, Abigail Kohler, Neel R Sangal, Jason A Brant, Robert M Brody, Timothy Cao, Ryan M Carey","doi":"10.1002/hed.27969","DOIUrl":"https://doi.org/10.1002/hed.27969","url":null,"abstract":"<p><strong>Background: </strong>Spindle epithelial tumors with thymus-like differentiation (SETTLE) and carcinomas showing thymus-like differentiation (CASTLE) are rare intrathyroid tumors.</p><p><strong>Methods: </strong>This retrospective cohort study included patients diagnosed with SETTLE, CASTLE, and papillary thyroid carcinoma (PTC) from 2004 to 2020 within the National Cancer Database (NCDB). Demographic, tumor, and treatment characteristics were compared. Overall survival (OS) was analyzed using the Kaplan-Meier method and Cox regression models.</p><p><strong>Results: </strong>This study identified 19 patients with CASTLE, 11 with SETTLE, and 483 474 with PTC. CASTLE and SETTLE patients had larger tumors, lymphovascular invasion, and positive surgical margins. They were rarely treated with radioactive iodine treatment but frequently received external beam radiation and chemotherapy. Five-year OS was significantly lower for CASTLE and SETTLE compared to PTC. SETTLE was associated with an increased risk of death.</p><p><strong>Conclusion: </strong>SETTLE and CASTLE are rare intrathyroid tumors with worse survival compared to PTC, often managed with radiation, chemotherapy, and surgery.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577151","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 Role of Radiotherapy in Indolent Ocular Adnexal and Orbital Lymphomas.","authors":"Gozde Yazici, Serkan Akin, Alper Kahvecioglu, Ecem Yigit, Fatma Alev Turker, Ferah Yildiz","doi":"10.1002/hed.27976","DOIUrl":"https://doi.org/10.1002/hed.27976","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the oncological outcomes and toxicities of indolent ocular adnexal and orbital lymphomas (OOLs) treated with radiotherapy (RT) ± systemic therapy.</p><p><strong>Methods: </strong>A retrospective analysis of 44 patients with indolent OOLs treated with RT was conducted.</p><p><strong>Results: </strong>Most patients (87%) had early-stage disease. Treatment involved RT alone (34%) or RT + systemic therapy (66%). The median RT dose was 30 Gy, with a median follow-up of 45 months. Local and systemic recurrence rates were 4% and 9%, respectively. Five-year overall and disease-free survival (DFS) rates were 96.2% and 83.6%. Early-stage patients showed similar DFS rates regardless of whether they received RT alone or RT plus systemic therapy. No grade 3 RT-related toxicity occurred, but systemic therapy led to grade 3 toxicity in 17% of patients.</p><p><strong>Conclusions: </strong>RT is essential for treating indolent OOLs, and combination with systemic therapies does not enhance outcomes for early-stage patients.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564834","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":"Exploring Trismus Management in Australia: A Mixed Methods Evaluation of Surveys and Interviews With Health Professionals.","authors":"Emma Charters, Rebecca Venchiarutti, Masako Dunn, Jonathan Clark","doi":"10.1002/hed.27982","DOIUrl":"https://doi.org/10.1002/hed.27982","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates how health care professionals manage trismus in Australia and identifies facilitators and barriers experienced by clinicians in routine patient care.</p><p><strong>Methods: </strong>A mixed-methods approach was used to evaluate the experience of clinicians. Medical, nursing, and allied health practitioners in Australia were invited to participate if they had treated patients with trismus in the last 5 years. Participants completed an investigator-designed survey and were invited to participate in a semi-structured audio-recorded interview to explore practice in more depth. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed thematically using an inductive, data-driven approach.</p><p><strong>Results: </strong>Fifty-six clinicians (38 speech pathologists, 9 physiotherapists, 7 medical doctors, 1 nurse, and 1 osteopath) completed the survey, 12 of which also participated in an interview. The most common assessment tool was a commercially available measurement tool (Therabite or Orastretch), the most common treatment approach was stacked tongue depressors, and the most common exercise regimen was a 30- s stretch 25 times per day. Common barriers to trismus management included the high cost of devices, lack of clinical experience, and lack of training opportunities outside their institution. Clinician-perceived facilitators were different modes of information provision and time to consider the exercise instructions and rationale. Several clinicians relied on telehealth to reach patients in remote locations and improve efficiency.</p><p><strong>Conclusion: </strong>A range of clinicians treat trismus arising from a variety of conditions. Training opportunities are critical for clinicians to develop and extend their skills in assessing and treating trismus.</p><p><strong>Impact statement: </strong>The morbidity associated with trismus, and the absence of a clinical guideline or consensus document warrants careful consideration as to the translation of evidence into the clinical context.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559515","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":"Impact of Postoperative Neck Radiotherapy Volumes on Long-Term Unstimulated Saliva Flow Following Primary Surgery and Ipsilateral Neck Dissection for Oral Cavity Squamous Cell Carcinoma.","authors":"Claire M Rooney, Shao Hui Huang, Jie Su, Scott Bratman, John Cho, John de Almeida, Michael Glogauer, David Goldstein, Ezra Hahn, Ali Hosni, Andrew Hope, Jonathan Irish, John Kim, Brian O'Sullivan, Jolie Ringash, Anna Spreafico, Jillian Tsai, John Waldron, Christopher Yao, Erin Watson, Andrew McPartlin","doi":"10.1002/hed.27988","DOIUrl":"https://doi.org/10.1002/hed.27988","url":null,"abstract":"<p><strong>Background: </strong>We investigate the association of postoperative radiotherapy (PORT) volumes and salivary function in oral cavity SCC (OSCC).</p><p><strong>Methods: </strong>OSCC patients undergoing PORT 2005-2021 underwent modified Schirmer test (MST) pre-PORT, 6 and/or 12 months post-PORT. Hyposalivation rates were compared by PORT volumes. MVA identified predictors for chronic hyposalivation.</p><p><strong>Results: </strong>Among 165 eligible patients, 88 (53%) received bilateral, 66 (40%) ipsilateral, and 11 (7%) no-neck (primary-only) PORT. Baseline characteristics were similar, except more N2b/N2c disease received bilateral PORT vs. ipsilateral or no-neck (60% vs. 36% vs. 0%, p < 0.001). Baseline hyposalivation was similar (26% vs. 30% vs. 18%, p = 0.67). Hyposalivation occurred more frequently in bilateral vs. ipsilateral vs. no-neck PORT at 6 (90% vs. 62% vs. 9%) and 12 months (90% vs. 48% vs. 0%) (both p < 0.001). On MVA, bilateral neck PORT and smoking predicted chronic hyposalivation.</p><p><strong>Conclusion: </strong>Increasing PORT volumes predict saliva function recovery and chronic hyposalivation, informing treatment discussions.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549035","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}