Serkan Karaisli, Selda Gucek Haciyanli, Emine Ozlem Gur, Mehmet Haciyanli
{"title":"Effect of Electromyography Findings of Traction-Related Signal Loss on Prognosis During Neuromonitored Thyroidectomy.","authors":"Serkan Karaisli, Selda Gucek Haciyanli, Emine Ozlem Gur, Mehmet Haciyanli","doi":"10.1002/hed.70332","DOIUrl":"10.1002/hed.70332","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative neuromonitoring (IONM) is a reliable tool to detect electromyographic loss of signal (LOS). Here, we investigated the effect of electromyography features of traction-related LOS on prognosis.</p><p><strong>Methods: </strong>Thyroidectomy patients with a traction-related LOS were included. The cases were divided into four groups as follows: Type 1 LOS with no amplitude (0 μV) (Group 1), Type 1 LOS with low-amplitude (1-99 μV) (Group 2), Type 2 LOS with no amplitude (Group 3), and Type 2 LOS with low-amplitude (Group 4).</p><p><strong>Results: </strong>A total of 788 patients (1429 nerves) were analyzed. Traction-related LOS was found in 74 patients (9.4%) and 77 nerves (5.4%). Intraoperative recovery was observed in 21 (48.8%) nerves in Group 4, and significantly higher (p = 0.011). Vocal cord paralysis was less in Group 4 (p = 0.001).</p><p><strong>Conclusions: </strong>In traction-related injury, electromyography features may contribute to the decision-making process. Type 2 LOS with low-amplitude is associated with a high likelihood of intraoperative recovery, potentially reducing the need for staged thyroidectomy.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"3135-3141"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Timothy Ping-Juei Liu, John Edward O'Connell, Andrew Schache, Richard Jackson, Taran Malhotra, Gemma Stonier, Fazilet Bekiroglu, Owais Khattak, Damian Broderick, Sarah Fleming, Richard Shaw
{"title":"Virtual Surgical Planning for Reconstruction of Mandibular Osteoradionecrosis: A Comparative Study on Its Safety and Outcomes.","authors":"Timothy Ping-Juei Liu, John Edward O'Connell, Andrew Schache, Richard Jackson, Taran Malhotra, Gemma Stonier, Fazilet Bekiroglu, Owais Khattak, Damian Broderick, Sarah Fleming, Richard Shaw","doi":"10.1002/hed.70335","DOIUrl":"10.1002/hed.70335","url":null,"abstract":"<p><strong>Background: </strong>The role of virtual surgical planning (VSP) in mandibular osteoradionecrosis (ORN) surgery remains uncertain due to the challenges posed by irradiated tissues METHODS: A consecutive series of patients with mandibular ORN undergoing resection and reconstruction with vascularized hard-tissue free flaps between 1996 and 2004 was included. VSP was analyzed as a predictor variable for ORN recurrence, fixation plate removal, and malocclusion.</p><p><strong>Results: </strong>Among 120 patients with mandibular ORN, 49 patients underwent VSP-guided resection and reconstruction. Multivariable Cox proportional hazards regression demonstrated a hazard ratio of 0.544 (95% CI: 0.098-3.010, p = 0.485) for ORN recurrence and 0.349 (95% CI: 0.145-0.841, p = 0.019) for plate removal. VSP was significantly associated with reduced malocclusion in 2 out of 30 dentate patients, compared to 10 out of 29 dentate patients in the non-VSP group (p = 0.010).</p><p><strong>Conclusions: </strong>VSP appears to be safe for ORN surgery with reduced rates of postoperative complications of plate removal and malocclusion.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"3142-3151"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044766","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":"Correction to \"Fluconazole for Preventing Radiation-Induced Oral Mucositis: A Randomized Controlled Trial\".","authors":"","doi":"10.1002/hed.70457","DOIUrl":"10.1002/hed.70457","url":null,"abstract":"","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"3227"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876466","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}
Andreja Radevic, Joaquin Austerlitz, Ashtyn McAdoo, Kyrionna Golliday, Takeshi Takahashi, Mitra Mehrad, Adam J Rosenberg, Barbara A Murphy, Eben Rosenthal, Michael C Topf
{"title":"Visualization of Scattered Tumor Regression Following Neoadjuvant Chemoimmunotherapy With a Novel Intraoperative PET/CT Scanner.","authors":"Andreja Radevic, Joaquin Austerlitz, Ashtyn McAdoo, Kyrionna Golliday, Takeshi Takahashi, Mitra Mehrad, Adam J Rosenberg, Barbara A Murphy, Eben Rosenthal, Michael C Topf","doi":"10.1002/hed.70333","DOIUrl":"10.1002/hed.70333","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemoimmunotherapy is being explored in locally advanced head and neck squamous cell carcinoma (HNSCC), yet the spatial patterns of pathologic response and clinical implications remain poorly characterized.</p><p><strong>Methods: </strong>A 79-year-old female with recurrent left oral tongue SCC (PD-L122C3 Combined Positive Score 90) who underwent prior resection and free flap reconstruction received neoadjuvant pembrolizumab, paclitaxel, and carboplatin followed by definitive surgical resection with intraoperative positron emission tomography/computed tomography (PET/CT) imaging.</p><p><strong>Results: </strong>Final histopathology revealed two discrete foci of residual poorly differentiated SCC, measuring 1.8 and 0.5 cm, separated by an 8 mm intervening bridge of inflammation without viable tumor. Intraoperative PET/CT with 3D specimen mapping confirmed the spatial relationship between residual foci and intervening treatment effect.</p><p><strong>Conclusions: </strong>Pathologic response to neoadjuvant chemoimmunotherapy in HNSCC can manifest as a multifocal regression pattern. Intraoperative real-time approaches to assessing treatment response warrant further investigation.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT06915454.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"E119-E125"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rahul D Patel, Connor J Dorais, Tristen Hofmann, Caroline Liu, Emily S Sagalow, Kurtis Young, Andrew Birkeland, Robert Wang
{"title":"Safety and Analgesic Outcomes of Nonsteroidal Anti-Inflammatory Drug-Containing Regimens After Transoral Robotic Surgery: A Systematic Review and Meta-Analysis.","authors":"Rahul D Patel, Connor J Dorais, Tristen Hofmann, Caroline Liu, Emily S Sagalow, Kurtis Young, Andrew Birkeland, Robert Wang","doi":"10.1002/hed.70471","DOIUrl":"10.1002/hed.70471","url":null,"abstract":"<p><strong>Background: </strong>Nonsteroidal anti-inflammatory drugs (NSAIDs) are increasingly used after transoral robotic surgery (TORS), but concerns regarding postoperative hemorrhage (POH) persist. This meta-analysis quantifies POH incidence and analgesic outcomes in NSAID-containing regimens after TORS.</p><p><strong>Methods: </strong>PubMed, Embase, and Scopus were searched through February 2026. Primary outcome was POH. Secondary outcomes included postoperative opioid administration and pain within 72 h, and discharge opioid prescribing. Random-effects models and sensitivity analyses addressing heterogeneity (prophylactic ligation and NSAID type) were used.</p><p><strong>Results: </strong>Eight studies (n = 2519 patients) were included in the primary quantitative synthesis. One study was included qualitatively. POH incidence in NSAID cohorts (n = 1091) was 8.31% (95% CI: 4.91%-12.39%) and 6.77% (95% CI: 2.96%-11.70%) in cohorts excluding prophylactic ligation. NSAIDs did not significantly increase POH risk (RR 1.56, p = 0.1768). NSAIDs reduced 72-h pain scores (standardized mean difference [SMD] -0.88), inpatient opioid administration (SMD -1.06), and discharge prescriptions.</p><p><strong>Conclusion: </strong>NSAIDs improved analgesia and reduced opioid use after TORS without significantly increasing POH risk, supporting NSAID integration into postoperative protocols.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"3202-3213"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957507","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}
Omar Elghawy, Jack Stylli, Martin Kurian, Eitan Halper-Stromberg, Aditi Singh, Christopher D'Avella, Lee Hartner, Roger B Cohen
{"title":"Clinicogenomic Features and Outcomes of Adenoid Cystic Carcinoma With Central Nervous System Metastases: A Single-Institution Cohort Study.","authors":"Omar Elghawy, Jack Stylli, Martin Kurian, Eitan Halper-Stromberg, Aditi Singh, Christopher D'Avella, Lee Hartner, Roger B Cohen","doi":"10.1002/hed.70342","DOIUrl":"10.1002/hed.70342","url":null,"abstract":"<p><strong>Background: </strong>Adenoid cystic carcinoma (ACC) is a rare malignancy with a propensity for perineural invasion and hematogenous spread. Central nervous system (CNS) involvement is uncommon, and detailed clinical and genomic data on this aspect of the disease remain limited.</p><p><strong>Methods: </strong>We performed a single-institution retrospective cohort study of patients with biopsy-confirmed ACC and CNS involvement treated at the University of Pennsylvania. Clinical features, CNS disease patterns, treatment modalities, molecular alterations, and survival outcomes were abstracted from the electronic medical record.</p><p><strong>Results: </strong>Seventeen patients were identified. CNS involvement occurred a median of 40 months after initial ACC diagnosis. CNS disease included parenchymal metastases, leptomeningeal disease, and patterns suggestive of neurotropic or perineural intracranial extension. Leptomeningeal involvement was present in 6 patients. Targeted next-generation sequencing demonstrated NOTCH1 alterations in 7 patients, with additional recurrent alterations in CREBBP, BAP1, FGFR2, and PI3K-pathway genes. CNS-directed therapy included surgery, stereotactic radiosurgery, hypofractionated radiotherapy, whole-brain radiotherapy, and conventionally fractionated radiotherapy. Median progression-free survival was 5.4 months, and median overall survival was 9.4 months after CNS involvement.</p><p><strong>Conclusions: </strong>CNS involvement in ACC was associated with poor outcomes despite multimodal therapy. NOTCH1 alterations and leptomeningeal disease were frequent in this cohort, but these findings should be interpreted as hypothesis-generating given the small sample size and absence of a matched non-CNS comparator cohort.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"3193-3201"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bartosz Wojtera, Avinash Beharry, Karma Lambercy, Pascaline Dübi, Jelena Todic, Christian Simon
{"title":"Robotic-Assisted Extended Sistrunk Approach (RESA) for Salvage Surgery After Head and Neck Irradiation.","authors":"Bartosz Wojtera, Avinash Beharry, Karma Lambercy, Pascaline Dübi, Jelena Todic, Christian Simon","doi":"10.1002/hed.70343","DOIUrl":"10.1002/hed.70343","url":null,"abstract":"<p><strong>Background: </strong>The robotic-assisted extended \"Sistrunk\" approach (RESA) is a minimally invasive technique providing access to hypopharyngeal and laryngeal structures via a submental incision and vallecular pharyngotomy, bypassing the base of tongue.</p><p><strong>Methods: </strong>We report 10 RESA procedures in previously irradiated head and neck cancer patients, including six organ-preservation surgeries and four total laryngectomies.</p><p><strong>Results: </strong>RESA enabled completion of the planned surgery, achieving R0 margins in all cases. Postoperative bleeding occurred in four patients (three Clavien-Dindo IIIb; one II). One cervical abscess was managed endoscopically. After total laryngectomy, three patients developed a subclinical pharyngeal dehiscence visualized on barium swallow exam, without evidence of a pharyngo-cutaneous fistula. Disease-specific survival was 100% (median 15.5 months); two patients died of unrelated causes. Swallowing improved or remained stable in seven patients at 1 year (three developed recurrence, a second primary, or died).</p><p><strong>Conclusion: </strong>RESA is a feasible salvage option with acceptable oncologic and functional outcomes in selected patients.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"3180-3192"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148177203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andreja Radevic, Joaquin Austerlitz, Ashtyn McAdoo, Kyrionna Golliday, Takeshi Takahashi, Mitra Mehrad, Adam J Rosenberg, Barbara A Murphy, Eben Rosenthal, Michael C Topf
{"title":"Response to: \"Letter to Editor Following 'Visualization of Scattered Tumor Regression Following Neoadjuvant Chemoimmunotherapy With a Novel Intraoperative PET/CT Scanner'\".","authors":"Andreja Radevic, Joaquin Austerlitz, Ashtyn McAdoo, Kyrionna Golliday, Takeshi Takahashi, Mitra Mehrad, Adam J Rosenberg, Barbara A Murphy, Eben Rosenthal, Michael C Topf","doi":"10.1002/hed.70410","DOIUrl":"10.1002/hed.70410","url":null,"abstract":"","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"3225-3226"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581180","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}
Jacob E Kapustin, Sabrina R Comess, Margaret Nurimba, Ike Kwon, Azita Khorsandi, Margaret Brandwein-Weber, Mark L Urken
{"title":"Basaloid Squamous Cell Carcinoma of the Midline Dorsal Tongue: Case Report and Review of the Literature.","authors":"Jacob E Kapustin, Sabrina R Comess, Margaret Nurimba, Ike Kwon, Azita Khorsandi, Margaret Brandwein-Weber, Mark L Urken","doi":"10.1002/hed.70250","DOIUrl":"10.1002/hed.70250","url":null,"abstract":"<p><strong>Background: </strong>Squamous cell carcinoma (SCC) of the dorsal tongue accounts for only 2%-5% of tongue cancers; midline dorsal tongue cancers account for less than 1% of these tumors. Basaloid SCC (BSCC) is usually associated with more aggressive features than conventional SCC. There are fewer than 30 reported cases of lingual BSCC.</p><p><strong>Methods: </strong>A 76-year-old woman presented with irregular, exophytic, rugated, and furrowed changes of the midline dorsal tongue, which was initially misdiagnosed as mucoepidermoid carcinoma on an outside institution biopsy. Other than mild linear enhancement of the oropharyngeal tongue, MRI was unremarkable. A midline partial glossectomy with primary closure was performed with the aid of intraoperative frozen section analysis.</p><p><strong>Results: </strong>Final pathology was rediagnosed as pT2 invasive BSCC, with depth of invasion of 2.43 mm, worst pattern of invasion of WPOI-3, and negative final margins. The decision was made to proceed with surveillance without any adjuvant therapy.</p><p><strong>Conclusions: </strong>This is the first reported case of BSCC of the midline dorsal tongue. This case report highlights the diagnostic challenges of BSCC and underscores the importance of comprehensive evaluation of all histological features using immunohistochemistry studies, as BSCC can mimic other pathologic entities but may confer a different prognosis. Early and definitive diagnosis of this disease has implications for management decisions and prognosis.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"E112-E118"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596390","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}
N D O'Donnell, E C Ward, L R Wishart, R Perera, C Barrett, K A Edmiston, E Mitchell, A Pigott, R Pitt, K Russell, B A Chan, R Ladwa
{"title":"Treatment-Related Adverse Events and Health-Related Quality of Life Associated With Immune Checkpoint Inhibitor Treatment for Mucosal Head and Neck Squamous Cell Carcinoma: A Scoping Review.","authors":"N D O'Donnell, E C Ward, L R Wishart, R Perera, C Barrett, K A Edmiston, E Mitchell, A Pigott, R Pitt, K Russell, B A Chan, R Ladwa","doi":"10.1002/hed.70306","DOIUrl":"10.1002/hed.70306","url":null,"abstract":"<p><strong>Background: </strong>Supportive care needs of patients receiving immune checkpoint inhibitors (ICIs) for head and neck squamous cell carcinoma (HNSCC) are ill-defined. Hence, known treatment-related adverse events (TRAEs) and health-related quality of life (HRQoL) associated with ICI treatment for HNSCC were examined to inform future supportive care services.</p><p><strong>Methods: </strong>Scoping review including 98 studies.</p><p><strong>Results: </strong>Moderate-severe TRAEs occurred at < 10% incidence, with most experiencing mild impacts. Dermatologic, endocrine, pulmonary, hepatic, gastrointestinal, and constitutional complaints were reported in > 40% of studies, with most symptoms occurring during treatment. ICI monotherapy had less reported toxicity than multimodality treatments. Adding ICIs to multimodality treatment creates a minimal increase in TRAEs. HRQoL scores were low, with little change during ICI treatment.</p><p><strong>Conclusions: </strong>ICIs for HNSCC are generally well tolerated; however, TRAEs are common and may carry long-term functional consequences. Flexible supportive care pathways are needed to assist early detection and individualized management of functional impacts to optimize survivorship.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"3152-3172"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}