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

{"title":"Single Stage Reconstruction of Composite Rhinectomy Defects Using Osteocutaneous Radial Forearm Free Flap.","authors":"Omar A Karadaghy, Allen L Feng","doi":"10.1002/hed.28042","DOIUrl":"https://doi.org/10.1002/hed.28042","url":null,"abstract":"<p><strong>Background: </strong>Composite rhinectomy defects pose significant challenges due to the nose's complex structure and role in facial esthetics and function. Traditional nasal reconstructions often require multiple stages to restore mucosal lining, structural support, and external skin.</p><p><strong>Methods: </strong>This case series examines the use of a single-stage osteocutaneous radial forearm free flap (OCRFFF) for composite rhinectomy reconstruction. Three patients who underwent composite rhinectomy due to malignancy were treated using OCRFFF, which allows for simultaneous reconstruction of composite nasal defects by incorporating skin, bone, and fascial tissue.</p><p><strong>Results: </strong>All three cases achieved successful postoperative outcomes, demonstrating both cosmetic and functional success without significant long-term complications. The single-stage approach streamlined the reconstructive process, reducing patient recovery time and the need for additional surgeries.</p><p><strong>Conclusions: </strong>OCRFFF is an effective, transformative technique for single-stage nasal reconstruction for composite rhinectomy defects, providing reliable functional and esthetic outcomes, and contributing to advancements in complex nasal defect management.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866503","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":"Decompression Obturator Prostheses in the Treatment of Cystic Odontogenic Lesions: A Case Series and Review of the Literature.","authors":"Maria Vlock, Annu Singh, Anthony J Farmer, Kenneth Kronstadt, Joseph D Randazzo, Jerry Halpern, Steven Tunick, Joseph M Huryn","doi":"10.1002/hed.28040","DOIUrl":"https://doi.org/10.1002/hed.28040","url":null,"abstract":"<p><strong>Background: </strong>To spare important anatomical structures from damage during treatment of cystic odontogenic lesions, decompression has become a conservative alternative to enucleation. Marsupialization, in combination with the use of a custom-made decompression prosthesis, is an effective method of inducing reduction and bony infill of cystic lesions of the jaw.</p><p><strong>Methods: </strong>In this case series and review of the literature, we describe three patients with odontogenic cysts of the mandible who were treated with custom-made decompression obturator prostheses (DOP) at the Memorial Sloan Kettering Cancer Center Dental Service.</p><p><strong>Results: </strong>At the conclusion of treatment, all patients demonstrated complete resolution of their respective bony defects.</p><p><strong>Conclusion: </strong>DOP provide effective means of keeping the cyst opening patent following marsupialization, which allows for adequate, if not complete, resolution of defects, often without need for subsequent enucleation.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873549","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 Novel Training Model to Improve Diagnostic Accuracy of Cervical Fine-Needle Aspiration.","authors":"Lukas Anschuetz, Samuel Tschopp, Mafalda Trippel, Sören Huwendiek, Roman Trepp, Marco Caversaccio, Moritz von Werdt, Urs Borner","doi":"10.1002/hed.28039","DOIUrl":"https://doi.org/10.1002/hed.28039","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to improve the diagnostic yield of cervical fine-needle aspiration (FNA) through training on a novel liver model. Ultrasonography-guided fine-needle aspiration (US-FNA) is crucial for diagnosing head and neck lumps but requires meticulous execution. Limited resources often hinder systematic teaching, making practical models essential for training.</p><p><strong>Methods: </strong>Fifteen otorhinolaryngology residents trained using a liver model with inserted Sensorium spheres to simulate cervical masses. The training involved viewing an instructional video, performing US-FNA on the model, and completing pre- and posttraining self-assessments. Performance was evaluated using visual analog scales (VAS), an adapted version of objective structured assessment of ultrasound skills (adapted OSAUS), and timing of procedures. Clinical impact was assessed by comparing diagnostic rates of US-FNA before and after training.</p><p><strong>Results: </strong>Participants reported increased comfort and proficiency in US-FNA techniques posttraining. Adapted OSAUS scores improved significantly for image recognition and both in-plane and out-of-plane techniques. The diagnostic yield of US-FNA in clinical practice increased from 71% to 85%. No significant influence of gender, preferred ultrasound orientation, age, or experience on the learning curve was found. However, male participants showed a more substantial benefit from the training.</p><p><strong>Conclusion: </strong>The liver model effectively enhances US-FNA skills, reflected in improved clinical diagnostic rates. Training on such models should be incorporated into medical education to reduce inconclusive punctures and enhance patient satisfaction. This study demonstrates the feasibility and effectiveness of a cost-efficient, reproducible model for US-FNA training, emphasizing the importance of practical training in medical education.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857093","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":"Airway Management in Microvascular Reconstruction of the Head and Neck: Current Practice Patterns.","authors":"Rotem Kimia, Samih J Nassif Abudinen, Craig Hanna, Christian Jung, Miriam O'Leary, Lauren F Tracy, Jeremiah C Tracy","doi":"10.1002/hed.28022","DOIUrl":"https://doi.org/10.1002/hed.28022","url":null,"abstract":"<p><strong>Objective: </strong>To identify current airway management practice patterns during free tissue transfer (FTT) reconstruction of head and neck defects.</p><p><strong>Methods: </strong>A 27-question survey distributed to American Head and Neck Society (AHNS) members. Correlation between surgeon and patient variables with likelihood to perform tracheotomy and tracheotomy technique were evaluated.</p><p><strong>Results: </strong>Our survey yielded 151 respondents. The majority (69.5%) reported performing tracheotomy for \"most\"/\"every\" FTT case. There was higher likelihood (p < 0.05) toward tracheotomy for patients with poor preoperative pulmonary status, larger defect size, and reconstruction of glossectomy and oropharyngeal defects. Tracheotomy was less likely (p < 0.05) during reconstruction of maxillary or palatal defects. Surgeons in practice for > 10 years were less likely to perform tracheotomy following reconstruction of hemiglossectomy defects (OR 0.36, p = 0.018, 95% CI 0.18-0.72).</p><p><strong>Conclusion: </strong>This study identified practice patterns of airway management in patients undergoing head and neck FTT reconstruction. There is no current consensus regarding perioperative airway management in these patients.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855858","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":"Role of the Laryngeal Adductor Reflex in the Prevention of Thermal Injury to the Recurrent Laryngeal Nerve in Thyroid Surgery: A Case Report.","authors":"M Ángeles Sánchez Roldán, Dulce Moncho, Mercedes Velasco, E Madalina Petriman, Héctor Duque, Ramón Vilallonga, Manuel Armengol, Óscar González","doi":"10.1002/hed.28038","DOIUrl":"https://doi.org/10.1002/hed.28038","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) aims to detect and prevent iatrogenic damage during thyroid surgery. Mechanisms of injury include traction, heat damage, and nerve transection. Continuous IONM (C-IONM) techniques detect impending damage due to traction and heat related when they are still reversible.</p><p><strong>Methods: </strong>We present a 73-year-old woman who underwent a total thyroidectomy due to a goiter. The IONM included intermittent IONM (I-IONM) in combination with C-IONM using the laryngeal adductor reflex (LAR). The intraoperative neurophysiological signals recorded were correlated with the surgical maneuver and the postoperative evaluation.</p><p><strong>Results: </strong>During surgery, a significant decrease in left LAR amplitude was observed, coinciding with the use of the harmonic. After some corrective maneuvers, the intraoperative signals recovered, and the postoperative examination showed adequate VF function.</p><p><strong>Conclusions: </strong>C-IONM of the RLN using the LAR can be a valuable tool for detecting and preventing thermal spread injury during thyroid surgery.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848500","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":"Comparison of Postoperative Outcomes in Two Lip-Splitting Approaches for Buccal Squamous Cell Carcinoma Ablation.","authors":"Maged Ali Al-Aroomi, Ye Liang, Jie Chen, Yiheng Feng, Liu Pei-Xuan, Canhua Jiang","doi":"10.1002/hed.28036","DOIUrl":"https://doi.org/10.1002/hed.28036","url":null,"abstract":"<p><strong>Objectives: </strong>The choice of surgical access for resection and reconstruction of buccal squamous cell carcinoma (BSCC) with the lip-splitting incision is controversial. Thus, this study aimed to evaluate the clinical and functional outcomes of midline lip split with lazy-S incision (MLSI) against the lateral lip-splitting incision (LLSI).</p><p><strong>Methods: </strong>A retrospective review was conducted on 41 patients with primary BSCC who underwent resection and reconstruction using MLSI approach (n = 19) and LLSI approach (n = 22) between 2022 and 2024. Functional outcomes, including skin sensitivity testing, oral competency, lip movement, cold perception, and other relevant measures, were evaluated with appropriate scales. Functional satisfaction and Patient and Observer Scar Assessment Scale (POSAS) were analyzed.</p><p><strong>Results: </strong>None of the patients in either group demonstrated differences in sensation to light touch from baseline at 6 months postoperatively. Patients with MLSI approach reported higher lip function satisfaction (p = 0.037), and no patients in either group reported drooling. Besides, groove formation was significantly more common in the LLSI compared to the MLSI groups (50% vs. 15.8%, respectively; p = 0.046). A statistically significant difference was also observed in the self-assessment of mouth-opening movement among MLSI patients (p = 0.041). No significant differences were found in the mean POSAS scores, except that irregularity and surface area parameters were better in the MLSI group.</p><p><strong>Conclusions: </strong>Objective sensation deficits are reversible and do not impact long-term daily activities. The MLSI approach provides better postoperative outcomes and low disfigurement perception.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848447","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":"Efficacy and Failure Patterns Following Target Volume and Dose Reduction After Neoadjuvant Therapy in Locoregionally Advanced Head and Neck Squamous Cell Carcinoma.","authors":"Xiong Zhou, Zheng Wu, Zichen Qiu, Minchuan Lin, Yalan Tao, Yong Su","doi":"10.1002/hed.28037","DOIUrl":"https://doi.org/10.1002/hed.28037","url":null,"abstract":"<p><strong>Background: </strong>In this study, we aimed to analyze the efficacy and failure patterns of contouring target volume based on the residual tumor and decreasing the dose to the area of tumor regression after neoadjuvant therapy in locoregionally advanced head and neck squamous cell carcinoma (HNSCC).</p><p><strong>Methods: </strong>We retrospectively analyzed the patients with locoregionally advanced HNSCC treated by our group from May 2011 to June 2023. All patients received neoadjuvant therapy followed by intensity-modulated radiation therapy. Gross tumor volumes for the primary tumor and metastatic lymph nodes were delineated according to postneoadjuvant extension. The tumor shrinkage after neoadjuvant therapy was included in the high-risk clinical target volume (CTV1) and prescribed a dose of 60 Gy. Kaplan-Meier analysis was employed to calculate local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), overall survival (OS), and distant metastasis-free survival (DMFS). Failure patterns were analyzed by mapping the location and extent of locoregional recurrence onto pretreatment planning CT.</p><p><strong>Results: </strong>This study included a total of 114 patients, with a median follow-up of 34 months. The 5-year LRFS, RRFS, OS, and DMFS rates were 70.2%, 70.7%, 74.8%, and 73.8%, respectively. Among the 14 patients with recurrences, there were 5 local failures, 6 regional recurrences, and 3 both local and regional recurrences. All local recurrences occurred within the 95% isodose line, classified as in-field failures. Only one regional recurrence was marginal failure. No out-of-field failure was observed.</p><p><strong>Conclusion: </strong>Reduction of target volume after neoadjuvant therapy and distribution of 60 Gy of dose to the tumor regression area may be feasible.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855872","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":"Investigating the Association Between Hashimoto's Thyroiditis and Papillary Thyroid Cancer.","authors":"Adriana I Báez Berríos, Mathilda Monaghan, Margaret Brandwein-Weber, Maaike van Gerwen","doi":"10.1002/hed.28031","DOIUrl":"https://doi.org/10.1002/hed.28031","url":null,"abstract":"<p><strong>Background: </strong>Hashimoto's thyroiditis' (HT) impact on the aggressive lymph node (ALN) status of papillary thyroid carcinoma (PTC) remains understudied.</p><p><strong>Methods: </strong>Univariate and multivariate analyses assessed PTC aggressiveness markers, comparing PTC + HT to PTC alone from a single center retrospectively. ALN categorization included > 5 positive, ≥ 1 > 3 cm, and/or ≥ 4 with extranodal extension lymph nodes.</p><p><strong>Results: </strong>Of 533 patients with PTC, 19.1% concurrently had HT. Compared to PTC alone, PTC + HT patients were predominantly female (p < 0.001), younger (p = 0.034), non-smokers (p = 0.035), and had more pN0 stage tumors (p < 0.001). PTC + HT was associated with lower odds of pN1 stage (OR_adj, 0.50) and lymphatic invasion (OR_adj, 0.53). No significant differences were observed in ALN status, pT stage, lymphatic and perineural invasion, gross ETE, margin, and focality.</p><p><strong>Conclusion: </strong>ALN status does not differ between PTC with or without HT.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839272","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":"Prognostic Effect of Patterns of Local Extension and Satellitosis in cT3 Squamous Cell Carcinoma of the Oral Tongue: A Prospective Observational Study.","authors":"Nausica Montalto, Simonetta Battocchio, Giacomo Contro, Piergiorgio Gaudioso, Francesca Mularoni, Alessandra Ruaro, Giulia Ramacciotti, Diego Cazzador, Giacomo Spinato, Andrea Luigi Camillo Carobbio, Stefano Taboni, Elisabetta Zanoletti, Cesare Piazza, Piero Nicolai, Marco Ferrari","doi":"10.1002/hed.28025","DOIUrl":"https://doi.org/10.1002/hed.28025","url":null,"abstract":"<p><strong>Introduction: </strong>The anatomy of the tongue is three-dimensionally complex and is thought to play a central role in the local growth of oral tongue squamous cell carcinoma (OTSCC). Understanding patterns of tumor extension could improve a multimodal therapeutic approach. Thus, the main aim of this study was to provide a histological and microanatomical analysis of surgical specimens after compartmental surgery for OTSCC.</p><p><strong>Materials and methods: </strong>The present prospective observational study included primary cT3 OTSCC (according to the eighth edition of the TNM classification) treated in an academic tertiary referral center with curative compartmental surgery, from July 2016 to July 2019. Analysis of histologic macrosections allowed assessment of standard pathologic parameters as well as a detailed analysis of the position of OTSCC cells from microanatomic and topographic standpoints.</p><p><strong>Results: </strong>Of the 28 patients included, 71.4% were males, with a mean age of 64.9 years. Nine (32.1%) patients presented satellitosis, which was always located within the T-N tract. OTSCCs displaying satellitosis had a significantly higher median pathologic depth of invasion (DOI). A radiologic and pathological DOI > 15 mm significantly predicted the presence of satellites. There was a significant relationship between the presence of satellites and both positive lymph nodes and distant metastases.</p><p><strong>Conclusion: </strong>Approximately one-third of cases of intermediate-to-advanced OTSCC are characterized by tumor satellites located in the T-N tract. DOI exceeding 15 mm and the presence of clinically appreciable nodal metastases best predict the presence of satellitosis. Satellite-bearing OTSCC behave more aggressively, with an increased risk of distant metastasis and reduced survival.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839426","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 Utility of the PTeye Autofluorescence Detection Device During Parathyroidectomy for the Treatment of Primary Hyperparathyroidism.","authors":"Camila Mancera, Tonya S King, Brittany A Long, Tyler P Tufano, Ralph P Tufano","doi":"10.1002/hed.28030","DOIUrl":"https://doi.org/10.1002/hed.28030","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the utility of PTeye autofluorescence (AF) technology in primary hyperparathyroidism (PHPT) surgery.</p><p><strong>Methods: </strong>A retrospective review analyzed 232 patients undergoing first-time parathyroid surgery between September 2021 and 2023. Of these, 92 underwent surgery consecutively without PTeye assistance, then 140 underwent PTeye-guided surgery consecutively.</p><p><strong>Results: </strong>The PTeye-guided surgery group showed significantly higher parathyroid gland identification rates (p < 0.001) and a 20.7 times greater likelihood of identifying all four glands compared to controls (3.3%). No cases of permanent hypoparathyroidism were reported, indicating the procedure's safety.</p><p><strong>Conclusions: </strong>PTeye appears to be a safe and effective technology that can be used to improve parathyroid gland identification during first time surgery for PHPT. This is particularly beneficial for patient population with a high prevalence of multiglandular disease.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831083","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}