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

{"title":"Exploring Quantitative MRI Biomarkers of Head and Neck Post-Radiation Lymphedema and Fibrosis: Post Hoc Analysis of a Prospective Trial.","authors":"Shitong Mao, Jihong Wang, Holly McMillan, Abdallah Sherif Radwan Mohamed, Sheila Buoy, Sara Ahmed, Samuel L Mulder, Mohamed A Naser, Renjie He, Kareem A Wahid, Melissa Mei Chen, Yao Ding, Amy C Moreno, Stephen Y Lai, Clifton David Fuller, Katherine Arnold Hutcheson","doi":"10.1002/hed.28062","DOIUrl":"10.1002/hed.28062","url":null,"abstract":"<p><strong>Background: </strong>Quantifying head and neck lymphedema and fibrosis (HN-LEF) is crucial in the investigation and management of treatment sequelae in head and neck cancer (HNC).</p><p><strong>Methods: </strong>The T1- and T2-weighted MRI signal intensity (SI) was examined in relation to HN-LEF categories per physical/tactile examination (No-LEF, A-B = edema, C = edema + fibrosis, D = fibrosis), and MRI structural volumes were examined in relation to a novel 10-point HN-LEF score in the intraoral and submental regions.</p><p><strong>Results: </strong>We identified differences in ranks among HN-LEF categories in relation to the MRI SI (A-B and C are higher than D and No-LEF for T2 SI, and A-B is the highest for T1). Furthermore, six pairs of FOM volumes on MRI demonstrated a strong negative correlation (p < 0.05) with the HN-LEF score at adjacent palpable sites.</p><p><strong>Conclusion: </strong>Both MRI SI and structural volumes can potentially be imaging biomarkers of edematous soft tissue states in HNC 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":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967456","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":"Modified Technique for Difficult Secondary Tracheoesophageal Puncture","authors":"Michelle Yoon,&nbsp;Justin Joseph,&nbsp;Ricardo Ramirez,&nbsp;Cindy Ganz,&nbsp;Michael S. Smith,&nbsp;Mark L. Urken","doi":"10.1002/hed.28068","DOIUrl":"10.1002/hed.28068","url":null,"abstract":"<div>\u0000 \u0000 <p>Tracheoesophageal puncture (TEP) with voice prosthesis (VP) placement is commonly used to restore voice in laryngectomy patients. The conventional procedure utilizes a rigid esophagoscope to open and visualize the pharyngeal inlet. However, this approach is challenging in patients with postradiation changes, reduced neck extension, or trismus. Here, we demonstrate a modified technique involving flexible endoscopy and endotracheal tube placement to reestablish the TEP tract in a patient with a challenging anatomic profile. This step-by-step video demonstrates retrieval of a dislodged prosthesis and TEP/VP placement under general anesthesia, which results in effective voice restoration. This modified technique can safely and effectively restore voice in patients with difficult exposure.</p>\u0000 </div>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":"47 3","pages":"1062-1064"},"PeriodicalIF":2.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958855","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":"Trends in Investigations for Suspected Head and Neck Carcinoma of the Unknown Primary: A HNCIG and IFHNOS International Survey of Practice.","authors":"Andrew Williamson, Paul Nankivell, Ahmed K Abou-Foul, Mohamed Ahmed, Hisham Mehanna","doi":"10.1002/hed.28065","DOIUrl":"https://doi.org/10.1002/hed.28065","url":null,"abstract":"<p><strong>Background: </strong>The aim of this clinical survey was to assess variations in head and neck squamous cell carcinoma from an unknown primary (HNSCCUP) diagnostic practices across international centers.</p><p><strong>Methods: </strong>Clinical practice survey of experts nominated by Head and Neck Cancer International Group (HNCIG) and International Federation of Head and Neck Oncologic Societies (IFHNOS).</p><p><strong>Results: </strong>Responses were received from 48/49 (97.9%) participants. Outpatient laryngoscopy, CT, and 18-FDG-PETCT were used always or most of the time by 81.3%, 77.1%, and 79.2%, but only 50% regularly used MRI. Unilateral and bilateral tonsillectomy were frequently performed in 41.6% and 27.1% of unilateral nodal disease, and in 18.8% and 52.1% for bilateral disease. Ipsilateral Tongue Base Mucosectomy (TBM) was used always or most of the time in 12.5% of unilateral and 6.3% of bilateral HNSCCUP. Bilateral TBM was used in 10.4% for unilateral and 22.9% for bilateral cancers.</p><p><strong>Conclusions: </strong>While there is broad agreement regarding examination and cross-sectional imaging, there are considerable differences in the surgical strategies used to identify occult primaries.</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":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958817","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":"Flow-Through Flaps as a Robust Method for Advanced Free Flap Reconstruction in the Head and Neck: A Multi-Institutional Experience.","authors":"Eric V Mastrolonardo, Sarah Sussman, Pablo Llerena, Dev R Amin, Kathryn Nunes, Kelly Bridgham, Emma De Ravin, Daniel J Campbell, Aarti Agarwal, Ramez Philips, Fahad Rind, Ryan Ivancic, Wesley McIlwain, Stephen Y Kang, Yadranko Ducic, Larissa Sweeny, Mauricio A Moreno, René P Meyers, Carissa M Thomas, Karthik Rajasekaran, Mark Wax, Joseph M Curry, Matthew M Hanasono","doi":"10.1002/hed.28061","DOIUrl":"https://doi.org/10.1002/hed.28061","url":null,"abstract":"<p><strong>Background: </strong>Flow-through flaps (FTFs) are an advanced technique in which a free flap is anastomosed to the pedicle of another free flap to reconstruct extensive head and neck defects when recipient vessels are scarce.</p><p><strong>Methods: </strong>A multi-institutional cohort of FTFs used for head and neck reconstruction were reviewed. For comparison, FTF outcomes were compared to free flaps that required vein grafts (VG) to reach distant recipient vessels.</p><p><strong>Results: </strong>A total of forty-two patients underwent surgery using a FTF configuration, including 32 simultaneous and 10 sequential FTFs. There were no instances of flap failure compared to a 7% flap failure rate in the VG group (n = 54). The overall postoperative complication rate was 28% compared to a 46% complication rate in the VG group (p = 0.093).</p><p><strong>Conclusion: </strong>FTFs are a reliable option for reconstruction of extensive head and neck defects when recipient blood vessel availability is limited.</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":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933323","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":"Use of the Superior Thyroid Artery as a Recipient Artery in Head and Neck Free Flap Reconstruction: Effects on Post-Operative Hypothyroidism.","authors":"Kaitlynne Y Pak, Alberto Nunez, Harsh Patel, Allen S Ho, Jon Mallen-St Clair","doi":"10.1002/hed.28049","DOIUrl":"https://doi.org/10.1002/hed.28049","url":null,"abstract":"<p><strong>Background: </strong>The superior thyroid artery (STA) as a recipient vessel in free flap reconstruction may theoretically impact thyroid function. This study aimed to assess whether the use of the STA has an adverse effect on thyroid function.</p><p><strong>Methods: </strong>Retrospective review of 101 head and neck reconstructive cases. Thyroid function tests were reviewed within 1 year of surgery.</p><p><strong>Results: </strong>The STA was used in 40 cases. The STA cohort had significantly higher TSH levels than the non-STA cohort (7.34 v. 2.87 mU/L, p = 0.02). About 27.5% developed subclinical post-operative hypothyroidism and 17.5% required new levothyroxine supplementation in the STA group.</p><p><strong>Conclusion: </strong>This represents the first study to our knowledge assessing the impact of the STA as a recipient vessel on postoperative thyroid function. While we found a statistically significant difference in average TSH after using the STA, the average TSH/FT4 values were subclinical. Post-operative monitoring for hypothyroidism is warranted in this population.</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":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933325","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":"Dedifferentiation of a Chondrosarcoma of the Larynx: A Case Report.","authors":"Steven J Charous, Brian Yuhan, Kerstin M Stenson, Vidit Talati, Phillip McMullen","doi":"10.1002/hed.28004","DOIUrl":"https://doi.org/10.1002/hed.28004","url":null,"abstract":"<p><strong>Background: </strong>Chondrosarcomas of the larynx, relatively rare tumors with low grade pathology in approximately 95% of cases, can most often be managed with conservation laryngeal procedures. Dedifferentiated chondrosarcomas are much more rare and aggressive requiring more aggressive surgical extirpation.</p><p><strong>Methods: </strong>A patient underwent three debulking procedures for a laryngeal chondrosarcoma Grade I/II histologically over a 2.5 year period of time during which slow growth was closely monitored. He then presented with relatively rapid onset of hoarseness and shortness of breath. Fiberoptic laryngoscopy demonstrated new bilateral vocal fold fixation with near occlusion of his subglottis by soft tissue mass.</p><p><strong>Results: </strong>A total laryngectomy was performed that pathologically demonstrated a Grade III dedifferentiated chondrosarcoma. Shortly thereafter, the patient developed regional metastases, then distant metastases and then succumbed to the disease.</p><p><strong>Conclusion: </strong>This first case of a Grade III dedifferentiating chondrosarcoma arising from closely monitored and multiple debulked previously Grade I/II tumor demonstrates the potential change in aggressiveness in low-grade chondrosarcomas of the larynx. Sudden increase in growth along with a soft tissue component to the tumor based on exam and/or imaging should heighten suspicion for dedifferentiation of the tumor and necessitates a more aggressive surgical resection. However, the chance of cure once dedifferentiation occurs is drastically reduced.</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":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916480","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":"Cost Outcomes of Virtual Surgical Planning in Head and Neck Reconstruction: A Systematic Review","authors":"Jenny B. Xiao,&nbsp;Norbert Banyi,&nbsp;Khanh Linh Tran,&nbsp;Eitan Prisman","doi":"10.1002/hed.28035","DOIUrl":"10.1002/hed.28035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Virtual surgical planning (VSP) is an emerging method in head and neck reconstruction with demonstrated benefits, however, its economic viability is supported with mixed evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A structured search was performed in five electronic databases. Studies that performed an economic evaluation on VSP in head and neck reconstruction were included. Data regarding VSP workflow, costs, and variables influencing costs were recorded and synthesized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighteen studies met the final inclusion criteria (<i>n</i> = 733). Fourteen out of 18 studies (78%) found that VSP either generated cost savings or was comparable to freehand surgery (FHS). The majority of cost savings were generated from reduced OR times and LOS/LOH. In addition, greater cost savings were associated with in-house VSP workflows compared to those that are outsourced.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>VSP is potentially cost-beneficial compared to traditional unplanned surgery, however, substantial heterogeneity amongst methods and outcome measures impedes the generalizability of these findings.</p>\u0000 \u0000 <p>\u0000 <b>Trial Registration:</b> PROSPERO: CRD42024504398</p>\u0000 </section>\u0000 </div>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":"47 3","pages":"1037-1057"},"PeriodicalIF":2.3,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hed.28035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907939","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}

{"title":"Adjuvant Intensity Modulated Radiation Therapy With a Pedicled Flap Reconstruction in Oral Cavity Squamous Cell Carcinomas: Implications on Target Delineation.","authors":"Sarbani Ghosh Laskar, Shwetabh Sinha, Pritha Roy, Rabi Das, Shivakumar Thigarajan, Anuj Kumar, Samarpita Mohanty, Ashwini Budrukkar, Monali Swain, Devendra Chaukar, Gouri Pantvaidya, Anuja Deshmukh, Prathamesh Pai, Deepa Nair, Sudhir Nair, Poonam Joshi, Rathan Shetty, Arjun Singh, Vidisha Tuljapurkar, Richa Vaish, Pankaj Chaturvedi","doi":"10.1002/hed.28056","DOIUrl":"https://doi.org/10.1002/hed.28056","url":null,"abstract":"<p><strong>Objectives: </strong>To address controversies regarding target volume delineation for adjuvant intensity-modulated radiation therapy for oral cavity squamous cell carcinoma with pedicled flap reconstruction and elective nodal irradiation (ENI).</p><p><strong>Materials and methods: </strong>During target volume delineation, the primary tumor bed was the pre-surgical gross tumor volume with an additional isotropic margin of 5-10 mm. Additionally, the flap and body tissue junction were given a margin of 5-10 mm (if not already given). An effort was not made to trace the flap for inclusion in the clinical target volume (CTV), except when it traversed through the involved nodal regions. Contralateral ENI was carried out only in tumors crossing the midline when there was a heavy nodal burden at Ia/Ib.</p><p><strong>Results: </strong>In the 143 patients analyzed, the most common sub-site was buccal mucosa (78, 54.5%). Contralateral ENI was done in 63 patients (36 Tongue, 23 Buccoalveolar). The median follow-up of surviving patients was 24 months. The 2-year Locoregional Control, Disease-Free Survival, and Overall Survival were 77.4%, 64.5%, and 79% respectively. Overall, there were 55 (38.5%) recurrences, of which 35 (24.5%) were either local, regional, or combined locoregional failures, 13 (9.1%) were distant failures alone, and 7 (4.9%) had both locoregional and distant failures. The elective nodal regions had 3 (2.1%) contralateral nodal failures.</p><p><strong>Conclusion: </strong>The entire flap need not be intentionally covered in the target volume. Contralateral ENI should be considered only for patients with heavy nodal burden at ipsilateral level Ia/Ib, in tumors crossing the midline, or in tumors having a high propensity for contralateral lymph nodal involvement.</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":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911144","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":"Outcomes of Radical Radiotherapy (RT) or Chemoradiotherapy (CRT) in Surgically Inoperable Advanced Oral Cavity Cancer: A Single Center Experience.","authors":"Shashank Shenoy, Ankita Mallick, Sudipta Pati, Sanjoy Chatterjee, Indranil Mallick","doi":"10.1002/hed.28055","DOIUrl":"https://doi.org/10.1002/hed.28055","url":null,"abstract":"<p><strong>Background: </strong>Patients with locally advanced, surgically unresectable oral squamous cell cancers (SU-OSCC) are often treated with palliative intent. There is limited information on the outcomes of radical intent treatment with radiotherapy (RT) or chemoradiotherapy (CRT).</p><p><strong>Methods: </strong>We retrospectively examined patients with Stage III/IV previously untreated SU-OSCC treated definitively from 2011 to 2021 in a single institution with RT or CRT with or without neoadjuvant chemotherapy (NACT).</p><p><strong>Results: </strong>Sixty-nine patients met the inclusion criteria. Oral tongue (38%) and buccal mucosa (32%) were the commonest subsites. T4a, T4b, and N2-3 disease were present in 28 (40.6%), 26 (37.7%), and 39 (56.5%) patients, respectively. Median OS and PFS of the whole group were 16 months and 10 months. The 2-year loco-regional control was 60.4%. Bone involvement or NACT use did not affect outcomes.</p><p><strong>Conclusions: </strong>Upfront radical RT/CRT in patients with SU-OSCC with good performance status results in good outcomes and should be preferred to a palliative approach.</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":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907946","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":"Assessing Dental Implant Success: A Systematic Review and Meta-Analysis of Primary Versus Secondary Implantation in Free Bone Flap Reconstruction for Malignant Tumors","authors":"Sophie Dugast,&nbsp;Julie Longis,&nbsp;Marine Anquetil,&nbsp;Pierre Corre,&nbsp;Svetlana Komarova,&nbsp;Hélios Bertin","doi":"10.1002/hed.28059","DOIUrl":"10.1002/hed.28059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dental implantation of bone reconstructions in oncologic situations improves patients' orofacial function and quality of life. There are currently no recommendations on the timing of implantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This systematic review with meta-analysis aimed to compare primary and secondary dental implantation of free bone flaps in reconstructions for malignant tumors of the oral cavity. The primary objective was to evaluate the implant survival rate, with secondary criteria including time to prosthesis placement, postoperative complications, and data on quality of life. Results—Three databases were screened for articles published between January 1990 and April 2024. Out of 2438 studies, 16 met the eligibility criteria, encompassing 284 patients. In total, 319 implants were placed in the primary implantation group and 1108 in the second group. Implant survival rate was 92.5% in the primary implantation group compared to 88.5% in the secondary implantation group. This systematic review underscores a higher success rate for implants placed primarily in patients with oral cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Given the rapid functional and aesthetic improvement offered by prosthetic rehabilitation, primary implantation should be systematically considered in the oncological population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":"47 4","pages":"1277-1290"},"PeriodicalIF":2.3,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907937","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}