Rohith M Bhethanabotla, Arushi Gulati, Inderpreet K Khalsa, Cara Evans, Claire E Perrin, James J Lappin, Joseph Kidane, Tyler W Crosby, Jason W Chan, Sue S Yom, VyVy N Young, Clark A Rosen, Sarah L Schneider, Patrick K Ha, W John Boscardin, Joey Laus, William R Ryan, Yue Ma
{"title":"Swallowing Function Outcomes in Head and Neck Cancer Survivors Followed by a Long-Term Dysphagia Surveillance Protocol.","authors":"Rohith M Bhethanabotla, Arushi Gulati, Inderpreet K Khalsa, Cara Evans, Claire E Perrin, James J Lappin, Joseph Kidane, Tyler W Crosby, Jason W Chan, Sue S Yom, VyVy N Young, Clark A Rosen, Sarah L Schneider, Patrick K Ha, W John Boscardin, Joey Laus, William R Ryan, Yue Ma","doi":"10.1002/hed.28166","DOIUrl":"https://doi.org/10.1002/hed.28166","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate swallow outcomes in head and neck cancer (HNC) survivors enrolled in a long-term dysphagia surveillance protocol following curative intent radiotherapy (RT).</p><p><strong>Methods: </strong>We conducted a retrospective review of videofluoroscopic swallow studies from 2015 to 2023 in HNC patients treated with RT. Swallow kinematics and function were assessed at baseline, 0-1, 1-2, 2-5, and 5+ years post-RT. Logistic regression models assessed kinematic deviations beyond 2SD from normative and dichotomized outcomes.</p><p><strong>Results: </strong>Among 638 patients with 1167 VFSS, 14.6% were 2 years post-RT, primarily oral cavity (29.6%) and oropharyngeal (46.7%) cancers treated with adjuvant (chemo) RT (53.3%). At 2 years, 51.3% exhibited abnormal hyolaryngeal movement, 27.5% had pharyngeal contraction abnormalities, and 9.0% had impaired pharyngoesophageal opening. Unsafe swallow was seen in 51.6% with moderate-to-profound dysphagia in 45%.</p><p><strong>Conclusion: </strong>Dysphagia surveillance revealed significant swallowing impairments in HNC survivors, with unsafe swallowing prevalent in over half of cases 2 years post-RT.</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":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040959","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}
Mina Bakhtiar, Zezhong Ye, Jonathan D Schoenfeld, Homan Mohammadi, Jeffrey P Guenette, Eleni M Rettig, Glenn J Hanna, Benjamin H Kann
{"title":"Artificial Intelligence Measured Tumor Burden and Pre-Treatment Circulating Tumor DNA in Human Papilloma Virus-Associated Oropharynx Cancer.","authors":"Mina Bakhtiar, Zezhong Ye, Jonathan D Schoenfeld, Homan Mohammadi, Jeffrey P Guenette, Eleni M Rettig, Glenn J Hanna, Benjamin H Kann","doi":"10.1002/hed.28180","DOIUrl":"https://doi.org/10.1002/hed.28180","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI)-based imaging analysis and circulating tumor-associated DNA (ctDNA) are both being used diagnostically in HPV-driven oropharynx squamous cell carcinoma (HPV-OPSCC). We evaluated associations between AI-measured tumor burden and ctDNA.</p><p><strong>Methods: </strong>We analyzed 170 patients treated definitively for HPV-OPSCC. All had pre-treatment serum tumor-tissue modified viral (TTMV) ctDNA levels. An AI algorithm measured tumor and lymph nodes on CT scans. Linear regressions detected associations between ctDNA (fragments/mL) and automated volumes, clinical tumor (T) and nodal (N) stage, and disease factors.</p><p><strong>Results: </strong>Automated tumor volume (coeff = 39.43, p < 0.001), nodal volume (coeff = 39.54, p < 0.001), T stage (coeff = 1031.09, p = 0.009), and N stage (coeff = 1840, p = 0.018) were associated with ctDNA. On multivariable analysis, tumor (coeff = 34.79, p = 0.001) and nodal volumes (coeff = 24.68, p = 0.022) were associated with ctDNA; T and N stage were not.</p><p><strong>Conclusions: </strong>Automated volumetrics are independently and more strongly associated with ctDNA, compared with clinical stage. Automated volumetrics provide a practical correlate to ctDNA.</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":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052663","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}
Alessandro Vinciguerra, Stefano Taboni, Pierfrancesco Bettini, Mario Turri-Zanoni, Benjamin Verillaud, Florian Chatelet, Paolo Castelnuovo, Piero Nicolai, Damien Bresson, Paolo Battaglia, Marco Ferrari, Philippe Herman
{"title":"Surgical Anatomy of the Scalp: Technical Hints for Harvesting the Temporoparietal Fascial and Pericranial Flap.","authors":"Alessandro Vinciguerra, Stefano Taboni, Pierfrancesco Bettini, Mario Turri-Zanoni, Benjamin Verillaud, Florian Chatelet, Paolo Castelnuovo, Piero Nicolai, Damien Bresson, Paolo Battaglia, Marco Ferrari, Philippe Herman","doi":"10.1002/hed.28161","DOIUrl":"https://doi.org/10.1002/hed.28161","url":null,"abstract":"<p><strong>Introduction: </strong>Scalp flaps are a cornerstone in skull base (SB) reconstruction thanks to their rich vascularization, large volume, and extra-nasal location. Among them, the pericranial flap (PF) and temporoparietal fascial flap (TPFF) are the most frequently applied. However, in the majority of cases, they result in being mutually exclusive based on the standard surgical technique to harvest them. The aim of this manuscript is to validate the concept of anatomical and thus surgical independence between the TPFF and PF through the analysis of topographic anatomy and description of challenging cases in which these scalp flaps were used.</p><p><strong>Methods: </strong>In this multicentric retrospective study, we have selected cases of SB reconstruction with TPFF and/or PF, for which the independence of underlying vascular and topographic anatomy has been exploited. Three different scenarios were encountered: (1) TPFF harvested after a coronal approach; (2) PF harvested with preservation of the TPFF pedicle; (3) Simultaneous harvesting of TPFF and PF. Data on surgical morbidity and outcomes were collected.</p><p><strong>Results: </strong>None of the 5 patients included in the study experienced flap or scalp necrosis, or perioperative adverse events, thus supporting the independent viability (or vascularization) of the 2 flaps. In all cases, an adequate SB reconstruction was achieved.</p><p><strong>Conclusion: </strong>The TPFF and PF are SB reconstructive solutions that can be applied independently thanks to their anatomical and vascular structure. This evidence expands the applicability and versatility of these regional flaps.</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":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054014","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}
Pauline Kim, Nabil F Saba, Ashley McCook-Veal, Yuan Liu, Adam M Klein, Jonathan J Beitler, Amy Chen, Fadlo R Khuri, Dong M Shin
{"title":"Prospective Pilot Study of Second Primary Tumor Prevention With Erlotinib and Celecoxib in Early-Stage Squamous Cell Carcinoma of the Head and Neck: Long-Term Follow-Up.","authors":"Pauline Kim, Nabil F Saba, Ashley McCook-Veal, Yuan Liu, Adam M Klein, Jonathan J Beitler, Amy Chen, Fadlo R Khuri, Dong M Shin","doi":"10.1002/hed.28178","DOIUrl":"https://doi.org/10.1002/hed.28178","url":null,"abstract":"<p><strong>Background: </strong>Patients with early-stage head and neck squamous cell carcinoma (HNSCC) have an increased risk for secondary primary tumors (SPT) after definitive treatment. The aim of this pilot trial was to investigate the safety and efficacy of erlotinib and celecoxib in preventing SPTs.</p><p><strong>Methods: </strong>Ten patients with stage I/II HNSCC who completed definitive treatment received erlotinib with celecoxib for 6 months. Primary objectives were safety assessment and SPT-free survival after completion of erlotinib and celecoxib. Secondary objectives included assessing overall survival (OS) and progression-free survival (PFS).</p><p><strong>Results: </strong>With a median follow-up of 9 (1.7-15.3) years, the median time to SPT-free survival was not reached. The estimated SPT-free survival was 78.8% at 15 years. Two patients had local recurrence, but none of our subjects developed mucosal squamous cell carcinoma at any site.</p><p><strong>Conclusion: </strong>All three doses of erlotinib and the fixed dose of celecoxib were well tolerated with excellent SPT-free survival with long-term follow-up.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov identifier: NCT00400374.</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":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053294","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}
Zhenzhen You, Botao Han, Zhenghao Shi, Shuangli Du, Minghua Zhao, Zhiyong Lv, Xinhong Hei, Haiqin Liu, Xiaoyong Ren, Yan Yan
{"title":"Single-View Contrastive Learning for Laryngeal Leukoplakia Classification With NBI Laryngoscopy Images.","authors":"Zhenzhen You, Botao Han, Zhenghao Shi, Shuangli Du, Minghua Zhao, Zhiyong Lv, Xinhong Hei, Haiqin Liu, Xiaoyong Ren, Yan Yan","doi":"10.1002/hed.28157","DOIUrl":"https://doi.org/10.1002/hed.28157","url":null,"abstract":"<p><strong>Background: </strong>Laryngeal cancer is the second most common upper respiratory tract cancer. Early and accurate diagnosis can improve the cure rate of patients. Laryngoscopy with NBI is a commonly used tool that can help endoscopists diagnose laryngeal diseases. However, the fine classification of laryngeal leukoplakia using NBI images is challenging for computer-aided diagnosis.</p><p><strong>Methods: </strong>In this article, we propose a single-view contrastive learning network to locate lesion regions, construct sample pairs for contrastive learning, and provide pseudo-labels to unlabeled data in order to achieve fine classification under small samples. Firstly, we pretrain the backbone network using the original NBI images. Secondly, in order to augment the number of samples for contrastive learning, we design different patch generation methods based on an attention-guided network. The original NBI images are cropped into small patches for the purpose of generating lesion-related regions and complementary samples. The pseudo-labels of these small patches are obtained by applying the pre-trained backbone network. Finally, we combine the contrastive loss function and the cross-entropy loss function for jointly training the backbone network and contrastive learning network. Our NBI dataset is classified into six categories: normal tissue, inflammatory keratosis, mild dysplasia, moderate dysplasia, severe dysplasia, and squamous cell carcinoma.</p><p><strong>Results and conclusion: </strong>Experimental results demonstrate that our model achieves an accuracy of 96.12%, which is higher than the current mainstream models. Our model also achieves high specificity and sensitivity. The code is available at https://github.com/hans-bbt/single-view-contrastive-learning.</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":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029882","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}
Anna Luíza Damaceno Araújo, Luiz Paulo Kowalski, Alvaro Sanabria, Alan Roger Santos-Silva, Andrés Coca-Pelaz, Kevin Thomas Robbins, Juan P Rodrigo, Orlando Guntinas-Lichius, Fernando López, Antti A Mäkitie, Remco de Bree, Timo Strandberg, Alessandra Rinaldo, Cesare Piazza, Robert P Takes, Nabil F Saba, Alfio Ferlito
{"title":"Older Patients with Head and Neck Cancer: A Scoping Review of Differences Regarding Diagnosis and Outcomes.","authors":"Anna Luíza Damaceno Araújo, Luiz Paulo Kowalski, Alvaro Sanabria, Alan Roger Santos-Silva, Andrés Coca-Pelaz, Kevin Thomas Robbins, Juan P Rodrigo, Orlando Guntinas-Lichius, Fernando López, Antti A Mäkitie, Remco de Bree, Timo Strandberg, Alessandra Rinaldo, Cesare Piazza, Robert P Takes, Nabil F Saba, Alfio Ferlito","doi":"10.1002/hed.28168","DOIUrl":"https://doi.org/10.1002/hed.28168","url":null,"abstract":"<p><strong>Background: </strong>Understanding the relationship between age and diagnostic challenges, as well as outcomes in older patients with head and neck cancer, is crucial. The significance of age as a prognostic factor and how it should influence treatment decisions is debated, highlighting the need for tailored insights to help physicians make more informed choices.</p><p><strong>Objective: </strong>This scoping review aims to address the diagnostic challenges/differences and patient outcomes as infection, pain, treatment-related complications (either postmedical or postoperative), treatment toxicities, disease control, morbidity, and/or survival/mortality in older patients (above the cut-off age of 60 years) with head and neck cancer.</p><p><strong>Methods: </strong>PubMed, Embase, Scopus, Web of Science, and LILACS were searched, as well as gray literature and reference lists of included articles.</p><p><strong>Results: </strong>A total of 5029 articles were retrieved and 57 studies were included, among which 5 appraised evidence on diagnostic challenges/differences, 53 addressed clinical (as postoperative complications, the impact of comorbidities in the occurrence of complications and treatment, postoperative delirium, swallowing outcomes, the correlation between age and infections, pain and opioid use, morbidity rates, treatment-related toxicities), and 26 reported survival. Evidence on diagnostic challenges and outcomes between older and younger patients is mixed, but age, comorbidities, and complications must be considered. While many studies show no significant differences in complications according to age, comorbidities often correlate with worse outcomes and are more frequent in the older group. Despite variable age cut-offs, survival rates between older and younger patients are similar.</p><p><strong>Conclusion: </strong>Treatment decisions should be based on a thorough medical evaluation and patient preferences rather than chronological age alone, as age itself does not account for outcome differences.</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":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060344","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 Models for Overall and Disease-Specific Survival in Palate Squamous Cell Carcinoma: Implications for Postoperative Radiotherapy.","authors":"Di Zhang, Lixi Li","doi":"10.1002/hed.28172","DOIUrl":"https://doi.org/10.1002/hed.28172","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to develop lymph node ratio (LNR)-integrated nomograms to predict overall survival (OS) and disease-specific survival (DSS) in palate squamous cell carcinoma (PSCC) and to guide postoperative radiotherapy (PORT) decisions.</p><p><strong>Methods: </strong>Data from PSCC patients were analyzed to identify prognostic factors, and nomograms were constructed. Performance was assessed using the area under the curve (AUC), calibration plots, and decision curve analysis. PORT benefits were evaluated across risk groups.</p><p><strong>Results: </strong>Among 959 patients, 5-year OS and DSS were 47.0% and 60.9%, respectively. LNR > 6% was associated with significantly increased mortality. The nomograms showed favorable accuracy (OS 1/3/5-year AUC: 0.780/0.703/0.745; DSS 1/3/5-year AUC: 0.789/0.714/0.700), with calibration plots showing excellent agreement between predicted and observed survival. High-risk patients had significantly poorer survival outcomes than low-risk patients, with PORT benefiting only high-risk groups.</p><p><strong>Conclusion: </strong>The LNR-based nomograms improve prognostic prediction and optimize PORT selection, offering valuable guidance for personalized treatment.</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":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050965","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}
Cristina P Rodriguez, Qian Vicky Wu, Kevin Ng, Jenna Voutsinas, Jonathan R Fromm, Ariana Dumenigo-Jimenez, Renato G Martins, Keith D Eaton, Rafael Santana-Davila, Christina Baik, Sylvia M Lee, Diane Tseng, Neal Futran, Brittany Barber, Emily Marchiano, George Laramore, Simon S Lo, Jay J Liao, Upendra Parvathaneni
{"title":"Dual PD-1 and CTLA4 Immune Checkpoint Blockade and Hypofractionated Radiation in Patients With Advanced Salivary Gland Cancers.","authors":"Cristina P Rodriguez, Qian Vicky Wu, Kevin Ng, Jenna Voutsinas, Jonathan R Fromm, Ariana Dumenigo-Jimenez, Renato G Martins, Keith D Eaton, Rafael Santana-Davila, Christina Baik, Sylvia M Lee, Diane Tseng, Neal Futran, Brittany Barber, Emily Marchiano, George Laramore, Simon S Lo, Jay J Liao, Upendra Parvathaneni","doi":"10.1002/hed.28169","DOIUrl":"https://doi.org/10.1002/hed.28169","url":null,"abstract":"<p><strong>Background: </strong>No standard systemic therapy exists for recurrent/metastatic salivary gland cancer (R/M SGC). We explored the safety and activity of nivolumab and ipilimumab with palliative hypofractionated radiation (XRT) in this population.</p><p><strong>Methods: </strong>This Phase I/II Trial enrolled R/M SGCs with evidence of progression, ECOG 0-1, no prior anti-PD-1 or CTLA4 therapy, measurable disease excluding the XRT site. Nivolumab 3 mg/kg iv Q2 weeks × 12 doses followed by 480 mg iv Q4 weeks × 8 doses and ipilimumab 1 mg/kg iv Q6 weeks × 4 doses was given. Twenty four gray XRT was given over three fractions, 2 weeks after the first dose of nivolumab. The primary endpoint was safety; secondary endpoints included RECIST 1.1 response (non-radiated lesions), progression free, and overall survival.</p><p><strong>Results: </strong>Between April 2019 and May 2022, 20 pts. were enrolled, the median age was 58 (range 27-77 years), 10 (50%) were male, and 12 (60%) had ECOG 0. Five (20%) Grade 3 AEs were observed in three pts.; no Grade 4 or 5 toxicities were observed. Among 19 response-evaluable patients, RECIST 1.1 PRs were observed in 4 (21%), in 2 pts. with salivary duct, 1 acinic cell, and 1 adenoid cystic, SD in 6 (31.5%) and PD in 9 (47.5%). With a median follow-up of 16 months, median OS was 25 months (95% CI: [18.7, 31]) and median PFS was 7.3 months (95% CI [2.5, 18.7]).</p><p><strong>Conclusion: </strong>Nivolumab/ipilimumab and palliative XRT result in low rates of severe toxicities and modest response rates for SGC; further work is necessary to explore predictors for response.</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":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026933","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}
Luca Canali, Gian Marco Pace, Marika D Russell, Francesca Gaino, Luca Malvezzi, Gherardo Mazziotti, Andrea Lania, Giuseppe Spriano, Michael Mannstadt, Gregory W Randolph, Giuseppe Mercante
{"title":"Preoperative Vitamin D Supplementation to Reduce Hypocalcemia Following Total Thyroidectomy: Systematic Review and Meta-Analysis of Randomized Clinical Trials.","authors":"Luca Canali, Gian Marco Pace, Marika D Russell, Francesca Gaino, Luca Malvezzi, Gherardo Mazziotti, Andrea Lania, Giuseppe Spriano, Michael Mannstadt, Gregory W Randolph, Giuseppe Mercante","doi":"10.1002/hed.28174","DOIUrl":"https://doi.org/10.1002/hed.28174","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to determine whether preoperative supplementation of vitamin D reduces the incidence of hypocalcemia following total thyroidectomy.</p><p><strong>Methods: </strong>Conducted in conformity with the PRISMA statement, a systematic review and meta-analysis of randomized clinical trials (RCT) was performed assessing postoperative hypocalcemia and postoperative symptomatic hypocalcemia.</p><p><strong>Results: </strong>The search strategy yielded 3808 potentially relevant publications, with eight RCTs ultimately included. These eight trials included a total of 902 patients (22.73% male, n = 205/902), with a median age of 48.9 years (95% CI, 43.5-53.5). Four trials administered only vitamin D in the interventional arm, three trials administered both calcium and vitamin D in the interventional arm, and one trial administered vitamin D in the interventional arm and calcium in both arms. Pooled results from the eight included trials showed a reduced risk of postoperative hypocalcemia in the intervention arm (RR, 0.77; 95% CI, 0.62-0.96; p = 0.02). When excluding the studies that administered calcium supplements in addition to vitamin D, the pooled results showed a similar reduced risk of postoperative hypocalcemia (RR, 0.74; 95% CI, 0.57-0.96; p = 0.03). Analysis of six trials reporting the incidence of postoperative symptomatic hypocalcemia (n = 564) showed a reduced risk in the vitamin D arm, with or without calcium, compared to the control arm (RR, 0.56; 95% CI, 0.34-0.93; p = 0.023).</p><p><strong>Conclusions: </strong>Our findings suggest that preoperative vitamin D administration, with or without calcium carbonate, significantly reduces the risk of postoperative hypocalcemia and symptomatic hypocalcemia in patients undergoing total thyroidectomy.</p><p><strong>Level of evidence: 1: </strong></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":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035888","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}
Emilien Chabrillac, Audrey Tourrette, Michel Habib, Marilys Blanchy, Céline Des Courtils, Grégoire D'Andréa, Philippe Lavalle, Agnès Dupret-Bories
{"title":"Application of Biomaterials for the Prevention of Pharyngeal Fistulae: A Systematic Review.","authors":"Emilien Chabrillac, Audrey Tourrette, Michel Habib, Marilys Blanchy, Céline Des Courtils, Grégoire D'Andréa, Philippe Lavalle, Agnès Dupret-Bories","doi":"10.1002/hed.28175","DOIUrl":"https://doi.org/10.1002/hed.28175","url":null,"abstract":"<p><strong>Background: </strong>PharyngoCutaneous Fistulae (PCF) represent a significant clinical challenge in otorhinolaryngology practice. The use of biomaterials could improve outcomes or even replace the use of a flap in pharyngolaryngeal surgery.</p><p><strong>Methods: </strong>This systematic review included all studies evaluating the application of biomaterials for the prevention of PCF after pharyngeal surgery.</p><p><strong>Results: </strong>A total of 19 articles (12 clinical and 7 animal studies) were included. They assessed the use of a biomaterial to cover mucosal sutures (n = 15) or to replace a mucosal defect and guide secondary healing (n = 4). Most studies evaluated commercialized biomaterials (n = 11) rather than experimental devices (n = 5) or platelet-derived autologous medical devices (n = 4).</p><p><strong>Conclusion: </strong>There are already strong arguments to support the use of several biomaterials to cover pharyngeal sutures in order to decrease the rate of PCF after TL or TPL. Replacing a pharyngeal mucosal defect by a biomaterial is currently a more elusive goal.</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":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058709","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}