Kimberly Wei, Brianna L Hill, Joel C Thompson, Zoey A Miller, Arielle Mueller, Robert J Lee, Ryan M Carey
{"title":"Bitter Taste Receptor Agonists Induce Apoptosis in Papillary Thyroid Cancer.","authors":"Kimberly Wei, Brianna L Hill, Joel C Thompson, Zoey A Miller, Arielle Mueller, Robert J Lee, Ryan M Carey","doi":"10.1002/hed.28120","DOIUrl":"10.1002/hed.28120","url":null,"abstract":"<p><strong>Background: </strong>Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy, with a 20% recurrence rate. Bitter taste receptors (T2Rs) and their genes (TAS2Rs) may regulate survival in solid tumors. This study examined T2R expression and function in PTC cells.</p><p><strong>Methods: </strong>Three PTC cell lines (MDA-T32, MDA-T68, and MDA-T85) were analyzed for expression using RT-qPCR and immunofluorescence. Live cell imaging measured calcium responses to six bitter agonists. Viability and apoptosis effects were assessed using crystal violet and caspase 3/7 activation assays. Genome analysis of survival was conducted.</p><p><strong>Results: </strong>TAS2R14 was consistently highly expressed in all cell lines. Five bitter agonists produced significant cytoplasmic and mitochondrial calcium responses across all cell lines. All bitter agonists significantly decreased viability and induced apoptosis. Higher TAS2R14 expression correlated with better progression-free survival in patients (p < 0.05).</p><p><strong>Conclusions: </strong>T2R activation by bitter agonists induces apoptosis, and higher TAS2R expression is associated with survival, suggesting potential therapeutic relevance in thyroid cancer 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":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558812","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}
Francesca Caspani, Stefano Cavalieri, Ester Orlandi, Cristiana Bergamini, Carlo Resteghini, Elena Colombo, Arianna Ottini, Imperia Nuzzolese, Salvatore Alfieri, Aurora Mirabile, Alessandra Cassano, Paolo Bossi, Toni Ibrahim, Maria Chiara Cau, Massimo Ghiani, Federica Bertolini, Rossana Ingargiola, Giulia Fontana, Lisa Licitra, Laura D Locati
{"title":"Lenvatinib in Relapsed/Metastatic Adenoid Cystic Carcinoma: Real-World Data From 17 Italian Centers.","authors":"Francesca Caspani, Stefano Cavalieri, Ester Orlandi, Cristiana Bergamini, Carlo Resteghini, Elena Colombo, Arianna Ottini, Imperia Nuzzolese, Salvatore Alfieri, Aurora Mirabile, Alessandra Cassano, Paolo Bossi, Toni Ibrahim, Maria Chiara Cau, Massimo Ghiani, Federica Bertolini, Rossana Ingargiola, Giulia Fontana, Lisa Licitra, Laura D Locati","doi":"10.1002/hed.28124","DOIUrl":"https://doi.org/10.1002/hed.28124","url":null,"abstract":"<p><strong>Background: </strong>Lenvatinib, a multi-target tyrosine kinase inhibitor (MTKI), has demonstrated activity in recurrent or metastatic (R/M) adenoid cystic carcinoma (ACC) in phase II studies.</p><p><strong>Methods: </strong>This multicenter, retrospective study included patients with R/M ACC treated with lenvatinib. The primary endpoint was the overall response rate (ORR).</p><p><strong>Results: </strong>Fifty-one patients were included across 17 Italian sites. Forty-six patients (90%) were evaluated for response: the ORR was 21.7%, with 10 patients achieving a partial response; 24 patients had a stable disease resulting in a disease control rate of 73.9%. At least one treatment-related adverse event (TRAE) was recorded in all patients. The most frequent TRAEs of grade > 3 were hypertension (25.5%), stomatitis (17.6%), and fatigue (15.7%); one grade 5 TRAE (bleeding) was reported. Median OS was 16.1 months (95% CI 12.2-NR) with six-month PFS at 75.7%.</p><p><strong>Conclusion: </strong>Lenvatinib confirmed its activity in the real-world population. A higher than expected rate of grade > 3 stomatitis was reported.</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":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544572","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}
Anner Moskovitz, Nir Tsur, Keren Kaminer, Dean Dudkiewicz, Eyal Robenshtok
{"title":"Lobectomy for Papillary Thyroid Carcinoma With Minimal Extrathyroidal Extension: Does the Site of Extension Matter?","authors":"Anner Moskovitz, Nir Tsur, Keren Kaminer, Dean Dudkiewicz, Eyal Robenshtok","doi":"10.1002/hed.28113","DOIUrl":"https://doi.org/10.1002/hed.28113","url":null,"abstract":"<p><strong>Background: </strong>There is limited data on the recurrence risk following lobectomy in patients with microscopic extrathyroidal extension (mETE) and the significance of the site of mETE.</p><p><strong>Methods: </strong>A retrospective study on patients treated with thyroid lobectomy between January 2012 and December 2023.</p><p><strong>Results: </strong>Sixty-seven patients with papillary thyroid carcinoma (PTC) and mETE were included. Two patients (4.66%) experienced disease recurrence during a mean follow-up of 50 months (IQR 18.8-70.3). Twenty-five patients (37.3%) had anterior extension, 28 (41.8%) posterior, and 14 (20.9%) unknown location. Tumors with posterior extension had a higher rate of tall-cell variant (23.1% vs. 12%) and fewer positive surgical margins (22.2% vs. 37.5%). Three non-disease-related deaths occurred during follow-up. No recurrences were noted in patients with anterior mETE.</p><p><strong>Conclusion: </strong>The recurrence risk after hemithyroidectomy for PTC with mETE was 4.66%, consistent with low-risk disease. Posterior mETE demonstrated a trend of a more aggressive variant and a higher recurrence rate.</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":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525331","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}
Peiran Zhou, Brandon J Yeshoua, Neeraja Konuthula, Cassie J Pan, Rocco M Ferrandino, Sarah E Holte, Zain Rizvi, Emily M Marchiano, Neal D Futran, Brittany R Barber
{"title":"Association of Oral Health Determinants With Oral Squamous Cell Carcinoma in Never-Smoking Adults.","authors":"Peiran Zhou, Brandon J Yeshoua, Neeraja Konuthula, Cassie J Pan, Rocco M Ferrandino, Sarah E Holte, Zain Rizvi, Emily M Marchiano, Neal D Futran, Brittany R Barber","doi":"10.1002/hed.28119","DOIUrl":"https://doi.org/10.1002/hed.28119","url":null,"abstract":"<p><strong>Background: </strong>The incidence of oral cavity squamous cell carcinoma (OCSCC) is increasing among non-smokers. This study investigates the association between local and systemic oral health determinants and OCSCC in never-smoking adults.</p><p><strong>Methods: </strong>A case-control study using the National Institutes of Health All of Us database was conducted. Lifetime exposures to periodontal disease, acquired absence of teeth, hyperlipidemia, hyperglycemia, HIV, oral-related autoimmune diseases, depression, and eating disorders were analyzed. Multivariate logistic regression estimated odds ratios (ORs) and 95% confidence intervals to identify independent OCSCC risk factors.</p><p><strong>Results: </strong>Several risk factors were independently associated with OCSCC: periodontal disease (OR 4.99), hyperlipidemia (OR 1.53), HIV infection (OR 2.96), oral-related autoimmune diseases (OR 2.40), depression (OR 1.51), and eating disorders (OR 8.46). Acquired absence of teeth and hyperglycemia did not show statistical significance.</p><p><strong>Conclusions: </strong>This study highlights the complex pathophysiology of OCSCC in never-smoking adults and underscores the need for comprehensive risk assessment and prevention strategies.</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":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531436","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":"EpCAM-Targeted Erlotinib Delivery: Enhancing Nasopharyngeal Carcinoma Treatment With Polyethylene Glycol-Coated Graphene Oxide.","authors":"Chien-Fu Yeh, Sheng-Wei Lee, Chin-Hsuan Liu, Yen-Bin Hsu, Ming-Chin Lan, Yu-Jen Lu, Jyh-Ping Chen, Ming-Ying Lan","doi":"10.1002/hed.28122","DOIUrl":"https://doi.org/10.1002/hed.28122","url":null,"abstract":"<p><strong>Background: </strong>Recently, graphene oxide (GO) has attracted significant attention as a potential innovative vehicle for the delivery of anticancer agents. In this study, we aimed to evaluate whether functionalized GO, known as epithelial cell adhesion molecule (EpCAM)-targeted polyethylene glycol (PEG)-coated GO (GO-PEG-EpCAM), could be used as a therapeutic agent against nasopharyngeal carcinoma (NPC) and to identify its underlying molecular mechanisms.</p><p><strong>Methods: </strong>We used NPC cells to assess the anticancer effects of GO-PEG-EpCAM/erlotinib in vitro and in vivo. Employing RNA sequencing and Ingenuity Pathway Analysis (IPA), we sought to elucidate the molecular pathways through which GO-PEG-EpCAM/erlotinib affects NPC cells.</p><p><strong>Results: </strong>Our findings revealed that GO-PEG-EpCAM/erlotinib reduced NPC cell viability and decreased invasion and migration abilities. An in vivo study further corroborated the anticancer potential of GO-PEG-EpCAM/erlotinib. Our comprehensive RNA sequencing analysis highlighted several molecular mechanisms underlying the anticancer effects of GO-PEG-EpCAM/erlotinib.</p><p><strong>Conclusions: </strong>GO-PEG-EpCAM/erlotinib could be a potential therapeutic strategy for NPC.</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":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517374","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 Longitudinal Study of a Novel Modified Submental Rectangular Flap for Postoperative Laryngeal Stenosis Reconstruction.","authors":"Zheng Jiang, Longhao Wang, Mailudan Ainiwaer, Jun Liu, Jia Ren, Yitao Zheng, Haiyang Wang, Fei Chen","doi":"10.1002/hed.28125","DOIUrl":"https://doi.org/10.1002/hed.28125","url":null,"abstract":"<p><strong>Background: </strong>This study aims to report and evaluate the efficacy of using a novel submental flap for addressing laryngeal stenosis.</p><p><strong>Methods: </strong>This study involved patients with glottic and supraglottic laryngeal stenosis following horizontal/vertical partial laryngectomy who were refractory to repeated interventions. Kaplan-Meier curves were used to demonstrate the decannulation, and the Mantel-Cox Log-rank test was used to compare the rate difference in quality-of-life subgroup analysis.</p><p><strong>Results: </strong>The average follow-up time was 30.04 ± 10.60 for all included patients; the flap survival was 100%, with only one patient in the horizontal laryngectomy group reported to have a flap-related complication. The decannulation rate was 93.75% and 80% in the horizontal and vertical groups, respectively, without any statistical analysis (p < 0.05). The average decannulation time was 10.17 ± 5.24 weeks in the horizontal group and 12.25 ± 5.56 in the vertical group.</p><p><strong>Conclusion: </strong>The modified submental flap technique provides a convenient and effective approach for laryngeal reconstruction in patients with postoperative laryngeal stenosis.</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":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517365","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}
Fredrik Jäwert, André Fehr, Marta Persson, Adel K El-Naggar, Göran Stenman, Mattias K Andersson
{"title":"Alternative MYB Promoter Activity Is a Potential Prognostic Biomarker in Head and Neck Adenoid Cystic Carcinoma.","authors":"Fredrik Jäwert, André Fehr, Marta Persson, Adel K El-Naggar, Göran Stenman, Mattias K Andersson","doi":"10.1002/hed.28123","DOIUrl":"https://doi.org/10.1002/hed.28123","url":null,"abstract":"<p><strong>Background: </strong>Adenoid cystic carcinoma (ACC) is an aggressive therapy-resistant head and neck cancer with a high frequency of local recurrences and distant metastases. Activation of the MYB gene, encoding an oncogenic master transcription factor, is the key genomic hallmark of ACC and a potential therapeutic target. Here, we have investigated the clinical significance of alternative MYB promoter (MYB TSS2) activation in primary ACCs.</p><p><strong>Methods: </strong>MYB TSS2 activity was studied in 28 ACCs using MYB exon-specific qPCR assays. Overall survival (OS) and risk analyses were done to estimate the outcomes of MYB TSS2 high and low cases, respectively. The genomic and transcriptomic profiles of the ACCs were also analyzed in relation to MYB TSS2 activity.</p><p><strong>Results: </strong>OS was significantly shorter among patients in the MYB TSS2 high group compared to the MYB TSS2 low group (p = 0.02). Multivariate analysis indicated that MYB TSS2 activity was a significant prognostic biomarker for OS (p = 0.03) that was independent of tumor grade and NOTCH1 mutation status. There was markedly higher MYB TSS2 activity in ACCs with 6q deletions compared to those without deletions (p = 0.04). Moreover, MYB TSS2 high tumors had an increased expression of cell cycle genes and known MYB target genes.</p><p><strong>Conclusion: </strong>The study demonstrates that alternative MYB promoter activity is a new potential prognostic biomarker for ACC and further strengthens the relevance of MYB-targeted therapy. Our findings indicate that MYB TSS2 high primary tumors are more aggressive and have a worse prognosis than MYB TSS2 low tumors.</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":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494950","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}
Grant Creaney, Mariél de Aquino Goulart, Alex McMahon, Claire Paterson, James McCaul, Sandra Perdomo, Laura Mendoza, Laia Alemany, Lidia Maria Rebolho Arantes, Paula Andrea Rodriguez Urrego, Tom Dudding, Mirana Pring, Marta Vilensky, Cecilia Cuffini, Silvia Adriana Lopez de Blanc, José Carlos de Oliveira, Shahid Pervez, Pierre Saintigny, Mauricio Cuello, Jaroslav Betka, Luis Felipe Ribeiro Pinto, Maria Paula Curado, Kazem Zendehdel, Lorenzo Richiardi, Maja Popovic, José Roberto de Podesta, Sandra Ventorin von Zeidler, Ricardo Mai Rocha, Shaymaa Alwaheidi, Paul Brennan, Shama Virani, Al Ross, David I Conway
{"title":"Advanced Stage Head and Neck Cancer Diagnosis: HEADSpAcE Consortium Health Systems Benchmarking Survey.","authors":"Grant Creaney, Mariél de Aquino Goulart, Alex McMahon, Claire Paterson, James McCaul, Sandra Perdomo, Laura Mendoza, Laia Alemany, Lidia Maria Rebolho Arantes, Paula Andrea Rodriguez Urrego, Tom Dudding, Mirana Pring, Marta Vilensky, Cecilia Cuffini, Silvia Adriana Lopez de Blanc, José Carlos de Oliveira, Shahid Pervez, Pierre Saintigny, Mauricio Cuello, Jaroslav Betka, Luis Felipe Ribeiro Pinto, Maria Paula Curado, Kazem Zendehdel, Lorenzo Richiardi, Maja Popovic, José Roberto de Podesta, Sandra Ventorin von Zeidler, Ricardo Mai Rocha, Shaymaa Alwaheidi, Paul Brennan, Shama Virani, Al Ross, David I Conway","doi":"10.1002/hed.28094","DOIUrl":"10.1002/hed.28094","url":null,"abstract":"<p><strong>Background: </strong>Globally, most people with head and neck cancers (HNCs) are diagnosed with advanced-stage disease. HNC diagnostic stage has multifactorial explanations, with the role of health system factors not yet fully investigated.</p><p><strong>Methods: </strong>HNC centres (n = 18) from the HEADSpAcE Consortium were surveyed via a bespoke health system questionnaire covering a range of factors. Centres were compared using the least square means for the presence/absence of each health system factor to their proportion of advanced-stage HNC.</p><p><strong>Results: </strong>Health system factors associated with lower proportion in advanced-stage diagnosis were formal referral triaging (14%, 95% CI-0.26, -0.03), routine monitoring of time from referral to diagnosis (16%, 95% CI-0.27, -0.05), and fully publicly funded systems (17%, 95% CI-0.29, -0.06). Several health systems factors had no routinely available data.</p><p><strong>Conclusions: </strong>Through identifying and monitoring health systems factors associated with lower proportions of advanced stage HNC, interventions could be developed, and systems redesigned, to improve early diagnosis.</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":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494948","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}
Nathalia Peres Borges Dos Santos, Izabella Costa Santos, Ana Catarina Alves E Silva, Andressa Silva de Freitas, Fernando Luiz Dias
{"title":"A 13-Year Retrospective Study on Tracheoesophageal Prosthesis Outcomes From a Single Institution.","authors":"Nathalia Peres Borges Dos Santos, Izabella Costa Santos, Ana Catarina Alves E Silva, Andressa Silva de Freitas, Fernando Luiz Dias","doi":"10.1002/hed.28112","DOIUrl":"https://doi.org/10.1002/hed.28112","url":null,"abstract":"<p><strong>Introduction: </strong>Tracheoesophageal voice prosthesis (TEP) is considered the gold standard among vocal rehabilitation methods. The evaluation of the clinical and epidemiological profile of patients rehabilitated with TEP is essential to describe the determining factors of rehabilitation with good functional results.</p><p><strong>Objective: </strong>To describe the population of patients with total laryngectomy rehabilitated with TEP and to identify the variables associated with the outcome of vocal rehabilitation with TEP at the Brazilian National Cancer Institute (BNCI), between 2006 and 2019.</p><p><strong>Method: </strong>Retrospective cohort study of patients with total laryngectomy enrolled in the Head and Neck Surgery Section of BNCI. Secondary data were collected through physical and electronic medical records, located through the database of patients undergoing vocal rehabilitation with TEP at BNCI from 2006 to 2019.</p><p><strong>Results: </strong>A total of 165 patients with total laryngectomy were eligible for vocal rehabilitation with TEP. With 140 (84.8%) patients being male, 112 (67.9%) married and 112 (67.9%) with low education, 127 (77%) smokers and 126 (76.4%) heavy drinkers. Removal of the TEP occurred in 48 (29.1%) patients due to complications or the manifestation of a new tumor. And 157 (95.15%) patients were able to achieve phonation with TEP.</p><p><strong>Conclusion: </strong>Older patients, with more advanced tumors, undergoing salvage laryngectomy or primary placement seem to be more likely to have complications and/or aphonia. Regular follow-up by a multidisciplinary team and consistent speech therapy with periodic assessments of the shunt/tract and voice prosthesis are crucial to preventing major complications and TEP removal.</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":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494916","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}
Chia-Kai Hsu, Fang-Yu Hsu, Hung-Chi Chen, Jian-You Ji, En-Wei Liu
{"title":"Tissue-Plug Modification of Pectoralis Major Myocutaneous Flap for Intractable Pharyngocutaneous Fistula Repair.","authors":"Chia-Kai Hsu, Fang-Yu Hsu, Hung-Chi Chen, Jian-You Ji, En-Wei Liu","doi":"10.1002/hed.28111","DOIUrl":"https://doi.org/10.1002/hed.28111","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility and effectiveness of a novel tissue-plug modification of the pectoralis major myocutaneous flap for repairing intractable pharyngocutaneous fistulas, especially in difficult-to-access defects.</p><p><strong>Materials and methods: </strong>The novel technique involved designing a tissue-plug modification of pectoralis major myocutaneous flap and suspension sutures. Cadaver studies were performed to refine the surgical method before clinical application. This method was applied to five patients. Postoperative outcomes, complications, and follow-up data were analyzed.</p><p><strong>Results: </strong>All five patients underwent successful fistula repair using the tissue-plug method. Healing was achieved without recurrent leakage in four patients, while one required permanent enteral feeding due to preexisting tongue dysfunction. Two patients experienced tracheal strictures, which were resolved with additional interventions. Swallowing function improved, and imaging confirmed fistula resolution.</p><p><strong>Conclusion: </strong>The tissue-plug modification of the pectoralis major myocutaneous flap is a viable and effective approach for managing intractable pharyngocutaneous fistulas, particularly in cases with posterior oropharyngeal defects or prior radiation exposure. Further studies with larger cohorts are needed to validate its long-term efficacy and outcomes.</p><p><strong>Level of evidence: </strong>Level 4.</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":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494952","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}