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

{"title":"Cancer Care Navigation Improves Timeliness of Treatment in Head and Neck Cancer.","authors":"Atif M Islam, Robert B Baldwin, Alec E Dallas, Brandon J Dyer, Alisa Vidwans, Emma Dunn, Chantell Preziosi, Samer T Elsamna, Julia Toman, Tara Mokhtari, Christopher J Nickel, Matthew Mifsud","doi":"10.1002/hed.70513","DOIUrl":"https://doi.org/10.1002/hed.70513","url":null,"abstract":"<p><strong>Background: </strong>Timely access to oncologic care is critical for patients with head and neck cancer (HNC), yet delays in treatment remain widespread. We sought to determine whether implementation of a care navigation program was associated with improved timeliness.</p><p><strong>Methods: </strong>Four hunded and four adult patients who underwent HNC resection with free flap reconstruction were retrospectively reviewed. The primary outcome was time to adjuvant therapy and disease-free survival.</p><p><strong>Results: </strong>Median [IQR] age was 64 [58-73] years and 133 (33%) were women. Significant interval decreases were observed from surgery to initiation of adjuvant radiotherapy (56 [39-83] vs. 45 [31-64] days, p = 0.004). Log-rank testing revealed no difference in disease-free survival between pre- and postprogram cohorts (p = 0.7695).</p><p><strong>Conclusions: </strong>Implementation of a care navigation program was associated with significant reductions in time to treatment. These findings suggest that structured pathways can meaningfully improve oncologic care delivery for HNC patients.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197931","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":"Cutaneous Leiomyosarcoma of the Head and Neck: Appreciation of a More Indolent Biological Behavior and Implications for Its Management.","authors":"Eelco de Bree, Remco de Bree, Carlos Chiesa-Estomba, Orlando Guntinas-Lichius, M P Sreeram, Dimosthenis Michelakis, Karthik N Rao, Alessandra Rinaldo, Alfio Ferlito","doi":"10.1002/hed.70512","DOIUrl":"https://doi.org/10.1002/hed.70512","url":null,"abstract":"<p><strong>Background: </strong>Leiomysosarcoma (LMS) is generally associated with high metastatic potential and poor survival. Cutaneous LMS (cLMS) has been considered a different entity with more indolent biological behavior.</p><p><strong>Methods: </strong>A narrative review was performed to assess the biological behavior of cLMS, with special attention for the head and neck location.</p><p><strong>Results: </strong>cLMS is located in the head and neck in 21%-33%. The local recurrence rate is 2%-18%, while only 3% develops metastatic disease at 10 years. The most important risk factor of recurrent disease is positive/close surgical margins, with a trend for increased risk at the head and neck. The vast majority of recurrences are local and appear during the first few years. No data support adjuvant treatment. The 5-year disease-specific survival is 96%-100%.</p><p><strong>Conclusions: </strong>cLMS exhibits a moderate risk of local recurrence, low metastatic potential, and excellent disease-specific survival. Surveillance may be focused on physical examination and limited in duration.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197890","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":"Stereotactic Body Radiation Therapy for Management of Locally Advanced Periorbital Tumors: Efficacy and Toxicity Profile.","authors":"Oluwatimileyin Ojo, Kamaldeep Gill, Breanna Huang, Bin Gui, Jeff Antone, Shaheer Khan, Craig Devoe, Nagashree Seetharamu, Maged Ghaly","doi":"10.1002/hed.70508","DOIUrl":"https://doi.org/10.1002/hed.70508","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The management of locally advanced periorbital skin tumors with orbital invasion is challenging. Orbital exenteration historically provides reliable local control but causes major functional and cosmetic morbidity. We evaluated stereotactic body radiation therapy (SBRT) as an eye-sparing alternative, focusing on local control, vision preservation, and toxicity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective series includes 26 consecutive patients with locally advanced periorbital tumors treated prospectively with SBRT. Tumors involved the canthi (zones III-IV) in 20 patients, with multi-zone involvement in 18 and complete periorbital skin invasion (zone V) in 4. Eighteen tumors violated the orbital septum; anterior orbital invasion was observed in 16, and middle orbital invasion in 14. Extraconal violation occurred in 16 patients, and intraconal invasion in 15 patients. All patients were presented with intact ipsilateral vision at baseline. SBRT was delivered using VMAT/IMRT with a simultaneous integrated boost of 35-40 Gy to GTV and 25 Gy to CTV + 2 mm over five biweekly fractions. Optic apparatus constraints included Orbit PRV and Optic N PRV maximum point ≤ 30 Gy and mean ≤ 20 Gy; Lacrimal gland mean &lt; 26 Gy when feasible. OAR constraints were based on institutional treatment directives supported by AAPM TG-101, QUANTEC, and Emami et al. 50% received systemic therapy, including immunotherapy, targeted therapy, or chemotherapy, with some receiving combined approaches. Local and regional control and toxicities (CTCAE v5.0) were recorded; statistical analysis was primarily descriptive. Kaplan-Meier methodology was used to estimate local control and overall survival. Given the limited cohort size and heterogeneous tumor histologies, no formal comparative statistical testing was performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty-four patients presented with primary cutaneous tumors and 2 had non-cutaneous histologies (solitary fibrous tumor and metastatic breast carcinoma). SBRT was delivered as definitive therapy in 19 patients and as adjuvant therapy in 7. Median planning target volumes (PTVs) were 45 cc (PTV25) and 9 cc (PTV35-40 Gy), with corresponding median D90 values of 29 and 34/42 Gy, respectively. At a median follow-up of 18 months (range 4-50 months), all patients retained intact vision. Twenty-one patients achieved complete response, one had stable disease, and three experienced locoregional recurrences-one cavernous sinus failure and two local-regional relapses. Acute toxicities were predominantly mild, including Grade 1 dermatitis (n = 15), conjunctivitis (n = 8), diplopia (n = 7), orbital pain (n = 1), and hyperpigmentation (n = 2). Grade 2 dermatitis occurred in 6 patients, while Grade 3 dermatitis was rare (n = 2), both requiring reconstructive grafting. On follow-up, late effects included blurred vision (n = 6), epiphora (n = 3), orbital pain (n = 2), and cataract progression (n = 2), with isolat","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186257","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":"Glypican-1-Targeted Antibody-Drug Conjugate Exhibits Antitumor Effects Against Oral Squamous Cell Carcinoma.","authors":"Kengo Obata, Satoshi Serada, Yuji Suzuki, Kodai Tuchida, Jun Miyaguchi, Eiji Funajima, Hiroyuki Yamada, Tetsuji Naka","doi":"10.1002/hed.70514","DOIUrl":"https://doi.org/10.1002/hed.70514","url":null,"abstract":"<p><strong>Background: </strong>Oral squamous cell carcinoma (OSCC) is a major health concern with limited therapeutic options. Glypican-1 (GPC1), a heparan sulphate proteoglycan, has been implicated in several malignancies; however, its therapeutic role in OSCC remains elusive. This study investigated the potential of a novel glypican-1 antibody-drug conjugate (GPC1-ADC) conjugated with monomethyl auristatin E as a therapeutic strategy for OSCC.</p><p><strong>Methods: </strong>GPC1 expression in OSCC tissues was examined by immunohistochemistry using tissue microarrays and by western blotting in OSCC cell lines. The cytotoxicity of GPC1-ADC was assessed using in vitro viability assays, and its effects on the cell cycle and apoptosis were analyzed using flow cytometry and caspase-3/7 activity assays. In vivo antitumor efficacy was evaluated using OSCC cell line-derived and patient-derived xenograft (PDX) mouse models.</p><p><strong>Results: </strong>High GPC1 expression was observed in 78% (39/50) of OSCC cases, whereas normal oral tissues showed no detectable expression. Western blotting confirmed GPC1 protein expression in all the OSCC cell lines tested. GPC1-ADC markedly reduced cell viability in a dose-dependent manner (IC5₅₀ = 0.053-0.117 nM), induced G2/M-phase arrest, and activated caspase-3/7, indicating apoptosis. In vivo, high-dose GPC1-ADC markedly inhibited tumor growth in both xenograft and PDX models compared with control treatments, without causing weight loss.</p><p><strong>Conclusion: </strong>GPC1-ADC demonstrated potent and specific antitumor activity against GPC1-expressing OSCC in vitro and in vivo. These findings suggest that GPC1-ADC is a promising therapeutic candidate for OSCC and may provide a basis for new treatment strategies; however, further preclinical and clinical evaluation is warranted.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186138","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":"Impact of Surgical Airways on Location of Death, Healthcare Utilization, and Costs Among Patients With Head and Neck Cancer: A Population-Based Study.","authors":"A Travis Pickett, Colleen Webber, Michael Pugliese, Katie Dover, Angelina Tohme, Stephanie Johnson-Obaseki, Peter Tanuseputro","doi":"10.1002/hed.70479","DOIUrl":"https://doi.org/10.1002/hed.70479","url":null,"abstract":"<p><strong>Background: </strong>Patients with surgical airways experience barriers to high quality end-of-life (EOL) care. Recognizing differences in healthcare utilization and location of death among patients with surgical airways may inform improvements in EOL care delivery. This study aimed to compare location of death and selected aspects of healthcare in the last 90 days of life between head and neck cancer (HNC) patients with and without a surgical airway.</p><p><strong>Methods: </strong>Retrospective decedent cohort study of health administrative data from the Institute of Clinical Evaluative Sciences in Ontario, Canada of individuals with HNC who died between January 1, 2008, and December 31, 2018. The exposure group included those with a total laryngectomy any time prior to death or emergency tracheostomy within 90 days prior to death. Primary outcomes included location of death and length of stay in hospital, palliative care encounters, and burdensome transitions of care in the last 90 days of life. Secondary outcomes included healthcare costs during the last 90 days of life.</p><p><strong>Results: </strong>Patients with surgical airways (n = 1280, 7.8%) were more likely to die in a subacute care center (OR = 1.51 [95% CI: 1.26-1.81], p < 0.001) than those without surgical airways. There were no significant differences between the groups for deaths occurring in acute care (OR = 1.11 [95% CI: 0.97-1.27], p = 0.14) or long-term care settings (OR = 0.85 [95% CI: 0.62-1.16], p = 0.30). In the last 90 days of life, they spent more time in acute care hospitals (6.37 days [95% CI: 5.40-7.39], p < 0.001), had higher odds of experiencing burdensome transitions (OR = 1.46 [95% CI: 1.29-1.67], p < 0.001) and had greater costs associated with their care (mean cost ratio = 1.43 [95% CI: 1.36-1.51], p < 0.001). However, after adjusting for covariates, there was no statistically significant difference in palliative care involvement between patients with and without surgical airways (OR = 1.14 [95% CI: 0.98-1.31], p = 0.09).</p><p><strong>Conclusions: </strong>Patients with surgical airways were more likely to die in subacute care centers and experienced increased healthcare utilization, including longer hospital stays, higher rates of burdensome transitions, and greater costs in the last 90 days of life. There was no statistically significant difference in palliative care involvement between groups after adjustment. These findings should be interpreted with caution, as adjustment for disease stage and tumor site was not possible due to missing data. Further research is needed to better understand the underlying drivers of these differences and their implications for EOL care.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186231","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":"Depth of Invasion as a Predictor of Contralateral Nodal Metastasis in Lateralized Oral Tongue Squamous Cell Carcinomas.","authors":"Jake Sims, Abdurrahman Abdurrob, Jun Jin, Wamidh L AlKhoory, Khalid Shittu, Steven Chang, Samantha H Tam, Rushil R Dang","doi":"10.1002/hed.70506","DOIUrl":"https://doi.org/10.1002/hed.70506","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the impact of depth of invasion (DOI) on risk of contralateral neck nodal disease (CND) in lateralized oral tongue squamous cell carcinoma (SCC).</p><p><strong>Methods: </strong>Retrospective review was conducted using a tertiary care institutional database from 1998 to 2021. Patients with lateralized oral tongue SCC who underwent surgical resection were included and evaluated for CND in both primary and recurrent settings.</p><p><strong>Results: </strong>A total of 103 patients underwent 104 surgical procedures. Recurrence was observed in 30 patients (28.8%), and CND occurred in 20 patients (19.2%). Multivariate analysis identified a DOI threshold of 9 mm as the earliest point of statistical significance. Patients with DOI ≥ 9 mm demonstrated approximately 6.5-fold higher adjusted odds of contralateral nodal disease (95% CI 1.5-27.4, p-value = 0.011).</p><p><strong>Conclusion: </strong>In this institutional cohort, increasing DOI was significantly associated with a higher risk of contralateral nodal disease.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186140","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":"Long-Term Oncologic Outcomes in Patients Undergoing Orbital Exenteration for Advanced Head and Neck Cutaneous Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.","authors":"Tanisha M Patel, Srivatsa Surya Vasudevan, Cherie-Ann O Nathan","doi":"10.1002/hed.70517","DOIUrl":"https://doi.org/10.1002/hed.70517","url":null,"abstract":"<p><strong>Background: </strong>Treatment of head and neck cutaneous squamous cell carcinoma (HNcSCC) with orbital invasion is challenging due to its aggressive local behavior and the limited effectiveness of eye-sparing options in advanced disease. This systematic review and meta-analysis aimed to evaluate the prognostic outcomes in advanced HNcSCC patients undergoing orbital exenteration (OE).</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and ScienceDirect were searched from inception to April 30, 2026, for studies reporting survival, tumor control, and complication outcomes in patients with advanced HNcSCC undergoing OE. Pooled estimates were calculated using a random-effects model, with further sensitivity analysis and meta-regression analysis.</p><p><strong>Results: </strong>Ten studies comprising 217 patients were analyzed. Most patients were male (83%); median age was 66.3 years. The pooled 2-year overall survival was 73.7% (95% CI, 63.4%-81.9%) and 5-year overall survival 70.8% (95% CI, 56.0%-82.2%). Pooled 2-year and 5-year disease-free survival were 66.1% (95% CI, 42.2%-83.9%) and 51.6% (95% CI, 37.8%-65.2%). Pooled local and regional recurrence were 23.7% (95% CI, 14.0%-37.1%) and 14.0% (95% CI, 3.9%-39.2%), and the pooled complication rate 39.2% (95% CI, 24.1%-56.7%). In meta-regression, the proportion of margin-positive resections was the only covariate associated with local recurrence (β = 0.076 per percentage point; 95% CI, 0.027 to 0.124; p = 0.015; R² = 100%); no demographic factor was associated with any outcome.</p><p><strong>Conclusions: </strong>Patients undergoing OE for advanced HNcSCC had moderate survival and locoregional control with substantial morbidity. Evidence directly comparing OE with orbit-preserving approaches remains sparse, and high-quality comparative studies are needed to define the role of eye-sparing strategies in this high-risk population, particularly in the era of neoadjuvant immunotherapy.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186220","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":"Mitochondrially Encoded Cytochrome C Oxidase 1, a Hypoxia- and Lactylation-Related Gene, Acts as a Tumor Suppressor and Therapeutic Target in Oral Squamous Cell Carcinoma.","authors":"Yuan-Dong Zuo, Si-Da Dong, Jian-Hao Li, Ji-Chen Li","doi":"10.1002/hed.70475","DOIUrl":"https://doi.org/10.1002/hed.70475","url":null,"abstract":"<p><strong>Background: </strong>Aberrant expression of mitochondrially encoded Cytochrome c Oxidase Subunit 1 (MT-CO1) has increasingly been associated with tumor invasiveness and adverse clinical outcomes across multiple malignancies. However, its functional role and regulatory mechanisms in oral squamous cell carcinoma (OSCC) remain poorly understood.</p><p><strong>Methods: </strong>Transcriptomic data from The Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO) were integrated to identify genes consistently dysregulated across datasets. Candidate prognostic genes were subsequently prioritized using Cox proportional hazards regression in combination with least absolute shrinkage and selection operator (LASSO) regression. A multi-omics validation framework was then applied, encompassing analysis of MT-CO1 expression in OSCC, protein-level validation using the Human Protein Atlas, and evaluation of associations with clinicopathological characteristics. The functional effects of MT-CO1 were evaluated in OSCC cell lines using gain-of-function assays. To assess the feasibility of pharmacologically targeting MT-CO1, molecular docking and subsequent molecular dynamics simulations were performed to characterize the interaction between amorolfine and MT-CO1; mechanistic rescue experiments were then conducted to determine whether the drug's effects were MT-CO1-dependent.</p><p><strong>Results: </strong>MT-CO1 was associated with hypoxia and lactylation and was downregulated in OSCC, with lower expression correlating with poorer survival. MT-CO1 overexpression reduced cell viability, proliferation, and invasion while enhancing apoptotic signaling in vitro. Computational analyses further predicted a stable, high-affinity interaction between amorolfine and MT-CO1. Importantly, MT-CO1 suppression attenuated the antineoplastic effects of amorolfine in OSCC cells, supporting an MT-CO1-dependent mechanism of action.</p><p><strong>Conclusions: </strong>MT-CO1 as an underappreciated tumor-suppressive factor in OSCC and support further evaluation of amorolfine for therapeutic repurposing. MT-CO1 may serve as a biomarker of treatment response and that the MT-CO1-amorolfine axis may represent an actionable therapeutic vulnerability in OSCC.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186260","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":"Effects of Isthmus-Sparing Lobectomy on Thyroid Function: A Prospective, Multicenter, Comparative Study.","authors":"Wan Wook Kim, Yeong San Jeon, Jihyoung Cho, Jun Ho Lee, Hyun Jo Youn, Su Hwan Kang, Jung Eun Choi, Young Ju Jeong, Dongsik Bae, Moo Hyun Lee, Jee Soo Kim","doi":"10.1002/hed.70510","DOIUrl":"https://doi.org/10.1002/hed.70510","url":null,"abstract":"<p><strong>Background: </strong>This prospective study evaluated the impact of isthmus management (isthmus-sparing vs. isthmus-removing lobectomy) on postoperative hypothyroidism risk.</p><p><strong>Methods: </strong>Between January 2022 and March 2023, 326 euthyroid patients with benign or low-risk papillary thyroid cancer were randomized into the isthmus-sparing (IS, n = 164) or isthmus-removing (IR, n = 162) group. Administration of levothyroxine was limited to patients with overt hypothyroidism or symptomatic subclinical hypothyroidism.</p><p><strong>Results: </strong>TSH levels were significantly lower in the IS group at 3, 6, 12, and 18 months ( <math><mrow><mi>p</mi> <mo><</mo> <mn>0.05</mn></mrow> </math> ). Euthyroidism maintenance was higher in the IS group (62.2% vs. 38.9%, <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.001</mn></mrow> </math> ). The IS group showed lower subclinical hypothyroidism (33.8% vs. 54.9%, <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.001</mn></mrow> </math> ) and hormone replacement rates (8.5% vs. 25.3%, <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.001</mn></mrow> </math> ). Overt hypothyroidism was lower in the IS group without statistical significance (6.1% vs. 12.3%, <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.057</mn></mrow> </math> ).</p><p><strong>Conclusion: </strong>Isthmus-sparing lobectomy better preserves thyroid function and reduces postoperative subclinical hypothyroidism and hormone replacement needs compared to isthmus-removing lobectomy.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168983","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":"Probe-Based Near-Infrared Autofluorescence for Parathyroid Identification During Thyroid Surgery: Clinical Outcomes, Surgeon Confidence, and Autofluorescence Thresholds.","authors":"Anthony Y Cheung, Bo Wang, Yoshiyuki Saito, Marika D Russell, Justin M Soffer, Okenwa C Okose, Lily N Trinh, Adithya Srikanthan, Farhad Salem, Anthea Sistovaris, Prachya Maneeprasopchoke, Elias Zavaro, Taylor Brown, Dioan McIlroy-Evans, Ian J Behr, Selen Soylu Yaliman, Lucy J Xu, Shayan Olumi, Amanda Silver Karcioglu, Katherine Larrabee, Isaac Wasserman, Dipti Kamani, Peter M Sadow, William C Faquin, Cheerasook Chongkolwatana, Frédéric Triponez, Neil Tolley, Marcin Barczynski, Ron Kuppersmith, Jeremy Freeman, Amr H Abdelhamid Ahmed, Gregory W Randolph","doi":"10.1002/hed.70503","DOIUrl":"https://doi.org/10.1002/hed.70503","url":null,"abstract":"<p><strong>Background: </strong>We evaluated experience with probe-based near-infrared autofluorescence (NIRAF) system (PTeye) in parathyroid gland (PTG) identification during total thyroidectomy.</p><p><strong>Methods: </strong>In this retrospective study, patients undergoing total thyroidectomy using PTeye (2020-2022; n = 84) were compared with a historical visual-identification cohort (2018-2019; n = 103).</p><p><strong>Results: </strong>PTG identification rates were comparable, although 42% of PTGs detected with PTeye were initially visualized with low or moderate confidence. Significantly fewer patients in the PTeye cohort had PTGs incidentally identified on histology (4.8% vs. 16.5%, p = 0.018), but there was no difference in the incidence of autotransplanted PTGs or total inadvertent parathyroidectomy. Postoperative calcium was higher with PTeye (median 9.2 vs. 9.0 mg/dL, p < 0.001). Postoperative PTH, transient, and permanent hypoparathyroidism did not differ. An autofluorescence ratio cutoff of 2.5 improved specificity compared with the manufacturer-recommended cutoff of 1.2.</p><p><strong>Conclusions: </strong>PTeye provides adjunctive confirmation of suspected parathyroid tissue, including glands initially identified with low or moderate visual confidence.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172084","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}