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

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Camera-based near-infrared autofluorescence versus visual identification in total thyroidectomy for parathyroid function preservation: Systematic review and meta-analysis of randomized clinical trials. 在保留甲状旁腺功能的全甲状腺切除术中,基于相机的近红外自动荧光与肉眼识别:随机临床试验的系统回顾和荟萃分析。
IF 2.3 3区 医学
Luca Canali, Marika D Russell, Anthea Sistovaris, Amr H Abdelhamid Ahmed, Michael Otremba, Hien T Tierney, Frédéric Triponez, Fares Benmiloud, Giuseppe Spriano, Giuseppe Mercante, Gregory W Randolph
{"title":"Camera-based near-infrared autofluorescence versus visual identification in total thyroidectomy for parathyroid function preservation: Systematic review and meta-analysis of randomized clinical trials.","authors":"Luca Canali, Marika D Russell, Anthea Sistovaris, Amr H Abdelhamid Ahmed, Michael Otremba, Hien T Tierney, Frédéric Triponez, Fares Benmiloud, Giuseppe Spriano, Giuseppe Mercante, Gregory W Randolph","doi":"10.1002/hed.27900","DOIUrl":"https://doi.org/10.1002/hed.27900","url":null,"abstract":"<p><strong>Background: </strong>Hypocalcemia is the most common postoperative complication of total thyroidectomy. Near-infrared autofluorescence (NIRAF) technology is a surgical adjunct that has been increasingly utilized with the aim of preventing postoperative hypocalcemia, but its clinical benefits have not yet been firmly established. The aim of this study was to assess the clinical benefit of utilizing NIRAF technology in patients undergoing total thyroidectomy.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized clinical trials was performed according to PRISMA guidelines.</p><p><strong>Results: </strong>Seven randomized clinical trials with 1437 patients (318 males, 22.13%) undergoing total thyroidectomy were included for analysis. Risk of postoperative hypocalcemia was reduced in the NIRAF arm (RR, 0.65; 95%CI, 0.50-0.84). Use of NIRAF was also associated with a reduction in the risk of permanent parathyroid dysfunction (RR, 0.46; 95%CI, 0.22-0.95) and inadvertent parathyroid gland resection (RR, 0.40; 95%CI, 0.26-0.60).</p><p><strong>Conclusions: </strong>We present a systematic review and meta-analysis of randomized clinical trials examining the impact of NIRAF technology on preservation of parathyroid function. Our results suggest that use of camera-based NIRAF technology reduces the risk of postoperative hypocalcemia, permanent parathyroid dysfunction, and inadvertent parathyroid gland resection.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894917","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}
引用次数: 0
Sequelae of carotid endarterectomy patch infection: An otolaryngologist perspective 颈动脉内膜切除术补片感染的后遗症:耳鼻喉科医生的视角。
IF 2.3 3区 医学
Bailey Balouch MD, Aakanksha Gupta MD, Bruce Tjaden MD, Joseph V. Lombardi MD, Jeffrey P. Carpenter MD, Nadir Ahmad MD, FACS, Yekaterina Shapiro MD
{"title":"Sequelae of carotid endarterectomy patch infection: An otolaryngologist perspective","authors":"Bailey Balouch MD,&nbsp;Aakanksha Gupta MD,&nbsp;Bruce Tjaden MD,&nbsp;Joseph V. Lombardi MD,&nbsp;Jeffrey P. Carpenter MD,&nbsp;Nadir Ahmad MD, FACS,&nbsp;Yekaterina Shapiro MD","doi":"10.1002/hed.27909","DOIUrl":"10.1002/hed.27909","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Postoperative carotid endarterectomy (CEA) patch infection is a rare but well-recognized complication of CEA. It is important for otolaryngologists to be aware of the presentation and challenges in its diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who presented with a neck mass or hemorrhage and a known prior history of carotid endarterectomy with synthetic patch reconstruction were worked up with ultrasound, CT, or MRI imaging. In one case, fine needle aspiration biopsy was performed. Ultimately, all patients were taken to the operating room for neck exploration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the three patients presented in this case series, two presented with a chronic neck mass, two-to-three years after carotid endarterectomy. One patient presented acutely with hemorrhage from the carotid endarterectomy site. Carotid patch infection was diagnosed after neck exploration in all cases. Vascular surgery was consulted intra-operatively to perform definitive vascular repair.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Infected carotid patch should be suspected in patients with a history of prior CEA, as many of the presenting complaints may resemble or mimic pathology managed by otolaryngology. The onset of symptoms can be perioperative or very delayed. A multidisciplinary approach with vascular surgery and infectious disease is required for appropriate management of these patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hed.27909","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879859","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}
引用次数: 0
Preoperative ultrasonography parathyroid gland mapping can improve identification of normal parathyroid gland during thyroidectomy: A propensity score-matched case-control study. 术前超声甲状旁腺造影可提高甲状腺切除术中正常甲状旁腺的识别率:倾向评分匹配病例对照研究
IF 2.3 3区 医学
Kwang Hyun Yoon, Jong Cheol Lee, Yong Jin Song, Won Jun Kim, Myoung Sook Shim, Ha Young Kim, Jin Yub Kim, Byeong-Joo Noh, Dong Gyu Na
{"title":"Preoperative ultrasonography parathyroid gland mapping can improve identification of normal parathyroid gland during thyroidectomy: A propensity score-matched case-control study.","authors":"Kwang Hyun Yoon, Jong Cheol Lee, Yong Jin Song, Won Jun Kim, Myoung Sook Shim, Ha Young Kim, Jin Yub Kim, Byeong-Joo Noh, Dong Gyu Na","doi":"10.1002/hed.27905","DOIUrl":"https://doi.org/10.1002/hed.27905","url":null,"abstract":"<p><strong>Background: </strong>Accurate intraoperative identification of normal parathyroid glands (PTGs) is vital to avoid hypocalcemia post total thyroidectomy. Although ultrasonography (US) has been shown to identify normal PTGs, the significance of preoperative US PTG mapping in this context is not well studied. This study evaluated the impact of preoperative US PTG mapping on intraoperative identification of normal PTGs during total thyroidectomy.</p><p><strong>Methods: </strong>The study involved 161 consecutive patients who underwent total thyroidectomy between January 2020 and June 2022. These included patients without preoperative US PTG mapping (group 1, n = 91) and those with the mapping (group 2, n = 70). Propensity score matching yielded 61 matched patients from each group. We developed a preoperative US PTG mapping technique combining US identification of normal PTGs with their localization on thyroid CT images. The intraoperative detectability of normal PTGs during thyroid surgery and detectability of normal PTGs by the preoperative US mapping were assessed by the number of PTGs identified per patient and by location.</p><p><strong>Results: </strong>In the matched cohort, group 2 demonstrated a higher median number of identified PTGs (3 vs. 2, p = 0.011), a greater proportion of patients with three or more identified PTGs (65.5% vs. 44.3%, p = 0.018), and a higher ratio of identified to expected PTGs (70.5% vs. 60.2%, p = 0.011) than group 1. In group 2, the median number of normal PTGs identified preoperatively was 3, with at least one identified in 95.7% of patients, two or more in 84.3%, three or more in 52.9%, and four or five in 24.3%.</p><p><strong>Conclusions: </strong>Preoperative US PTG mapping identified two or more normal PTGs in the majority of adult patients undergoing total thyroidectomy. Those with preoperative mapping showed a higher number of intraoperatively identified normal PTGs, including inferior PTGs, compared to those without. This technique appears to enhance the intraoperative identification of normal PTGs, thereby potentially improving surgical outcomes in total thyroidectomy.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876761","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}
引用次数: 0
The association between skeletal muscle mass and sensorineural hearing loss upon cisplatin-based chemoradiotherapy in patients with head and neck squamous cell carcinoma. 头颈部鳞状细胞癌患者接受顺铂化放疗时骨骼肌质量与感音神经性听力损失之间的关系。
IF 2.3 3区 医学
Anouk W M A Schaeffers, Anouk V M Burger, Charlotte W Duinkerken, Klaske E van Sluis, Jan Paul de Boer, Lisette van der Molen, Alex E Hoetink, Abrahim Al-Mamgani, Katarzyna Jóźwiak, Lot A Devriese, Remco de Bree, Charlotte L Zuur
{"title":"The association between skeletal muscle mass and sensorineural hearing loss upon cisplatin-based chemoradiotherapy in patients with head and neck squamous cell carcinoma.","authors":"Anouk W M A Schaeffers, Anouk V M Burger, Charlotte W Duinkerken, Klaske E van Sluis, Jan Paul de Boer, Lisette van der Molen, Alex E Hoetink, Abrahim Al-Mamgani, Katarzyna Jóźwiak, Lot A Devriese, Remco de Bree, Charlotte L Zuur","doi":"10.1002/hed.27907","DOIUrl":"https://doi.org/10.1002/hed.27907","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with head and neck squamous cell carcinoma (HNSCC) treated with cisplatin-based chemoradiotherapy (CRT) frequently experience irreversible sensorineural hearing loss (SNHL). Patients with low lumbar skeletal muscle index (LSMI) may experience higher serum peak dosages of cisplatin. This study investigated whether pre-treatment low LSMI is associated with increased SNHL upon cisplatin-based CRT.</p><p><strong>Materials and methods: </strong>LSMI was assessed using routine pre-treatment CT scans. Pure tone audiometry was performed at baseline and at follow-up to assess treatment-related SNHL. Linear mixed models were used to reveal a potential association between the continuous variable LSMI and SNHL.</p><p><strong>Results: </strong>This retrospective cohort study included 81 patients and found a significant association between low LSMI and increased treatment-related SNHL at pure tone frequencies vital for the perception of speech (averaged of 1, 2, and 4 kHz) (p = 0.048).</p><p><strong>Conclusions: </strong>HNSCC patients with low LSMI suffer increased treatment-related SNHL upon cisplatin-based CRT.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879860","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}
引用次数: 0
Radiologic findings of occult nodal metastasis during clinically-N0 salvage total laryngectomy. 临床为 N0 的全喉切除术中隐匿性结节转移的放射学发现。
IF 2.3 3区 医学
Tyler G Chan, Jaime Wicks, Ila Sethi, Jennifer Becker, David Brandon, Nicole C Schmitt, Azeem Kaka, Brian Boyce, Harry Michael Baddour, Mark W El-Deiry, Mihir R Patel, Jennifer H Gross
{"title":"Radiologic findings of occult nodal metastasis during clinically-N0 salvage total laryngectomy.","authors":"Tyler G Chan, Jaime Wicks, Ila Sethi, Jennifer Becker, David Brandon, Nicole C Schmitt, Azeem Kaka, Brian Boyce, Harry Michael Baddour, Mark W El-Deiry, Mihir R Patel, Jennifer H Gross","doi":"10.1002/hed.27889","DOIUrl":"https://doi.org/10.1002/hed.27889","url":null,"abstract":"<p><strong>Introduction: </strong>Occult nodal disease (OND) during clinically-N0 salvage total laryngectomy (TL) can be detected with the Neck-Imaging-Reporting-and-Data-Systems (NI-RADS). However, some patients will still have OND revealed on final pathology.</p><p><strong>Methods: </strong>A retrospective study on all patients who had OND during salvage TL with elective neck dissection (END) between 2009 and 2021 was performed. Repeat CT and PET scan interpretation was performed to evaluate their preoperative imaging for suspicious features.</p><p><strong>Results: </strong>Among 81 salvage TL patients undergoing END, 12 (16%) had OND and a total of 26 occult nodes were identified. On pathology, the average node length [SD] was 0.6 cm [0.3]. On CT, 31% (8 of 26) had rounded morphology. On PET, most had SUV<sub>max</sub> below blood pool. One patient scored NI-RADS 2; the rest scored 1.</p><p><strong>Conclusions: </strong>On re-review of preoperative imaging, occult nodes were subtle and challenging to identify. Despite no clear impact on survival, performing an END may provide prognostic information.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876763","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}
引用次数: 0
Neoadjuvant chemotherapy followed by transoral robotic surgery versus upfront surgery for locoregionally advanced oropharyngeal carcinoma: A propensity score matched analysis. 局部晚期口咽癌的新辅助化疗后经口腔机器人手术与前期手术:倾向评分匹配分析。
IF 2.3 3区 医学
Claudio Sampieri, Eleonora Cioccoloni, Andrea Costantino, Dahee Kim, Kyuin Lee, Giuseppe Meccariello, Giovanni Cammaroto, Claudio Vicini, Se-Heon Kim
{"title":"Neoadjuvant chemotherapy followed by transoral robotic surgery versus upfront surgery for locoregionally advanced oropharyngeal carcinoma: A propensity score matched analysis.","authors":"Claudio Sampieri, Eleonora Cioccoloni, Andrea Costantino, Dahee Kim, Kyuin Lee, Giuseppe Meccariello, Giovanni Cammaroto, Claudio Vicini, Se-Heon Kim","doi":"10.1002/hed.27904","DOIUrl":"https://doi.org/10.1002/hed.27904","url":null,"abstract":"<p><strong>Background: </strong>Transoral robotic surgery (TORS) performed after neoadjuvant chemotherapy (NAC) is a promising treatment for advanced-stage oropharyngeal carcinoma (OPSCC) able to reduce the adjuvant therapy administration rate.</p><p><strong>Methods: </strong>A retrospective bi-centric study was conducted to analyze NAC + TORS versus upfront TORS patients. A 1:1 propensity score matching was used to compare the two groups.</p><p><strong>Results: </strong>Among the 300 patients with stage III-IV OPSCC, 204 patients were matched for comparing NAC + TORS versus upfront TORS. Between the two groups, no significant difference was observed in recurrences and in survival for RFS, OS, and DSS. In the NAC + TORS p16-positive population, adjuvant therapy could be spared in 51% versus 16% in the upfront surgery cohort (p < 0.001) due to the lower frequency of pathological risk factors after NAC.</p><p><strong>Conclusions: </strong>NAC followed by TORS for locoregionally advanced OPSCC demonstrated to achieve non-inferior survival outcomes to upfront surgery, while in the p16-positive population allowed to significantly spare adjuvant therapy.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861730","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}
引用次数: 0
Preventing radiation-induced dysphagia and trismus in head and neck cancer-A randomized controlled trial. 预防头颈部癌症患者因辐射引起的吞咽困难和咀嚼障碍--随机对照试验。
IF 2.3 3区 医学
Kerstin Petersson, Caterina Finizia, Nina Pauli, Lisa Tuomi
{"title":"Preventing radiation-induced dysphagia and trismus in head and neck cancer-A randomized controlled trial.","authors":"Kerstin Petersson, Caterina Finizia, Nina Pauli, Lisa Tuomi","doi":"10.1002/hed.27886","DOIUrl":"https://doi.org/10.1002/hed.27886","url":null,"abstract":"<p><strong>Background: </strong>Radiation-induced dysphagia and restricted mouth opening are common problems among patients with head and neck cancer. The aim of the present randomized controlled trial was to determine if an exercise protocol could prevent swallowing and mouth opening impairment.</p><p><strong>Methods: </strong>Eighty-nine participants were randomly assigned to either an active group performing preventive swallowing and mouth opening exercises (n = 45) or to a control group (n = 44). Outcome measures were collected at baseline before radiotherapy and approximately 1-month post-treatment. Primary endpoints were changes in swallowing function according to the Penetration Aspiration Scale and mouth opening ability measured in millimeters. Intention-to-treat analysis was used.</p><p><strong>Results: </strong>Swallowing function and mouth opening deteriorated in both groups, with no statistically significant positive effect of the protocol detected at follow-up. Among patients who completed >75% of exercises, there was a trend toward better outcomes.</p><p><strong>Conclusions: </strong>Preventive exercises did not improve short-term swallowing function and mouth opening after radiotherapy.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876762","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}
引用次数: 0
The role of radiotherapy in the treatment of sinonasal undifferentiated carcinoma: A population-based analysis. 放射治疗在鼻窦未分化癌治疗中的作用:基于人群的分析。
IF 2.3 3区 医学
Xin Zhao, Ziqi Pei, Xiang Song, Gang Jin
{"title":"The role of radiotherapy in the treatment of sinonasal undifferentiated carcinoma: A population-based analysis.","authors":"Xin Zhao, Ziqi Pei, Xiang Song, Gang Jin","doi":"10.1002/hed.27862","DOIUrl":"https://doi.org/10.1002/hed.27862","url":null,"abstract":"<p><strong>Background: </strong>Sinonasal undifferentiated carcinoma (SNUC) is a rare, aggressive disease with ambiguous management and poor prognosis. This study aimed to evaluate the role of radiation therapy (RT) and explore the optimal treatment sequence.</p><p><strong>Methods: </strong>Retrospective analysis of survival trends of 410 SNUC patients between 1973 and 2015.</p><p><strong>Results: </strong>The 5-year cancer-specific survival (CSS) rate (45.1%) and overall survival (OS) rates (38.1%) were reported in the 84-month median follow-up. Radiotherapy was a prognosticator for improving CSS (hazard ratio [HR] = 0.425, 95% confidence interval [CI]: 0.299-0.603, p = 0.000) and OS (HR = 0.415, 95% CI: 0.303-0.570, p = 0.000), either with surgery (p = 0.000) or without surgery (p = 0.000). However, in a combined therapy of surgery and RT, preoperative and postoperative RT (5-year OS rates were 47.1% and 45.6%, respectively, p = 0.486) were not significantly different.</p><p><strong>Conclusions: </strong>Radiotherapy plays a key role in improving SNUC survival rates. No significant difference in survival rates was observed in preoperative and postoperative RT treatment.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861731","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}
引用次数: 0
Surgical outcomes of profunda artery perforator flap in head and neck reconstruction: A systematic review and meta-analysis. 头颈部重建中深动脉穿孔器皮瓣的手术效果:系统回顾和荟萃分析。
IF 2.3 3区 医学
Filippo Marchi, Andrea Iandelli, Gian Marco Pace, Elisa Bellini, Alessandro Tirrito, Andrea Costantino, Luca Cerri, Antonio Greco, Antonella Polimeni, Giampiero Parrinello, Giorgio Peretti, Armando De Virgilio
{"title":"Surgical outcomes of profunda artery perforator flap in head and neck reconstruction: A systematic review and meta-analysis.","authors":"Filippo Marchi, Andrea Iandelli, Gian Marco Pace, Elisa Bellini, Alessandro Tirrito, Andrea Costantino, Luca Cerri, Antonio Greco, Antonella Polimeni, Giampiero Parrinello, Giorgio Peretti, Armando De Virgilio","doi":"10.1002/hed.27891","DOIUrl":"https://doi.org/10.1002/hed.27891","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the efficacy of the profunda artery perforator (PAP) flap in head and neck reconstruction.</p><p><strong>Methods: </strong>A single arm meta-analysis was performed for flap survival rate (primary outcome), reoperation for major complication, and overall complication rates (secondary outcomes).</p><p><strong>Results: </strong>The search strategy yielded a total of 295 potentially relevant publications, of which 13 were included. A total of 305 patients (males: 80.8%, n = 232/281), with a median age of 56.1 years (n = 305/305; 95% CI 53.9-63), who underwent a total of 307 PAP flap reconstructions for head and neck defects were included. Flap survival rate was 100% (n = 306/307; 95% CI 99.6%-100%), with a reoperation rate for major complications of 3.7% (n = 15/307; 95% CI 1.85%-6.1%) and an overall complication rate of 26.5% (n = 92/307; 95% CI 15.7%-38.9%). Notable postoperative complications included wound dehiscence (n = 15/307, 4.9%), delayed healing (n = 14/307, 4.6%), and wound infection (n = 12/307, 3.9%). Partial flap necrosis and hematoma occurred in 2.6% of cases (n = 8/307), while arterial and venous thrombosis were documented in 0.7% (n = 2/307) and 1.3%, respectively (n = 4/307).</p><p><strong>Conclusion: </strong>The application of the PAP flap in head and neck reconstructions showed several favorable aspects, such as an exceptionally low flap failure rate, versatility in achieving variable dimensions, and a relatively low incidence of complications. PAP flap might be considered as a compelling alternative to the traditionally employed soft tissue free flaps in head and neck reconstruction.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857170","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}
引用次数: 0
Machine learning-derived prognostic signature for progression-free survival in non-metastatic nasopharyngeal carcinoma. 非转移性鼻咽癌无进展生存期的机器学习预后特征。
IF 2.3 3区 医学
Zhichao Zuo, Jie Ma, Mi Yan, Wu Ge, Ting Yao, Lu Zhou, Ying Zeng, Yang Liu
{"title":"Machine learning-derived prognostic signature for progression-free survival in non-metastatic nasopharyngeal carcinoma.","authors":"Zhichao Zuo, Jie Ma, Mi Yan, Wu Ge, Ting Yao, Lu Zhou, Ying Zeng, Yang Liu","doi":"10.1002/hed.27895","DOIUrl":"https://doi.org/10.1002/hed.27895","url":null,"abstract":"<p><strong>Background: </strong>Early detection of high-risk nasopharyngeal carcinoma (NPC) recurrence is essential. We created a machine learning-derived prognostic signature (MLDPS) by combining three machine learning (ML) models to predict progression-free survival (PFS) in patients with non-metastatic NPC.</p><p><strong>Methods: </strong>A cohort of 653 patients with non-metastatic NPC was divided into a training (n = 457) and validation (n = 196) dataset (7:3 ratio). The study included clinicopathological characteristics, hematologic markers, and MRI findings in three machine learning models-random forest (RF), extreme gradient boosting (XGBoost), and least absolute shrinkage and selection operator (LASSO)-to predict progression-free survival (PFS). A Venn diagram identified the overlapping signatures from the three ML algorithms. Cox proportional hazard analysis determined the MLDPS for PFS.</p><p><strong>Results: </strong>The RF, XGBoost, and LASSO algorithms identified six consensus factors from the 33 signatures. Cox proportional hazards analysis showed that the MLDPS includes age, lymphocyte count, number of positive lymph nodes, and regional lymph node density. Additionally, MLDPS effectively stratified prognosis, with low-risk individuals showing better PFS than high-risk individuals (p < 0.001).</p><p><strong>Conclusion: </strong>MLDPS, based on clinicopathological characteristics, hematologic markers, and MRI findings, is crucial for guiding clinical management and personalizing treatments for patients with non-metastatic NPC.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794160","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}
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