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

{"title":"Submandibular Gland Flap Reconstruction for Oropharyngeal Defects After Transoral Robotic Surgery (TORS).","authors":"Daniel P Lander, Nikhil Vettikattu, Tuleen Sawaf, Naomi Wang, Mihir R Patel, Azeem S Kaka, Andrés M Bur, Ryan S Jackson","doi":"10.1002/hed.28051","DOIUrl":"https://doi.org/10.1002/hed.28051","url":null,"abstract":"<p><strong>Background: </strong>To describe utilization and outcomes of submandibular gland flap (SGF) reconstruction after transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC).</p><p><strong>Methods: </strong>A multi-institutional retrospective case series of patients who underwent TORS for OPSCC followed by SGF reconstruction with harvest via transcervical approach from 1/1/2016 to 4/1/2023.</p><p><strong>Results: </strong>In total, 14 patients underwent SGF reconstruction after TORS for OPSCC. All patients had HPV-positive disease, predominantly in early local (N = 10 with pT1/pT2 disease, 71%) and regional stages (N = 11 with pN0/pN1 disease, 79%). Most patients received adjuvant radiation treatment (N = 9, 64%). Median hospital LOS after surgery was 4 days (IQR 2 days) with median functional oral intake scale (FOIS) score of 5 (IQR 0.8) at 1-3 weeks after surgery.</p><p><strong>Conclusions: </strong>SGF reconstruction is a useful technique for closure of appropriately selected TORS defects requiring reconstruction beyond healing by secondary intention and mobilization of adjacent tissue but not large enough to warrant free flap reconstruction.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911158","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":"Postauricular Approach for Enucleation of Cervical Vagal Schwannomas.","authors":"Jong-Lyel Roh","doi":"10.1002/hed.28053","DOIUrl":"https://doi.org/10.1002/hed.28053","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the outcomes of intracapsular enucleation using the retroauricular hairline incision (RAHI) approach for treating cervical vagal schwannomas.</p><p><strong>Methods: </strong>A longitudinal study was conducted on patients with cervical vagal schwannomas. Eleven patients who underwent RAHI-based enucleation were included. Preoperative imaging was performed using contrast-enhanced MRI. Postoperative evaluations assessed pain, neurological function, cosmetic outcomes, voice, and swallowing functions.</p><p><strong>Results: </strong>Eleven patients underwent surgery. The median tumor size was 4.6 cm. The median operation time was 42 min, with minimal bleeding. Common complications were earlobe numbness (45%) and temporary vocal cord paralysis (27%), which were resolved within a year. Cosmetic satisfaction was high, with median VAS scores of nine for scars and 10 for facial deformities. No significant dysphagia was found. No recurrences were observed over a median follow-up of 79 months.</p><p><strong>Conclusions: </strong>Intracapsular enucleation using the RAHI approach is a safe and effective method for treating cervical vagal schwannomas.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911146","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":"On TRacK With Larotrectinib in a Neonate With a Giant Congenital ETV6::NTRK3 Fusion-Positive Infantile Fibrosarcoma of the Head and Neck.","authors":"Teresa M Cardesa-Salzmann, Monika Sparber-Sauer, Peter Hingst, Andreas Erbersdobler, Bjoern Schneider, Maja Hühns, Andre Jakob, Friederike Terpe, Christian Spang, Dorothea Stalmann, Claudia Bierwirth, Christina Hauenstein, Stefanie Märzheuser, Manfred Ballmann, Carl Friedrich Classen","doi":"10.1002/hed.28058","DOIUrl":"https://doi.org/10.1002/hed.28058","url":null,"abstract":"<p><strong>Background: </strong>Infantile fibrosarcoma (IFS) is a rare pediatric tumor of intermediate malignancy with high local aggressiveness that typically presents in young infants. Its occurrence in the head and neck region is rare. Complete non-mutilating surgical resection is often not possible, requiring multimodal treatment. IFS frequently harbors neurotrophic receptor tyrosine kinase (NTRK) fusions. Targeted therapy with NTRK inhibitors is modifying treatment paradigms of IFS.</p><p><strong>Methods: </strong>Herein, we report the case of a neonate with a giant unresectable congenital ETV6::NTRK3 (+) IFS of the head and neck region without rapid response to chemotherapy who was treated with larotrectinib oral suspension.</p><p><strong>Results: </strong>Larotrectinib was well tolerated and induced an impressive clinical and radiologic response.</p><p><strong>Conclusions: </strong>This case illustrates an example of pediatric precision oncology in a neonate with an ETV6::NTRK3 (+) congenital IFS of the head and neck region and provides further reference for the use of larotrectinib in the neonatal period.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907944","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":"Is transoral robotic surgery useful as a salvage technique in head and neck cancers: a systematic review and meta analysis.","authors":"Sahil Goel, Delu Gunasekera, Giri Krishnan, Suren Krishnan, John-Charles Hodge, Lucylynn Lizarondo, Andrew Foreman","doi":"10.1002/hed.28021","DOIUrl":"https://doi.org/10.1002/hed.28021","url":null,"abstract":"<p><strong>Background: </strong>Residual, recurrent, and second primary head and neck cancers are on the rise. This is largely driven by a younger age at diagnosis and increasingly targeted chemoradiotherapy options. Salvage surgery remains the only curative intent option in this cohort of patients. With transoral robotic surgery (TORS), achieving good oncological and functional outcomes in primary cancer cohorts, there remains a paucity of synthesized evidence on treating residual, recurrent, or second primary disease in previously irradiated fields.</p><p><strong>Methods: </strong>Conducted in accordance with the JBI's methodology for systematic reviews of effectiveness, three databases were searched including PubMed, Embase, and Scopus. This study represents the largest systematic review till date finding 679 studies and including 15 after screening and critical appraisal. A meta-analysis of proportions and comparison was conducted using Freeman-Tukey arcsine transformation statistical method and the Mantel-Haenszel statistical method, respectively.</p><p><strong>Results: </strong>Data from 515 patients was analyzed with a median follow-up time up to 47 months and a mean hospital stay of 8.5 days. Two-year overall survival (OS) rate and disease-free survival (DFS) rate were 73.8% and 56.1%, respectively. Compared to primary head and neck cancer, risk ratios for OS and DFS were 0.35 (95% CI, 0.18-0.67) and 0.44 (95% CI, 0.22-0.88). Weighted mean for tracheostomy decannulation and nasogastric dependence was 9.7 and 12.8 days, respectively, with long term tracheostomy dependence in 0%-11.5% of patients. Positive surgical margins were obtained in 19.4% with a risk ratio of 1.08 (95% CI, 0.66-1.75) when compared to primary head and neck cancer. Recurrence rate was 36% (95% CI, 24-48.9). Pooled complication rate was 32.3% with 92% of complications being classed as Clavien Dindo grade 2 or 3.</p><p><strong>Conclusion: </strong>TORS is an emerging technique for salvage in recurrent, residual, and second primary head and neck cancers in previously irradiated fields. Survival outcomes are encouraging with decreased morbidity and mortality rates when compared to traditional open surgical techniques. Future studies need to mandate collection of swallowing data as a key tool to evaluate functional outcomes, deploy longer follow-up times, and address confounding factors including HPV status and prior adjuvant therapy.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907942","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":"The Burden of Recurrent Head and Neck Squamous Cell Carcinoma Across the United Kingdom: Results From a National Snapshot Study.","authors":"Andrew Williamson, Alison E Lim, Freddie Green, Ying Ki Lee, Lucy Li, Christy Moen, Rishi Vasanthan, Olivia Wharf, Jeremy Wong, Vinidh Paleri","doi":"10.1002/hed.28045","DOIUrl":"https://doi.org/10.1002/hed.28045","url":null,"abstract":"<p><strong>Background: </strong>To investigate the management of recurrent head and neck squamous cell carcinoma (rHNSCC) and describe survival outcomes.</p><p><strong>Methods: </strong>Post hoc subgroup analysis of a retrospective national observational cohort was conducted. All patients with rHNSCC who received a definitive treatment decision between September 1, 2021 and November 30, 2021 were included. Survival analysis was stratified according to subsite, primary versus recurrent disease, and surgical versus nonsurgical treatment.</p><p><strong>Results: </strong>Data from 202 rHNSCC patients were derived from a cohort of 1488 patients submitted by 50 UK centers. Median age was 66 years (IQR 58-74), and 142 (70.3%) were male. The most common recurrence subsites were oropharynx (20.5%), oral cavity (19.5%), larynx (16.4%), and hypopharynx (14.9%). Ninety-three (48.4%) were managed curatively. Surgery was the most common treatment for laryngeal (59.4%), oral cavity (60.5%), hypopharyngeal (44.8%), and oropharyngeal (37.5%) cancers. Two-year overall (OS), disease-free (DFS), disease-specific (DSS), and local recurrence free survival (LRFS) were 41.1%, 39.1%, 42.2%, and 39.3%, respectively. rHNSCC treated with surgery had improved OS (p = 0.0005), DFS (p = 0.012), DSS (p = 0.0003), and LRFS (p = 0.007), over nonsurgical treatments. Compared to primary cancers, rHNSCC presents with more advanced T stage (p < 0.001) and distant metastasis (p < 0.001), receives less curative treatment (p < 0.001), and has worse survival outcomes (all p < 0.001). On multivariate analysis, salvage surgery, radiotherapy, and p16 status were independent prognostic factors of all survival outcomes.</p><p><strong>Conclusions: </strong>Recurrent HNSCC is associated with high rates of incurable disease and worse survival than primary cancers. Surgery remains the most common curative treatment in rHNSCC, however future studies are necessary to improve patient selection and optimize outcomes following salvage 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":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900475","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":"The Efficacy of Liquid Biopsy of Total cfDNA for Predicting Systemic Metastasis in Japanese Patients With Oral Squamous Cell Carcinoma.","authors":"Masahiro Uchibori, Kazuyoshi Hosomichi, Yasutaka Hoshimoto, Masashi Sasaki, Takayuki Aoki, Atsushi Tajima, Yoshihide Ota, Minoru Kimura","doi":"10.1002/hed.28054","DOIUrl":"https://doi.org/10.1002/hed.28054","url":null,"abstract":"<p><strong>Background: </strong>The use of liquid biopsy of total cell-free DNA (cfDNA) to identify otherwise undetectable cancers has attracted interest; however, its efficacy remains unknown. We explored whether analysis using total cfDNA is efficacious for Japanese patients with oral squamous cell carcinoma (OSCC).</p><p><strong>Methods: </strong>We collected total cfDNA from nine patients with OSCC preoperatively, 1 month postoperatively, and every 3 months thereafter to analyze this association. We used a target DNA sequence for genetic mutation analysis of tumor tissues collected from 33 patients, including the aforementioned nine patients.</p><p><strong>Results: </strong>Patients with good disease control showed negligible changes in preoperative and postoperative total cfDNA concentrations. A rapid increase in total cfDNA concentration was observed in patients who developed systemic metastases. Patients whose tumor tissue DNA showed genetic mutations had the same mutations in preoperative circulating tumor DNA.</p><p><strong>Conclusions: </strong>Our data suggested that analyzing total cfDNA is efficacious for patients with OSCC.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900476","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 Complications in Patient-Specific Plates for Maxillary Reconstruction.","authors":"Skylar Trott, Sara Yang, Zoey Morton, Mackenzie Sautter, Gavin Young, Alexandra Hoffman, Daniel Petrisor, Srinivasa R Chandra, Mark K Wax","doi":"10.1002/hed.28047","DOIUrl":"https://doi.org/10.1002/hed.28047","url":null,"abstract":"<p><strong>Objectives: </strong>Virtual surgical planning (VSP) allows for optimal reconstruction of maxillary defects with fibula free flaps. Current data are limited regarding long-term complications of patient-specific plates (PSPs) in this setting. Our objective was to determine long-term complications of PSPs in maxillary reconstruction using fibula free flaps.</p><p><strong>Methods: </strong>A retrospective chart review was performed on patients undergoing maxillary reconstruction with a fibula free flap and PSP between January 2010 to July 2022. The primary outcomes were plate-related complications, which were defined as plate exposure, fracture, removal or evidence of loose screws. Secondary outcomes were wound infection, nonunion, or flap failure.</p><p><strong>Results: </strong>A total of 39 patients underwent fibular reconstruction of maxillary defects using PSP. The average age was 56 years, with 56% of patients being female. There were 14 (35.8%) patients with plate-related complications, 10 (25.6%) underwent plate removal, 12 (30.8%) developed exposed hardware, 2 (5.1%) had loose screws, and none had a plate fracture. The average time to plate removal was 2.76 ± 1.94 years. With regard to age, sex, tobacco or alcohol use, diabetes, hypothyroidism, preoperative radiation therapy, number of fibula segments, type of cancer, postoperative radiation therapy, or whether the patient underwent orodental rehabilitation, there were no significant differences between patients who did and did not experience plate complications.</p><p><strong>Conclusions: </strong>VSP allows for patient-specific reconstruction of maxillary defects with a fibula free flap that remains stable in the majority of patients. In the long term, up to 25% of patients may require plate removal, but the reconstruction remains stable.</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":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900460","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":"Submental Intubation: Clinical Anatomy and Video Technical Note.","authors":"Adèle Rohée-Traoré, Pierre Gagnieur, Arnaud Gleizal, Mathieu Daurade","doi":"10.1002/hed.28050","DOIUrl":"https://doi.org/10.1002/hed.28050","url":null,"abstract":"","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900461","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":"Locked Dimerized CXCL12 Exerts Radiosensitizing Effects in Head and Neck Cancer.","authors":"Oscar Villarreal Espinosa, Musaddiq Awan, Abdullah A Memon, Anne Frei, Jamie Foeckler, Rachel Kuehn, Jennifer Bruening, Becky Massey, Stuart Wong, Monica Shukla, Julia Kasprzak, Amit Joshi, Michael Dwinell, Heather A Himburg, Joseph Zenga","doi":"10.1002/hed.28048","DOIUrl":"https://doi.org/10.1002/hed.28048","url":null,"abstract":"<p><strong>Background: </strong>Head and neck squamous cell carcinoma (HNSCC) presents significant treatment challenges, particularly in cases unrelated to human papillomavirus (HPV). The chemokine receptor CXCR4, interacting with its ligand CXCL12, plays a crucial role in tumor proliferation, metastasis, and treatment resistance. This study explores the therapeutic potential of engineered monomeric and dimerized CXCL12 variants (CXCL12₁ and CXCL12₂, respectively) in HNSCC and evaluates potential additive effects when combined with radiation therapy.</p><p><strong>Methods: </strong>Clinical HNSCC biopsies were evaluated for CXCR4 expression in both previously untreated and radiorecurrent disease. HNSCC cell lines were then treated with combinations of CXCL12 variants and radiotherapy and interrogated for proliferation, gene expression change, and underlying molecular mechanisms. In vivo studies evaluated the biodistribution of engineered CXCL12 and tested these treatments in humanized cell line-derived xenograft (CDX) models.</p><p><strong>Results: </strong>CXCL12₂ significantly reduced HNSCC cell proliferation and enhanced the effects of radiotherapy, likely through biased agonism at the CXCR4 receptor and upregulation of the KISS1R pathway. In vivo, CXCL12₂ localized to tumor sites and augmented the effects of radiation to inhibit tumor growth.</p><p><strong>Conclusions: </strong>CXCL12₂, in combination with radiation, demonstrates potent anti-tumor effects in HNSCC. These findings support further clinical investigation of CXCL12₂ to enhance the effects of radiotherapy.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900459","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 Trilobed Radial Forearm Free Flap: A Novel Approach to Oral Cavity Reconstruction.","authors":"Liang Zuo, Zheng Jiang, Jun Liu, Hao Tian, ShuiChao Gao, WeiLun Huang","doi":"10.1002/hed.28046","DOIUrl":"https://doi.org/10.1002/hed.28046","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the effectiveness of trilobed forearm flaps in repairing postoperative defects in T2 stage oral cancer patients, while minimizing the impact on the donor site.</p><p><strong>Methods: </strong>16 male patients with oral cancer were treated at two tertiary medical centers. Patients' demographic characteristics, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and University of Washington Quality of Life Questionnaire (UW-QoL) were recorded.</p><p><strong>Results: </strong>Postoperatively, all flaps survived with primary closure of donor site. One patient experienced neck wound edema, which healed after re-drainage. The quality-of-life evaluation shows a UW-QoL score indicating an excellent quality of life, with the mean score of 78.86 ± 4.26 and a mean DASH score of 23.29 ± 9.89, indicating good function preservation of the donor site.</p><p><strong>Conclusion: </strong>The trilobed forearm flap technique significantly improves the repair range for oral cancer defects while maintaining donor site integrity and is recommended for wider application.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886506","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}