Current Opinion in Otolaryngology & Head and Neck Surgery最新文献_第2页

When neck lymph nodes metastases do not origin from a head and neck unknown primary. 当颈部淋巴结转移不起源于头颈部未知原发灶时。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-04-01 Epub Date: 2025-01-22 DOI: 10.1097/MOO.0000000000001031

Erim Pamuk, Christian Simon

{"title":"When neck lymph nodes metastases do not origin from a head and neck unknown primary.","authors":"Erim Pamuk, Christian Simon","doi":"10.1097/MOO.0000000000001031","DOIUrl":"10.1097/MOO.0000000000001031","url":null,"abstract":"Purpose of review: The evidence for a standardized approach to the management of cervical metastasis from a distant primary tumour is limited. The objective of this review is to provide an overview of the current status of research in this field and to present the latest diagnostic and therapeutic approaches.Recent findings: Although infraclavicular tumours are typically observed to metastasise to levels IV and V of the neck, all levels may potentially be affected. In conjunction with imaging and immunohistochemical analyses, next-generation sequencing and artificial intelligence-based tools are emerging as potential methods for identifying the primary tumour. Cervical metastasis can be classified as N3 or M1 in accordance with the histology and site of the primary tumour. A neck dissection + adjuvant chemoradiotherapy may prove beneficial in selected patients with breast, nonsmall cell lung, renal cell, oesophageal and testicular cancers, resulting in improved survival rates.Summary: The diagnosis and subsequent treatment of such cases requires the input of a multidisciplinary team, as the condition is often complex and requires a multifaceted approach. Isolated supraclavicular metastases should prompt the clinician to investigate a distant primary. In select patients with some types of primary tumours, surgical treatment of the neck may improve the prognosis. It is, therefore, essential to control the primary tumour in order to optimize the success of the overall treatment plan.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"102-108"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Good and bad indications for adjuvant radiotherapy after transoral laser microsurgery for laryngeal cancer. 喉癌经口激光显微手术后辅助放疗的利弊。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-04-01 Epub Date: 2024-12-18 DOI: 10.1097/MOO.0000000000001030

Claudio Sampieri, Laura Ruiz-Sevilla, Isabel Vilaseca

{"title":"Good and bad indications for adjuvant radiotherapy after transoral laser microsurgery for laryngeal cancer.","authors":"Claudio Sampieri, Laura Ruiz-Sevilla, Isabel Vilaseca","doi":"10.1097/MOO.0000000000001030","DOIUrl":"10.1097/MOO.0000000000001030","url":null,"abstract":"Purpose of review: To summarize current evidence regarding the indication of adjuvant treatment after transoral laser microsurgery (TOLMS).Recent findings: Apart from well known risk factors, margins represent the key point in the decision-making. If margins are affected, additional treatment is mandatory. One exception could be the presence of one superficial margin in early tumors that can be strictly followed up by fiberendoscopy. As a general rule, the best option is margin-revision surgery by repeating TOLMS or switching to open partial surgery. (Chemo)radiotherapy can be also considered, being total laryngectomy the last alternative. In locally advanced tumors with uncertain margins (e.g. posterior paraglottic space invasion, vertical anterior commissure reaching the cartilage during primary resection), adjuvant treatment may improve local control with laser but with little impact on disease-specific or overall survival. In this scenario, QoL may be in part reduced after radiotherapy, although recent studies suggest that functional outcomes are favorable. Therefore, decision should be discussed individually with the patient, especially if a total laryngectomy is the only alternative after a possible relapse.Summary: Considerable work needs to be done to identify those cases that may benefit from adjuvant treatment after TOLMS, including a detailed description of functional outcomes.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"109-114"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Current surgical management of malignant parotid tumors.

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-04-01 Epub Date: 2025-02-24 DOI: 10.1097/MOO.0000000000001039

Davide Di Santo, Alessandra Deretti, Vincent Vander Poorten

{"title":"Current surgical management of malignant parotid tumors.","authors":"Davide Di Santo, Alessandra Deretti, Vincent Vander Poorten","doi":"10.1097/MOO.0000000000001039","DOIUrl":"10.1097/MOO.0000000000001039","url":null,"abstract":"Purpose of review: Surgical treatment of parotid cancer presents challenges due to the rarity of the disease, the histologic heterogeneity, and the complex regional anatomy. Recently published international guidelines contain recommendations for surgical management of the primary tumor and the neck lymph nodes, but still allow both T and N to be managed in different ways. This review summarizes the remaining areas of discussion.Recent findings: The reference treatment for parotid cancer is total parotidectomy; however, for low-grade, low-stage tumors a superficial parotidectomy may be sufficient. The cN+ neck requires a comprehensive neck dissection; for cN0 multiple valuable options remain. Frozen section analysis on level II nodes can guide the extent of neck dissection. The definition of 'clear margins' remains debated; close margins in low-grade tumors appear to be acceptable, positive margins always require additional treatment.Summary: A thorough understanding of the guidelines, fine-tuned if needed based on accurate preoperative workup and intraoperative surgeon's decision-making will provide the best outcome for the patient with parotid cancer.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"79-84"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Ewing's sarcoma of the head and neck: differential diagnosis, treatment and outcomes. 头颈部尤文氏肉瘤：鉴别诊断、治疗及预后。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-04-01 Epub Date: 2024-12-26 DOI: 10.1097/MOO.0000000000001032

Deepa Nair, Linu Thomas, Vasundhara Patil

{"title":"Ewing's sarcoma of the head and neck: differential diagnosis, treatment and outcomes.","authors":"Deepa Nair, Linu Thomas, Vasundhara Patil","doi":"10.1097/MOO.0000000000001032","DOIUrl":"10.1097/MOO.0000000000001032","url":null,"abstract":"Purpose of review: Ewing's sarcoma is a small round-cell tumour typically arising in the bones, and only rarely affecting soft tissues. These are rarely seen in the head and neck comprising 1-9% of all cases, making management of these tumours a challenge. This review aims to review the current literature to update the current diagnostic and treatment options in head and neck Ewing's sarcoma.Recent findings: The tumour is characterized in most cases by recurrent balanced translocations between the EWSR1 gene on chromosome 22 and genes belonging to the ETS family of transcription factors. Its main driver is the reciprocal translocation between the EWSR1 and FLI1 genes ( EWSR1 : FLI1 ). Molecular techniques for the detection of FET/ETS fusions are widely used to confirm the diagnosis. Newer entities like adamantinoma-like Ewing sarcoma have been recently described. The chemotherapy protocols also have changed following Euro Ewing 2012 study. Reclassification of margin status may help standardize treatment in these cases.Summary: Head and neck Ewings sarcoma is an uncommon tumour, mainly affecting paediatric/adolescent male individuals. Histopathological diagnosis is often challenging and immunohistochemical markers and/or molecular tests are generally used. Several molecular techniques for the detection of FET/ETS fusions are widely used to confirm the diagnosis. Management of Ewing's consists of a multimodal treatment regimen, including surgical resection and/or local radiotherapy, as well as intensive multiagent chemotherapy. Increase in age and the presence of distant metastasis are associated with shorter survival times.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"85-91"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Delivering a bespoke education programme and learning framework for the integrated speech & language therapy head and neck cancer service across Cheshire and Merseyside, within the UK.

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-03-21 DOI: 10.1097/MOO.0000000000001042

Catriona Fleming, H Fiona Robinson

{"title":"Delivering a bespoke education programme and learning framework for the integrated speech & language therapy head and neck cancer service across Cheshire and Merseyside, within the UK.","authors":"Catriona Fleming, H Fiona Robinson","doi":"10.1097/MOO.0000000000001042","DOIUrl":"https://doi.org/10.1097/MOO.0000000000001042","url":null,"abstract":"Purpose of review: The Cheshire and Merseyside (C&M) integrated head and neck cancer (HNC) speech and language therapy (SLT) service based in Liverpool in the UK successfully developed and delivered an in house, fast-track education programme for the primary purpose of advancing SLT clinicians from specialist to highly specialist roles to deliver care to the C&M HNC population as part of a novel integrated service. The bespoke curriculum, competency and assessment framework were intensively delivered through a range of workplace-based training.The aim of this review is to share the principles underpinning the developed frameworks.Recent findings: The development of the bespoke SLT HNC education programme and competency framework was informed by Macmillan AHP competencies, the Aspirant Cancer Career Education and Development (ACCEND) programme and with reference to the four pillars of practice as described in the advanced clinical practitioner framework. The C&M framework was centred around evidence based principles of medical education specifically Constructivist Learning theory and included foundation theory teaching, self-directed learning, technical skills mastery, delivered by blended and workplace-based learning events. The assessment framework incorporated peer and clinical supervision, viva and case reviews and workplace-based assessment including Direct Observation of Procedural Skills (DOPS) with entrustable professional activities (EPA).Summary: The education programme was successful in progressing SLT staff within 18 months to achieve appropriate competencies to deliver a new integrated service across C&M. The detailed competency and assessment frameworks developed spans the whole of the HNC patient pathway. Next steps are sharing the success of this work and further development of the learning programme for C&M and other services.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Advancing laryngology through artificial intelligence: a comprehensive review of implementation frameworks and strategies. 通过人工智能推动喉科学发展：实施框架和战略综合评述。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-03-04 DOI: 10.1097/MOO.0000000000001041

Rachel B Kutler, Linh He, Ross W Green, Anaïs Rameau

{"title":"Advancing laryngology through artificial intelligence: a comprehensive review of implementation frameworks and strategies.","authors":"Rachel B Kutler, Linh He, Ross W Green, Anaïs Rameau","doi":"10.1097/MOO.0000000000001041","DOIUrl":"https://doi.org/10.1097/MOO.0000000000001041","url":null,"abstract":"Purpose of review: This review aims to explore the integration of artificial intelligence (AI) in laryngology, with specific focus on the barriers preventing translation from pilot studies into routine clinical practice and strategies for successful implementation.Recent findings: Laryngology has seen an increasing number of pilot and proof-of-concept studies demonstrating AI's ability to enhance diagnostics, treatment planning, and patient outcomes. Despite these advancements, few tools have been successfully adopted in clinical settings. Effective implementation requires the application of established implementation science frameworks early in the design phase. Additional factors required for the successful integration of AI applications include addressing specific clinical needs, fostering diverse and interdisciplinary teams, and ensuring scalability without compromising model performance. Governance, epistemic, and ethical considerations must also be continuously incorporated throughout the project lifecycle to ensure the safe, responsible, and equitable use of AI technologies.Summary: While AI hold significant promise for advancing laryngology, its implementation in clinical practice remains limited. Achieving meaningful integration will require a shift toward practical solutions that prioritize clinicians' and patients' needs, usability, sustainability, and alignment with clinical workflows.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 'art' of communication therapy.

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-02-28 DOI: 10.1097/MOO.0000000000001040

Camilla Dawson, Jo Wheeler

引用次数: 0

Delivering an integrated care systems approach for speech and language therapy head and neck cancer services in the UK: service development and redesign in Cheshire and Merseyside.

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-02-18 DOI: 10.1097/MOO.0000000000001038

Heulwen Sheldrick, Stuart Kingston, Julie Crane

{"title":"Delivering an integrated care systems approach for speech and language therapy head and neck cancer services in the UK: service development and redesign in Cheshire and Merseyside.","authors":"Heulwen Sheldrick, Stuart Kingston, Julie Crane","doi":"10.1097/MOO.0000000000001038","DOIUrl":"https://doi.org/10.1097/MOO.0000000000001038","url":null,"abstract":"Purpose of review: The purpose of this review is to share the implementation of an integrated care systems approach for head and neck cancer speech and language therapy services. Facilitating factors and barriers to change are highlighted and links to relevant literature are indicated. The intention is that this paper will provide a 'non blueprint' for others embarking on large scale integrative change.Recent findings: Integrating health and social care provision across organizations is necessary for improving outcomes for people, reducing health inequalities and improving efficiencies in care. Whilst recognizing this intention, the current structure for providing care in NHS organizations does not foster cross-organizational working.Summary: Integration enhances patient centred care, however implementation of change across organizations is challenging. Managerial support is pivotal and differences in organizational culture need to be acknowledged, respected and overcome. A clearly defined vision, to which all staff are committed provides an anchor in challenging situations. Transformational change is iterative and cannot always be predetermined. Success is possible; tenacity, flexibility and agility are key.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Prosthetic Rehabilitation for Speech and Swallowing (PReSS): a novel, interdisciplinary approach to head and neck cancer survivorship.

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-02-14 DOI: 10.1097/MOO.0000000000001037

Holly McMillan, Pattii Montgomery, Richard Cardoso

引用次数: 0

Long-term complications of extracranial pericranial flaps in skull base reconstruction. 颅外颅周皮瓣在颅底重建中的长期并发症。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-02-01 Epub Date: 2024-10-29 DOI: 10.1097/MOO.0000000000001021

Kelly E Daniels, Joseph Mocharnuk, Zainab Balogun, Georgios A Zenonos, Paul A Gardner, Carl H Snyderman, Eric W Wang

{"title":"Long-term complications of extracranial pericranial flaps in skull base reconstruction.","authors":"Kelly E Daniels, Joseph Mocharnuk, Zainab Balogun, Georgios A Zenonos, Paul A Gardner, Carl H Snyderman, Eric W Wang","doi":"10.1097/MOO.0000000000001021","DOIUrl":"10.1097/MOO.0000000000001021","url":null,"abstract":"Purpose of review: Nasoseptal flaps are a frequently used and well characterized means of reconstruction following endoscopic endonasal approach surgery (EEA). However, there are alternative means of reconstruction, including the extracranial pericranial flap (ePCF), that while used infrequently fulfill a specialized need in larger or salvage reconstructions. This review aims to better characterize long-term outcomes using ePCF where there is currently a paucity of objective data on use and outcomes.Recent findings: A traditional pericranial flap involves elevating and rotating the flap through a craniotomy defect to reconstruct defects of the ventral skull base. The ePCF is implemented without performing a craniotomy, and instead tunnels the flap through a bony opening created at the level of the nasion. This review presents outcomes in a large single-center cohort of patients with ePCFs to better characterize the short- and long-term success, risks, and complications of this reconstructive method.Summary: Long-term follow-up demonstrates that obstruction of the frontal sinus outflow may occur but rarely requires surgical intervention. ePCF are a reasonable alternative to consider in cases where local tissue would be insufficient, is not available, or has already failed. There is a low risk of flap complications.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"43-49"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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