Current Opinion in Otolaryngology & Head and Neck Surgery最新文献_第4页

Parapharyngeal space metastasis from squamous cell carcinoma: indications and limits of different surgical approaches. 鳞状细胞癌咽旁间隙转移：不同手术入路的适应症和局限性。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-04-01 Epub Date: 2024-12-19 DOI: 10.1097/MOO.0000000000001029

Matteo Fermi, Carlotta Liberale, Gabriele Molteni

{"title":"Parapharyngeal space metastasis from squamous cell carcinoma: indications and limits of different surgical approaches.","authors":"Matteo Fermi, Carlotta Liberale, Gabriele Molteni","doi":"10.1097/MOO.0000000000001029","DOIUrl":"10.1097/MOO.0000000000001029","url":null,"abstract":"Purpose of review: The aim of this review is to investigate the most suitable surgical approach to managing parapharyngeal space (PPS) squamous cell carcinoma (SCC) metastasis.Recent findings: SCC metastasis in PPS are extremely rare. The PPS itself is a complex anatomical area, requiring extensive surgical experience and various surgical approaches for effective management. Several authors have attempted to systematize the surgical approaches to the PPS based on the anatomical location and histological nature of the lesions. However, there are currently few studies in the literature on the specific management of SCC metastases in the PPS, as these lesions are extremely rare.Summary: The treatment of SCC metastases in the PPS must be determined based on the individual patient. If the patient is a candidate for surgery, the surgical approach should be chosen based on the location of the metastases and must ensure a sufficiently wide surgical corridor to allow for as complete a resection as possible. To date, the surgical approach that best meets these requirements is the transcervical transparotid approach. With new technologies, including the use of robotics and endoscopy, surgery can become increasingly less invasive while maintaining the wide exposure provided by open surgical procedures.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"74-78"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959169","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

Skull base osteoradionecrosis: from pathogenesis to treatment. 颅底放射性骨坏死：从发病机理到治疗。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-04-01 Epub Date: 2025-01-31 DOI: 10.1097/MOO.0000000000001036

Vittorio Rampinelli, Gabriele Testa, Alberto Daniele Arosio, Cesare Piazza

{"title":"Skull base osteoradionecrosis: from pathogenesis to treatment.","authors":"Vittorio Rampinelli, Gabriele Testa, Alberto Daniele Arosio, Cesare Piazza","doi":"10.1097/MOO.0000000000001036","DOIUrl":"10.1097/MOO.0000000000001036","url":null,"abstract":"Purpose of review: This review aims to provide a comprehensive analysis of skull base osteoradionecrosis (ORN), a severe and rare complication of radiotherapy for head and neck malignancies. It explores pathogenesis, clinical presentation, diagnostic strategies, and management approaches, emphasizing the importance of multidisciplinary care in addressing this challenging condition.Recent findings: Skull base ORN results from radiotherapy-induced tissue damage, characterized by hypovascularity, hypoxia, and necrosis, often compounded by secondary infections. Advances in radiotherapy techniques, such as intensity-modulated radiotherapy and heavy particles, have reduced ORN incidence, though cases persist, particularly in high-dose radiotherapy fields. Emerging treatments, including hyperbaric oxygen therapy and the pentoxifylline-tocopherol protocol, show promise but lack robust evidence for standardized use. Surgical interventions, especially those incorporating vascularized tissue reconstruction, have demonstrated favorable outcomes in refractory cases. Recent studies underscore the utility of multimodal imaging techniques, including MRI and PET/CT, for distinguishing ORN from tumor recurrence.Summary: Skull base ORN represents a complex and potentially life-threatening condition requiring tailored, multidisciplinary management. Although advancements in diagnostics and therapeutics have improved outcomes, significant challenges remain, particularly in developing standardized protocols. Further research is needed to refine treatment strategies and improve evidence-based practices for this entity.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"65-73"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191194","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

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. 恶性腮腺肿瘤的外科治疗现状。

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

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

Olfactory outcomes in skull base surgery. 颅底手术的嗅觉效果

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-02-01 Epub Date: 2024-11-04 DOI: 10.1097/MOO.0000000000001023

Sanjena Venkatesh, Jennifer E Douglas

{"title":"Olfactory outcomes in skull base surgery.","authors":"Sanjena Venkatesh, Jennifer E Douglas","doi":"10.1097/MOO.0000000000001023","DOIUrl":"10.1097/MOO.0000000000001023","url":null,"abstract":"Purpose of review: This review examines the impact of skull base surgery on olfactory function, a critical yet often overlooked aspect of postoperative quality of life. As surgical techniques continue to evolve, understanding their impact on olfaction is key to optimizing patient outcomes.Recent findings: The relationship between skull base surgery and olfactory function continues to be debated in the literature. With the adoption of transnasal surgical approaches, a significant concern has been its impact on olfaction. Prior studies have shown evidence of olfactory dysfunction following transnasal skull base surgery, though these findings are not universal. A particular area of discussion involves the use of the pedicled nasoseptal flap, which has demonstrated potentially negative short-term olfactory impacts. Additional concerns surround flap design (olfactory strip preservation) and technique of flap harvest (cold knife versus electrocautery). Evidence suggests that olfactory strip preservation may effectively maintain postoperative olfactory performance, while cold knife techniques offer no clear advantage over electrocautery.Summary: The inconsistencies in the literature underscore the need for standardized, large-scale studies that directly compare surgical techniques to better understand the impact of transnasal skull base surgery on olfaction. This is essential to optimizing surgical outcomes and improving patient quality of life postoperatively.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"31-42"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669810","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

Chronic rhinosinusitis and asthma: epidemiology, pathophysiology, morbidity, treatment. 慢性鼻窦炎与哮喘：流行病学、病理生理、发病率、治疗。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-02-01 Epub Date: 2024-11-27 DOI: 10.1097/MOO.0000000000001022

Marlene M Speth, David T Liu, Gerold Besser, Ahmad R Sedaghat

引用次数: 0

Postoperative management following endoscopic skull base surgery. 内窥镜颅底手术后的术后管理。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-02-01 Epub Date: 2024-09-11 DOI: 10.1097/MOO.0000000000001010

Domen Vozel, Jure Urbančič

引用次数: 0