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Head & Neck

Jason L Kass, Sameer Lakha, Matthew A Levin, Thomas Joseph, Hung-Mo Lin, Eric M Genden, Marita S Teng, Brett A Miles, Samuel DeMaria
BACKGROUND: In free flap head and neck reconstructions, hemodynamic management is complicated by the deleterious effects of excessive crystalloid administration. Patients may undergo periods of hypotension or excess fluid administration. The purpose of this study was to present our examination of the hypotheses that intraoperative hypotension and blood pressure lability are associated with increased fluid administration and flap failure. METHODS: We reviewed the records of 445 patients undergoing head and neck surgery involving free tissue transfer...
September 19, 2018: Head & Neck
Seong Oh Park, Yoosung Son, Il-Kug Kim, Ung Sik Jin, Hak Chang
BACKGROUND: Monitoring free muscle flaps with skin grafts is difficult. To intensify the monitoring process for this type of flap, a small skin paddle was included in the flap and analyzed its effects. METHODS: A retrospective analysis of all patients who underwent scalp reconstruction with a free latissimus dorsi flap and skin graft between 1994 and 2016 was conducted. Flap monitoring was proceeded using a combination of clinical examination and handheld Doppler for both types of flaps...
September 3, 2018: Head & Neck
Rufus A Scrimger, Hadi Seikaly, Larissa J Vos, Jeffrey Harris, Dan O'Connell, Sunita Ghosh, Brock Debenham, Naresh Jha
BACKGROUND: Xerostomia is a debilitating side effect of radiotherapy for head and neck cancer. Combining surgical submandibular-gland transfer (SMGT) with intensity-modulated radiotherapy (IMRT) may provide greater protection of salivary function. METHODS: This was a single-institution, prospective phase II feasibility trial. Patients with head and neck cancer or unknown primary with neck node metastases received primary surgery with SMGT and postoperative radiotherapy with tomotherapy (60 Gy in 30 fractions)...
September 3, 2018: Head & Neck
Catherine F Sinclair, Maria J Téllez, Sedat Ulkatan
BACKGROUND: Continuous vagal intraoperative neuromonitoring (IONM) currently requires placement of a vagal nerve electrode. Herein, we present data from 100 patients (134 nerves-at-risk) monitored continuously during neck endocrine surgeries using a noninvasive, new methodology that solely utilizes endotracheal tube electrodes to simultaneously stimulate laryngeal mucosa and record a laryngeal adductor reflex continuous IONM (LAR-C-IONM) response. METHODS: The laryngeal adductor reflex (LAR) was elicited by electrical laryngeal mucosal stimulation on the side contralateral to the operative field using endotracheal tube electrodes...
August 18, 2018: Head & Neck
Cátia Sofia da Costa Domingues, Beatriz Prazeres Serambeque, Mafalda Sofia Laranjo Cândido, Carlos Miguel Machado Marto, Francisco José de Baptista Veiga, Ana Bela Sarmento Antunes Cruz Ribeiro, Ana Rita Ramalho Figueiras, Maria Filomena Roque Botelho, Marília de Assunção Rodrigues Ferreira Dourado
BACKGROUND: Head and neck cancer is the sixth most common cancer worldwide, with oral squamous cell carcinoma (OSCC) being the most representative type. OSCC is a public health problem with high morbidity and poor survival rate. Epithelial-mesenchymal transition is emerging as a hallmark in OSCC. METHODS: In this study, we described the role of microRNAs in epithelial-mesenchymal transition regulation in OSCC based on a PubMed search using articles published in English between January 1, 2010, and January 31, 2018...
August 18, 2018: Head & Neck
Deguang Zhang, Li Gao, Gaofei He, Jian Chen, Liang Fang
BACKGROUND: The purpose of this study was to identify predictors associated with graft function after parathyroid autotransplantation during thyroid surgery. METHODS: One hundred fifty patients who underwent thyroid surgery with parathyroid autotransplantation were enrolled prospectively. During surgery, the misresected or devascularized parathyroid gland was autografted in the brachioradialis muscle of the forearm. Parathyroid hormone (PTH) levels in both arms were measured regularly after surgery...
August 13, 2018: Head & Neck
Ming-Nan Chien, Po-Sheng Yang, Yi-Chiung Hsu, Tsang-Pai Liu, Jie-Jen Lee, Shih-Ping Cheng
BACKGROUND: Telomerase reverse transcriptase (TERT) promoter mutations have recently been identified as an important prognostic factor in thyroid cancer. Studies suggest that TERT may have noncanonical functions beyond telomere maintenance. METHODS: Clinicopathological information and transcriptome data for papillary thyroid carcinoma (PTC) samples were obtained from The Cancer Genome Atlas (TCGA). Propensity score matching was performed to adjust for potential confounding variables between the TERT promoter wild-type group and the mutant group...
August 13, 2018: Head & Neck
Harold Heah, Ryan P Goepfert, Katherine A Hutcheson, Adam S Garden, G Brandon Gunn, Clifton D Fuller, Jan S Lewin, Michael E Kupferman, F Christopher Holsinger, Amy C Hessel, Neil D Gross
BACKGROUND: Functional outcomes after treatment for oropharyngeal squamous cell carcinoma (SCC) are increasingly prioritized. The purpose of this study was to investigate the incidence of gastrostomy tube placement and weight loss in patients with oropharyngeal SCC who may be eligible for either transoral robotic surgery (TORS) or nonsurgical management. METHODS: We conducted a retrospective review of previously untreated T1 to T2 and N0 to N2b oropharyngeal SCC to determine the rates of gastrostomy tube placement and weight loss according to Common Terminology Criteria for Adverse Events (CTCAE) criteria...
August 13, 2018: Head & Neck
Kornelia Kreiser, Isabell Gröber, Claus Zimmer, Katharina Storck
BACKGROUND: Carotid blowout syndrome due to tumor infiltration, fistulas, and therapy-related necrosis can occur as late as years after the treatment. Reporting our experiences with preventive and acute treatment with stent grafts and discussing different ways of antiplatelet therapy. METHODS: We reviewed all patients between 2010 and 2016 who underwent stent graft placement and analyzed outcome, complications, and antiplatelet regime. RESULTS: Seventeen patients were treated in 24 sessions (n = 7 threatened, n = 5 imminent, and n = 12 acute bleeding)...
August 13, 2018: Head & Neck
Yukinori Takenaka, Ryohei Oya, Takahiro Kitamiura, Naoki Ashida, Kotaro Shimizu, Kazuya Takemura, Yoshifumi Yamamoto, Atsuhiko Uno
BACKGROUND: Thrombocytosis is associated with the prognosis of various types of cancer. The purpose of this study was to quantify the prognostic impact of platelet count and platelet-lymphocyte ratio (PLR) in head and neck squamous cell carcinoma (HNSCC). METHODS: We systematically searched electronic databases and identified articles reporting an association between platelet count or PLR and HNSCC prognosis. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) were extracted, and the pooled HRs were estimated using random effect models...
August 13, 2018: Head & Neck
Harman S Parhar, Elizabeth Gausden, Jayendrakumar Patel, Eitan Prisman, Donald W Anderson, J Scott Durham, Barret Rush
BACKGROUND: As transoral robotic surgery (TORS) is being increasingly used to treat patients with oropharyngeal squamous cell carcinoma (OPSCC), there is an interest in determining contributors to readmission. METHODS: We conducted this retrospective multivariate analysis modeling 30-day readmission using the Nationwide Readmissions Database (2012-2014). RESULTS: Of 950 patients, 117 (12.3%) were readmitted. Hemorrhage and diet/aspiration accounted for 32...
August 13, 2018: Head & Neck
Omer Faruk Karatas
BACKGROUND: Laryngeal cancer is a frequent cause of cancer-associated mortality worldwide with an overall poor prognosis along with high mortality rates. Therefore, comprehensive investigation of underlying molecular mechanisms of laryngeal carcinogenesis remains an important problem. METHODS: In this study, proliferative and apoptotic features of Hep-2 cells overexpressing microRNA-33a (miR-33a) were evaluated and in silico analysis along with literature search was used to find putative targets of miR-33a...
August 13, 2018: Head & Neck
Narayana Subramaniam, Samskruthi Murthy, Deepak Balasubramanian, Tsu-Hui Hubert Low, Sivakumar Vidhyadharan, Jonathan R Clark, Krishnakumar Thankappan, Subramania Iyer
BACKGROUND: The American Joint Committee on Cancer (AJCC) eighth edition has incorporated depth of invasion into TNM classification of oral cavity squamous cell carcinoma (SCC) due to the prognostic impact on recurrence and survival. After reclassifying our patients with T1 to T2 oral cavity SCC according to these recommendations, we intended to study the effect of adverse pathological features (perineural invasion [PNI], lymphovascular invasion, and differentiation) on overall survival (OS)...
August 13, 2018: Head & Neck
Jun Jia, Meng-Qi Jia, Hai-Xiao Zou
BACKGROUND: The treatment failure for oral squamous cell carcinoma (SCC) frequently takes the form of local and regional recurrences. We investigated the role of lingual lymph nodes (LLNs) in the recurrence of SCC of the tongue and the floor of the mouth. METHODS: A total of 111 patients with SCC of the tongue and the floor of the mouth who received treatment between 2012 and 2017 were included in this study. The patients with lingual lymph nodes that were confirmed to be metastasis on pathological examination were classified into the LNN group...
July 26, 2018: Head & Neck
John M Floberg, Todd A DeWees, Re-I Chin, Adam A Garsa, Farrokh Dehdashti, Brian Nussenbaum, Peter J Oppelt, Douglas R Adkins, Hiram A Gay, Wade L Thorstad
BACKGROUND: This study evaluates the prognostic significance of 18 F-fluorodeoxyglucose-positron emission tomography ([F-18]FDG-PET)-derived metabolic tumor volume (MTV) in human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinomas (OPSCCs) in the context of AJCC 8th edition staging. METHODS: We performed a retrospective study of HPV-associated OPSCCs treated with postoperative or definitive radiation. The prognostic significance of pretreatment MTV for freedom from recurrence (FFR), freedom from distant metastasis (FFDM), and overall survival (OS) was determined using Kaplan-Meier analysis...
July 26, 2018: Head & Neck
Ching-Nung Wu, I-Chieh Chuang, Ming-Jung Chuang, Wei-Chih Chen
BACKGROUND: Sinonasal renal cell-like adenocarcinoma is rare and exhibits unique pathological and clinical manifestations. Correct diagnosis and treatment of this newly described entity are challenging for both clinicians and pathologists. METHODS: We report a female patient with sinonasal renal cell-like adenocarcinoma who initially presented with right intermittent epistaxis. RESULTS: A 26-year-old woman presented with a 1-year history of right intermittent epistaxis and hyposmia...
September 2018: Head & Neck
Yong Tae Hong, Ki Hwan Hong
BACKGROUND: Chyle leakage after central neck dissection for thyroid carcinoma is an extremely rare condition. We investigated chyle leakage in patients with thyroidectomy and central neck dissection. METHODS: We experienced 3 cases of chyle leakage. The patterns of lymphatic drainage from the central neck to the lateral neck (supraclavicular fossa) were reviewed. The amount and duration of chyle leakage were measured in patients with postoperative chyle leakages...
September 2018: Head & Neck
Marianne Doazan, Stéphane Hans, Sylvain Morinière, Benjamin Lallemant, Sébastien Vergez, Karine Aubry, Erwan De Monès, Florent Espitalier, Franck Jegoux, Pierre Pradat, Philippe Céruse
BACKGROUND: Transoral robotic surgery (TORS) is an option to treat supraglottic squamous cell carcinomas (SCCs). We studied the oncologic outcomes after TORS for supraglottic laryngectomy (SGL). METHODS: We conducted a multicenter observational study of SGL using TORS for patients with supraglottic SCC with at least 2 years of follow-up. RESULTS: One hundred twenty-two patients were included in our study. Mean follow-up was 42.8 months. Local control was 94...
September 2018: Head & Neck
Meriem Mokhtech, Catherine E Mercado, James W Lynch, Nancy P Mendenhall, William M Mendenhall
BACKGROUND: Classic Hodgkin lymphoma is a malignant neoplasm of the lymphatic system that commonly presents with cervical and mediastinal lymphadenopathy. Primary extranodal disease of the head and neck is rare, with only a few cases reported in the literature. In this case report, we describe the presentation, treatment, and clinical outcome of a patient who presented with extranodal Hodgkin lymphoma of the maxillary sinus. METHODS: We report a case of extranodal classic Hodgkin lymphoma of the maxillary sinus treated with 2 cycles of chemotherapy and consolidative radiotherapy (RT)...
September 2018: Head & Neck
Gino Marioni, Rocco Cappellesso, Giancarlo Ottaviano, Elena Fasanaro, Rosario Marchese-Ragona, Niccolò Favaretto, Luciano Giacomelli, Vincenza Guzzardo, Alessandro Martini, Ambrogio Fassina, Stella Blandamura
BACKGROUND: In epithelial-to-mesenchymal transition, epithelial cells lose their features, acquiring a mesenchymal-like phenotype. Nm23-H1 protein relates to tumor cells' metastatic potential, its low expression in carcinomas often meaning a poor prognosis. This study newly investigated the role of nuclear nm23-H1 in laryngeal squamous cell carcinoma epithelial-to-mesenchymal transition. METHODS: Immunohistochemical analyses of nuclear nm23-H1, E-cadherin, N-cadherin, Snail, Zinc finger E-box binding homeobox (ZEB)1, and ZEB2 were performed in 33 consecutive patients with laryngeal SCC...
September 2018: Head & Neck
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