Head and Neck
SCOPUS (SonsInc.)SCIE-ISI
1097-0347
1043-3074
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Cơ quản chủ quản: WILEY , John Wiley & Sons Inc.
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The present study uses population‐based data from the Surveillance, Epidemiology, and End Results (SEER) database to evaluate the behavior of sinonasal tumors.
Data for all sinonasal malignancies reported between 1973 and 2006 (
The overall incidence of sinonasal cancer was 0.556 cases per 100,000 population per year with a male:female ratio of 1.8:1. The most common histologies were squamous cell carcinoma (51.6%) and adenocarcinoma (12.6%), whereas the most common primary sites were the nasal cavity (43.9%) and maxillary sinus (35.9%). The incidence of sinonasal cancer remained relatively stable during the study period. No significant changes in overall relative survival were noted. The best relative survival was noted in patients treated with surgery or a combination of surgery and radiotherapy.
The prognosis of patients with sinonasal cancer is generally poor, and has not changed substantially over the last 3 decades. © 2011 Wiley Periodicals, Inc.
This study reviews our experience with deep neck infections and tries to identify the predisposing factors of life‐threatening complications.
A retrospective review was conducted of patients who were diagnosed as having deep neck infections in the Department of Otolaryngology at National Taiwan University Hospital from 1997 to 2002. Their demographics etiology, associated systemic diseases, bacteriology, radiology, treatment, duration of hospitalization, complications, and outcomes were reviewed. The attributing factors to deep neck infections, such as the age and systemic diseases of patients, were also analyzed.
One hundred eighty‐five charts were recorded; 109 (58.9%) were men, and 76 (41.1%) were women, with a mean age of 49.5 ± 20.5 years. Ninety‐seven (52.4%) of the patients were older than 50 years old. There were 63 patients (34.1%) who had associated systemic diseases, with 88.9% (56/63) of those having diabetes mellitus (DM). The parapharyngeal space (38.4%) was the most commonly involved space. Odontogenic infections and upper airway infections were the two most common causes of deep neck infections (53.2% and 30.5% of the known causes).
When dealing with deep neck infections in a high‐risk group (older patients with DM or other underlying systemic diseases) in the clinic, more attention should be paid to the prevention of complications and even the possibility of death. Early surgical drainage remains the main method of treating deep neck abscesses. Therapeutic needle aspiration and conservative medical treatment are effective in selective cases such as those with minimal abscess formation. © 2004 Wiley Periodicals, Inc.
Oral mucosa squamous cell carcinoma (OSCC) has locoregional evolution, with frequent neck involvement (the most important parameter for prognosis). There are still many doubts concerning the best way to approach N0 neck disease in early‐stage lesions (T1 and T2). Many parameters have been studied to identify N0 patients with a high likelihood of harboring occult node metastases or of having them develop.
A review of the studies analyzing “tumor thickness”/“depth of invasion” in predicting regional metastases and survival was undertaken.
The literature suggests that “tumor thickness”/“depth of invasion” is a reliable parameter for predicting regional nodal involvement and survival in OSCC.
Authors are in substantial agreement regarding the reliability of tumor thickness. The lack of comparable study groups, measurement techniques, and cut‐off values points to the need for further studies so as to reach a consensus and to develop therapy protocols that include tumor thickness. © 2005 Wiley Periodicals, Inc.
The purpose of this study was to analyze the results of radiotherapy (RT) alone or combined with surgery for adenoid cystic carcinoma.
Between September 1966 and November 2001, 101 previously untreated patients were treated with curative intent with RT alone or combined with surgery. Follow‐up ranged from 0.4–30.6 years (median, 6.6 years). All living patients had follow‐up for at least 1 year.
The 5‐ and 10‐year rates of local control were as follows: RT alone, 56% and 43%; surgery and RT, 94% and 91%; and overall, 77% and 69%. Multivariate analysis of local control revealed that T stage (
The optimal treatment for patients with adenoid cystic carcinoma is surgery and adjuvant RT. A significant proportion of patients with incompletely resectable disease are cured after RT alone. Improvements in locoregional control are offset, in part, by the relatively high incidence of distant metastases. © 2004 Wiley Periodicals, Inc.
The supraomohyoid neck dissection is a selective cervical node dissection that removes the contents of the submentai and submandibular triangles (lymph node level I), the jugulodigastric and jugulo‐omohyoid lymph node groups, and the lymph nodebearing tissues located anterior to the cutaneous branches of the cervical plexus and above the omohyoid muscle (lymph node levels II and III). The sternocleidomastoid muscle, the spinal accessory nerve, and the internal jugular vein are preserved. This type of neck dissection is indicated in the surgical management of the neck in patients with large T2, T3, and T4 squamous cell carcinomas of the oral cavity in whom the cervical lymph nodes are either clinically negative (NO) or single, discrete, and less than 3 cm in diameter (N1). In this paper, we discuss the rationale for this operation, its staging, and its therapeutic value, and present a detailed description of the surgical technique.
Adequate resection margins are critical to the treatment decisions and prognosis of patients with head and neck squamous cell carcinoma (HNSCC). However, there are numerous controversies regarding reporting and interpretation of the status of resection margins. Fundamental issues relating to the basic definition of margin adequacy, uniform reporting standards for margins, optimal method of specimen dissection, and the role of intraoperative frozen section evaluation, all require further clarification and standardization. Future horizons for margin surveillance offer the possible use of novel methods such as “molecular margins” and contact microscopic endoscopy, However, the limitations of these approaches need to be understood. The goal of this review was to evaluate these issues to define a more rational, standardized approach for achieving resection margin adequacy for patients with HNSCC undergoing curative resection. © 2012 Wiley Periodicals, Inc. Head Neck, 2013
To evaluate the role of radiation therapy in patients with nasal cavity and paranasal sinus tumors.
Between October 1964 and July 1998, 78 patients with malignant tumors of the nasal cavity (48 patients), ethmoid sinus (24 patients), sphenoid sinus (5 patients), or frontal sinus (1 patient) were treated with curative intent by radiation therapy alone or in the adjuvant setting. There were 25 squamous cell carcinomas, 14 undifferentiated carcinomas, 31 minor salivary gland tumors (adenocarcinoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma), 8 esthesioneuroblastomas, and 1 transitional cell carcinoma. Forty‐seven patients were treated with irradiation alone, 25 with surgery and postoperative irradiation, 2 with preoperative irradiation and surgery, and 4 with chemotherapy in combination with irradiation with or without surgery.
The 5‐year actuarial local control rate for stage I (limited to the site of origin; 22 patients) was 86%; for stage II (extension to adjacent sites (eg, adjacent sinuses, orbit, pterygomaxillary fossa, nasopharynx; 21 patients) was 65%; and for stage III (destruction of skull base or pterygoid plates, or intracranial extension; 35 patients) was 34%. The 5‐year actuarial local control rate for patients receiving postoperative irradiation was 79% and for patients receiving irradiation alone was 49% (
Surgery and postoperative radiation therapy may result in improved local control, absolute survival, and complications when compared with radiation therapy alone. Elective neck irradiation is probably unnecessary for patients with early‐stage disease. © 2002 Wiley Periodicals, Inc. Head Neck 24: 821–829, 2002
The 2019 novel coronavirus disease (COVID‐19) is a highly contagious zoonosis produced by SARS‐CoV‐2 that is spread human‐to‐human by respiratory secretions. It was declared by the WHO as a public health emergency. The most susceptible populations, needing mechanical ventilation, are the elderly and people with associated comorbidities. There is an important risk of contagion for anesthetists, dentists, head and neck surgeons, maxillofacial surgeons, ophthalmologists, and otolaryngologists. Health workers represent between 3.8% and 20% of the infected population; some 15% will develop severe complaints and among them, many will lose their lives. A large number of patients do not have overt signs and symptoms (fever/respiratory), yet pose a real risk to surgeons (who should know this fact and must therefore apply respiratory protective strategies for all patients they encounter). All interventions that have the potential to aerosolize aerodigestive secretions should be avoided or used only when mandatory. Health workers who are: pregnant, over 55 to 65 years of age, with a history of chronic diseases (uncontrolled hypertension, diabetes mellitus, chronic obstructive pulmonary diseases, and all clinical scenarios where immunosuppression is feasible, including that induced to treat chronic inflammatory conditions and organ transplants) should avoid the clinical attention of a potentially infected patient. Health care facilities should prioritize urgent and emergency visits and procedures until the present condition stabilizes; truly elective care should cease and discussed on a case‐by‐case basis for patients with cancer. For those who are working with COVID‐19 infected patients' isolation is compulsory in the following settings: (a) unprotected close contact with COVID‐19 pneumonia patients; (b) onset of fever, cough, shortness of breath, and other symptoms (gastrointestinal complaints, anosmia, and dysgeusia have been reported in a minority of cases). For any care or intervention in the upper aerodigestive tract region, irrespective of the setting and a confirmed diagnosis (eg, rhinoscopy or flexible laryngoscopy in the outpatient setting and tracheostomy or rigid endoscopy under anesthesia), it is strongly recommended that all health care personnel wear personal protective equipment such as N95, gown, cap, eye protection, and gloves. The procedures described are essential in trying to maintain safety of health care workers during COVID‐19 pandemic. In particular, otolaryngologists, head and neck, and maxillofacial surgeons are per se exposed to the greatest risk of infection while caring for COVID‐19 positive subjects, and their protection should be considered a priority in the present circumstances.
The efficacy of salvage treatment of recurrent head and neck squamous cell carcinomas (HNSCC) after primary curative surgery was evaluated.
The management outcome of 377 patients who had recurrent squamous cell carcinoma of oral cavity, oropharynx, hypopharynx, and larynx after primary curative surgery was reviewed.
The surgical salvage rates of recurrence were 29% local, 30% tracheostomal, 56% unilateral nodal recurrence of previously undissected neck, 32% of unilateral neck recurrence after prior neck dissection, and 11% lung metastasis. The 5‐year tumor‐free actuarial survival rates of those patients who received surgical salvage was 35% for local recurrence, 32% for unilateral nodal recurrence of the previously undissected neck, and 18% for nodal recurrence of the previously dissected neck. One patient of six with tracheostomal recurrence salvaged with surgery and one patient of six with lung metastasis salvaged with lobectomy survived without tumor at 5 years. There was no 5‐year survivor of all patients salvaged with other nonsurgical methods. The mean survival of patients without surgical salvage was 6 months.
There was a moderate chance of cure after surgical salvage of locoregional recurrent HNSCC. Surgical salvage was, however, only feasible for early recurrent tumor. Close follow‐up surveillance of early recurrence is essential after primary treatment of patients. © 2003 Wiley Periodicals, Inc. Head and Neck 25: 000–000, 2003