scholarly journals Midface Resection And Reconstruction In Head And Neck Oncology: A 20 Years Single Institution Experience

2022 ◽  
Author(s):  
G. Vakis ◽  
M. Kotrotsiou ◽  
F. Neamonitou ◽  
D. Papala ◽  
S. Stavrianos
Keyword(s):  
Head And Neck ◽  
Malignant Tumors ◽  
Vastus Lateralis ◽  
Distinct Group ◽  
Biological Behavior ◽  
Anterolateral Thigh Flap ◽  
Anatomical Site ◽  
Head And Neck Oncology ◽  
Level Of Evidence ◽  
Anterior Fossa

Abstract Background: Midface tumors are relatively uncommon as midface comprises less than 1% of all malignant tumors and incorporate a distinct group of lesions, with a high variety of histological types and biological behavior. The purpose of the study is to present our experience in managing patients with advanced midface tumors for a 20-year period.Materials & Methods: From January 2000 to May 2020, we performed 72 excisions and reconstructions in 36 patients where their medical records were reviewed by the head and neck oncology clinic. The commonest anatomical site of the primary was the maxilla in 19 patients and bilaterally in 5 patients. In 15 patients there was an orbital and anterior fossa extension. In 6 patients there was a parotid and middle ear extension and in 1 patient there was a lip involvement.Results: Surgical resection included maxillectomy in the majority of the cases in combination with orbital exenteration or orbitectomy and anterior fossa resection. In 8 cases parotidectomy and mastoidectomy/ core petrosectomy was performed. One patient was subjected to total petrosectomy. Reconstruction was performed with radial forearm osteocutaneous free flap in 4 cases, latissimus with scapular bone flap in one case, lengthening temporalis myoplasty in 19 cases, rectus femoris in one case and anterolateral thigh flap in 5 cases in combination with temporalis and vastus lateralis in one case respectively and bilateral karapandzic flap in 1 case. The patients were followed-up from 2005 to 2020. To date, 23 patients (63.8%) are disease free with no recurrences of the disease and 4.4% of all patients presented disease recurrence during the follow-up period.Conclusions: In conclusion midface resections are safely performed with a combination of microvascular and dynamic reconstruction of the face offering our patients quality of life improvement.Level of Evidence: Level V, therapeutic study

scholarly journals Institution-Specific Strategies for Head and Neck Oncology Triage During the COVID-19 Pandemic

2020 ◽  
pp. 014556132097550
Author(s):  
Michael H. Freeman ◽  
Justin R. Shinn ◽  
Alexander Langerman
Keyword(s):  
United States ◽  
Head And Neck ◽  
Surgical Oncology ◽  
The United States ◽  
Oncologic Outcomes ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Head And Neck Oncology ◽  
Level Of Evidence ◽  
Individual Surgeon

Background: This work seeks to better understand the triage strategies employed by head and neck oncologic surgical divisions during the initial phases of the coronavirus 2019 (COVID-19) outbreak. Methods: Thirty-six American head and neck surgical oncology practices responded to questions regarding the triage strategies employed from March to May 2020. Results: Of the programs surveyed, 11 (31%) had official department or hospital-specific guidelines for mitigating care delays and determining which surgical cases could proceed. Seventeen (47%) programs left the decision to proceed with surgery to individual surgeon discretion. Five (14%) programs employed committee review, and 7 (19%) used chairman review systems to grant permission for surgery. Every program surveyed, including multiple in COVID-19 outbreak epicenters, continued to perform complex head and neck cancer resections with free flap reconstruction. Conclusions: During the initial phases of the COVID-19 pandemic experience in the United States, head and neck surgical oncology divisions largely eschewed formal triage policies and favored practices that allowed individual surgeons discretion in the decision whether or not to operate. Better understanding the shortcomings of such an approach could help mitigate care delays and improve oncologic outcomes during future outbreaks of COVID-19 and other resource-limiting events. Level of Evidence: 4.

scholarly journals Head and Neck Cancers Are Not Alike When Tarred with the Same Brush: An Epigenetic Perspective from the Cancerization Field to Prognosis

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5630
Author(s):  
Diego Camuzi ◽  
Tatiana de Almeida Simão ◽  
Fernando Dias ◽  
Luis Felipe Ribeiro Pinto ◽  
Sheila Coelho Soares-Lima
Keyword(s):  
Risk Factor ◽  
Head And Neck ◽  
Molecular Mechanisms ◽  
Current Knowledge ◽  
Response To Therapy ◽  
Field Cancerization ◽  
Biological Behavior ◽  
Second Primary ◽  
Anatomical Site ◽  
Primary Tumors

Head and neck squamous cell carcinomas (HNSCC) are among the ten most frequent types of cancer worldwide and, despite all efforts, are still diagnosed at late stages and show poor overall survival. Furthermore, HNSCC patients often experience relapses and the development of second primary tumors, as a consequence of the field cancerization process. Therefore, a better comprehension of the molecular mechanisms involved in HNSCC development and progression may enable diagnosis anticipation and provide valuable tools for prediction of prognosis and response to therapy. However, the different biological behavior of these tumors depending on the affected anatomical site and risk factor exposure, as well as the high genetic heterogeneity observed in HNSCC are major obstacles in this pursue. In this context, epigenetic alterations have been shown to be common in HNSCC, to discriminate the tumor anatomical subsites, to be responsive to risk factor exposure, and show promising results in biomarker development. Based on this, this review brings together the current knowledge on alterations of DNA methylation and microRNA expression in HNSCC natural history, focusing on how they contribute to each step of the process and on their applicability as biomarkers of exposure, HNSCC development, progression, and response to therapy.

Preliminary Functional Outcomes and Quality of Life after Tongue Reconstruction with the Vastus Lateralis Myofascial Free Flap

2021 ◽  
Author(s):  
Armando De Virgilio ◽  
Andrea Costantino ◽  
Raul Pellini ◽  
Gerardo Petruzzi ◽  
Giuseppe Mercante ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck ◽  
Free Flap ◽  
Functional Outcomes ◽  
Vastus Lateralis ◽  
Life Questionnaire ◽  
Donor Area ◽  
Tongue Reconstruction ◽  
Eortc Qlq

AbstractThe aim of the present study is to report our preliminary experience with the vastus lateralis myofascial free flap (VLMFF) for tongue reconstruction according to tongue and donor site functional outcomes. Twelve consecutive patients (F: 5; median age: 54.0 years, interquartile range or IQR 42.75–69.0) were included. The validated European Organization for Research and Treatment of Cancer of the Head and Neck 35 Quality of Life Questionnaire (EORTC QLQ-H&N35) and the performance status scale for head and neck cancer (PSS-HN) questionnaires were used to assess the health-related quality of life (HRQOL). The lower extremity functional scale (LEFS) was used to self-report the donor area function. All patients were successfully treated, and no VLMFF failure was detected during a median follow-up period of 10.5 months (IQR: 6.5–33.0). The HRQOL showed a median EORTC QLQ-H&N35 score of 56.0 (IQR: 50.0–72.5). The median PSS-HN score was 80.0 (IQR: 45.0–95.0), 75.0 (IQR: 62.5–100.0), 75.0 (IQR: 62.5–100.0) for “Normalcy of Diet,” “Public Eating,” and “Understandability of Speech,” respectively. The self-reported function of the lower extremities (donor area) showed a median LEFS of 59.0 (IQR: 32.5–74.0). This study reports optimistic data regarding the functional and quality of life outcomes after tongue reconstruction using VLMFF. Prospective controlled studies are needed to demonstrate advantages and disadvantages when compared with other reconstructive techniques.

Systemic Therapy for Head and Neck Skin Cancers

FACE ◽  
2021 ◽  
pp. 273250162110138
Author(s):  
Rebecca Knackstedt ◽  
Peter Taub ◽  
Gary Rogers ◽  
Brian Gastman
Keyword(s):  
Radiation Therapy ◽  
High Risk ◽  
Head And Neck ◽  
Systemic Therapy ◽  
Malignant Tumors ◽  
Curative Therapy ◽  
Recurrent Tumors ◽  
Skin Cancers ◽  
Systemic Therapies ◽  
Melanoma Skin

The mainstay of curative therapy for head and neck skin cancers relies upon surgery and/or radiation therapy. However, for some aggressive, non-resectable or recurrent tumors, systemic therapy is necessary. Recent emerging classes of drugs have shown to improve survival for high-risk, recurrent, and unresectable variants of these tumors. The goal of this paper is to review options for systemic therapies for head and neck skin cancers including melanoma, non-melanoma skin cancers and other rare and non-malignant tumors.

scholarly journals Clinical Evaluation of Immunological Parameters in Patients with Malignant Tumors of Head and Neck

1989 ◽  
Vol 1989 (Supplement33) ◽  
pp. 127-135
Author(s):  
Junichi Yoda ◽  
Tadahito Saito ◽  
Takaaki Kawaguchi ◽  
Hiroki Arai ◽  
Toshihide Tabata
Keyword(s):  
Head And Neck ◽  
Clinical Evaluation ◽  
Malignant Tumors ◽  
Immunological Parameters
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