-
Oral Surgery, Oral Medicine, Oral... Feb 2022Salivary gland tumors are a heterogeneous group of neoplasms with complex clinicopathologic behavior. These tumors often show an extremely diverse morphology and... (Review)
Review
OBJECTIVE
Salivary gland tumors are a heterogeneous group of neoplasms with complex clinicopathologic behavior. These tumors often show an extremely diverse morphology and significant histologic patterns, making diagnosis a difficult task. Owing to the considerable differences in prognosis, treatment, and follow-up, accurately distinguishing these histologic mimickers is imperative. The aim of the present systematic review was to establish the diagnostic utility of p63/p40 immunostaining in histologic differentiation of salivary gland tumors.
STUDY DESIGN
An electronic search was carried out using MEDLINE by PubMed, Scopus, Google Scholar, Trip, Cochrane Library, and EMBASE databases. Articles in which both p63 and p40 immunohistochemical expressions were assessed were included for systematic review and their sensitivity and specificity were calculated. Risk of bias was analyzed for each study using the Quality Assessment of Diagnostic Accuracy Studies tool.
RESULTS
Ten eligible articles were included in the quantitative synthesis, which revealed a concordant positivity of p63 and p40 by nearly all cases of adenoid cystic carcinoma, pleomorphic adenoma, and mucoepidermoid carcinoma and most polymorphous adenocarcinomas showed discordant immunohistochemical expression (p63+/p40-).
CONCLUSIONS
The current evidence supports that integrated immunostaining of p63/p40 is a valuable adjunct for discerning enigmatic salivary gland tumors with true myoepithelial and/or squamous differentiation.
Topics: Adenocarcinoma; Adenoma, Pleomorphic; Biomarkers, Tumor; Carcinoma, Adenoid Cystic; Humans; Salivary Gland Neoplasms
PubMed: 34518135
DOI: 10.1016/j.oooo.2021.07.010 -
European Archives of... Jun 2023Based on a systematic review and meta-analysis, our study aimed to provide information about the factors that influence the success of tympanic membrane reconstruction. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Based on a systematic review and meta-analysis, our study aimed to provide information about the factors that influence the success of tympanic membrane reconstruction.
METHODS
Our systematic search was conducted on November 24, 2021, using the CENTRAL, Embase, and MEDLINE databases. Observational studies with a minimum of 12 months of follow-up on type I tympanoplasty or myringoplasty were included, while non-English articles, patients with cholesteatoma or specific inflammatory diseases, and ossiculoplasty cases were excluded. The protocol was registered on PROSPERO (registration number: CRD42021289240) and PRISMA reporting guideline was used. Risk of bias was evaluated with the QUIPS tool. A random effect model was used in the analyses. Primary outcome was the rate of closed tympanic cavities.
RESULTS
After duplicate removal, 9454 articles were found, of which 39 cohort studies were included. Results of four analyses showed significant effects: age (OR: 0.62, CI 0.50; 0.78, p value: 0.0002), size of the perforation (OR: 0.52, CI 0.29; 0.94, p value: 0.033), opposite ear condition (OR: 0.32, CI 0.12; 0.85, p value: 0.028), and the surgeon's experience (OR: 0.42, CI 0.26; 0.67, p value: 0.005), while prior adenoid surgery, smoking, the site of the perforation, and discharge of the ear did not. Four factors: etiology, Eustachian tube function, concomitant allergic rhinitis, and duration of the ear discharge were analyzed qualitatively.
CONCLUSIONS
The age of the patient, the size of the perforation, the opposite ear status, and the surgeon's experience have a significant effect on the success of tympanic membrane reconstruction. Further comprehensive studies are needed to analyze the interactions between the factors.
LEVEL OF EVIDENCE
Not applicable.
Topics: Humans; Tympanic Membrane Perforation; Treatment Outcome; Myringoplasty; Tympanoplasty; Tympanic Membrane; Retrospective Studies
PubMed: 36811654
DOI: 10.1007/s00405-023-07831-2 -
The Journal of Laryngology and Otology Apr 2016To study and review the short- and long-term effects of intranasal steroids on obstructive adenoids. (Review)
Review
OBJECTIVES
To study and review the short- and long-term effects of intranasal steroids on obstructive adenoids.
METHODS
In this prospective cohort study, 19 children previously treated with mometasone furoate for 3 months were contacted at 3, 6 and 12 months after cessation of treatment. Main outcome measures included: change in severity of nasal obstruction, allergic rhinitis and obstructive symptoms. A systematic review of literature was also performed.
RESULTS
By one year, 25 per cent of patients required adenoidectomy; the remaining children had no significant change in clinical score (p = 0.464), obstruction severity (p = 0.191) or allergic symptoms (p = 0.284). Fourteen pertinent studies were identified; all but one study showed improvement in the patients' symptoms and/or degree of obstruction. Two studies with follow up reaching 25 months showed positive effects.
CONCLUSION
The short-term positive effect of some intranasal steroids on obstructive adenoids seems to persist in a significant number of patients after the cessation of treatment.
Topics: Adenoidectomy; Adenoids; Administration, Intranasal; Administration, Topical; Anti-Inflammatory Agents; Child; Child, Preschool; Female; Humans; Male; Mometasone Furoate; Nasal Obstruction; Prospective Studies; Rhinitis, Allergic; Severity of Illness Index; Time
PubMed: 26847580
DOI: 10.1017/S0022215116000256 -
Oral Surgery, Oral Medicine, Oral... Dec 2016We performed a systematic review to assess the prognostic value of perineural invasion (PNI) for patients with head and neck adenoid cystic carcinoma. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
We performed a systematic review to assess the prognostic value of perineural invasion (PNI) for patients with head and neck adenoid cystic carcinoma.
STUDY DESIGN
A literature search of MEDLINE and EMBASE was used to identify relevant literature up to December 2015. The primary outcomes of interest were overall survival, disease-free survival, and locoregional control. Study information and hazard ratios (HRs) were extracted, and HRs were pooled using the Mantel-Haenszel fixed-effects model and the DerSimonian and Laird random-effects model according to heterogeneity.
RESULTS
Twenty-two studies and 1332 patients were included in this study. The PNI ratio was 43.2%. PNI was at increasing risk for overall survival (HR = 2.98; 95% confidence interval [CI] 2.00-4.46), disease-free survival (HR = 1.88; 95% CI, 1.42-2.49), and locoregional control (HR = 2.15; 95% CI, 1.48-3.13) with statistical significance.
CONCLUSIONS
PNI is an independent factor for poor prognosis in patients with head and neck adenoid cystic carcinoma. Moreover, PNI poses a significantly higher threat to male patients and younger patients.
Topics: Carcinoma, Adenoid Cystic; Head and Neck Neoplasms; Humans; Neoplasm Invasiveness; Peripheral Nervous System Neoplasms; Prognosis; Risk Factors
PubMed: 27727107
DOI: 10.1016/j.oooo.2016.08.008 -
Frontiers in Oncology 2019The purpose of the present meta-analysis was to provide evident data about use of apparent diffusion coefficient (ADC) values for distinguishing malignant and benign...
The purpose of the present meta-analysis was to provide evident data about use of apparent diffusion coefficient (ADC) values for distinguishing malignant and benign lesions in the head and neck region. MEDLINE and Scopus databases were screened for associations between ADC and malignancy/benignancy of head and neck lesions up to December 2018. Overall, 22 studies met the inclusion criteria. The following data were extracted: authors, year of publication, study design, number of patients/lesions, lesion type, mean value, and standard deviation of ADC. The primary endpoint of the systematic review was the analysis of the association between lesion nature and ADC values. The methodological quality of the involved studies was checked according to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) instrument. The meta-analysis was undertaken by using RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance weights were used without further correction to account for the heterogeneity between the studies. Mean ADC values including 95% confidence intervals were calculated separately for benign and malignant lesions. The acquired 22 studies comprised 1,227 lesions. Different malignant lesions were diagnosed in 818 cases (66.7%) and benign lesions in 409 cases (33.3%). The mean ADC value of the malignant lesions was 1.04 × 10 mm/s, and the mean value of the benign lesions was 1.46 × 10 mm/s. Lymphomas and sarcomas showed the lowest calculated mean ADC values, 0.7 and 0.79 × 10 mm/s, respectively. Adenoid cystic carcinomas had the highest ADC values (1.5 × 10 mm/s). None of the analyzed malignant tumors had mean ADC values above 1.75 × 10 mm/s. ADC values play a limited role in distinguishing between malignant and benign lesions in the head and neck region. It may be only suggested that lesions with mean ADC values above 1.75 × 10 mm/s are probably benign. Further large studies are needed for the analysis of the role of diffusion-weighted imaging (DWI)/ADC in the discrimination of benign and malignant lesions in the head and neck region.
PubMed: 31970081
DOI: 10.3389/fonc.2019.01362 -
European Archives of... Mar 2022Cleft palate children have a higher incidence of otitis media with effusion, more frequent recurrent acute otitis media episodes, and worse conductive hearing losses... (Review)
Review
PURPOSE
Cleft palate children have a higher incidence of otitis media with effusion, more frequent recurrent acute otitis media episodes, and worse conductive hearing losses than non-cleft children. Nevertheless, data on adenoidectomy for middle ear disease in this patient group are scarce, since many feared worsening of velopharyngeal insufficiency after the procedure. This review aims at collecting the available evidence on this subject, to frame possible further areas of research and interventions.
METHODS
A PRISMA-compliant systematic review was performed. Multiple databases were searched with criteria designed to include all studies focusing on the role of adenoidectomy in treating middle ear disease in cleft palate children. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for clinical indications and outcomes.
RESULTS
Among 321 unique citations, 3 studies published between 1964 and 1972 (2 case series and a retrospective cohort study) were deemed eligible, with 136 treated patients. The outcomes were positive in all three articles in terms of conductive hearing loss improvement, recurrent otitis media episodes reduction, and effusive otitis media resolution.
CONCLUSION
Despite promising results, research on adenoidectomy in treating middle ear disease in the cleft population has stopped in the mid-Seventies. No data are, therefore, available on the role of modern conservative adenoidectomy techniques (endoscopic and/or partial) in this context. Prospective studies are required to define the role of adenoidectomy in cleft children, most interestingly in specific subgroups such as patients requiring re-tympanostomy, given their known risk of otologic sequelae.
Topics: Adenoidectomy; Child; Cleft Palate; Humans; Middle Ear Ventilation; Otitis Media with Effusion; Retrospective Studies
PubMed: 34453572
DOI: 10.1007/s00405-021-07035-6 -
BioMed Research International 2018Previous literatures have investigated the change of miR-20a expression level in the progression of multiple cancers and its influence on patients' survival outcome, but... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Previous literatures have investigated the change of miR-20a expression level in the progression of multiple cancers and its influence on patients' survival outcome, but results of now-available evidence are inconsistent.
OBJECTIVE
To elucidate the prognostic value of circulating and tissue-based miR-20a for patients with various cancers.
METHODS
A systematic search and review of eligible publications were carried out in three electronic databases including the Cochrane Library, PubMed, and Embase, and the methodological quality of included studies was assessed according to Newcastle-Ottawa Scale (NOS). Hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for overall survival (OS), recurrence-free survival (RFS), disease-free survival (DFS), and progressive-free survival (PFS) of each study were pooled using a random effect model.
RESULTS
In total, 24 studies involving 4186 samples of multiple cancers published in 20 articles were included in the statistical analysis. As for circulating miR-20a, five kinds of cancers containing gastric cancer, lymphoma, glioblastoma, prostate cancer, and non-small-cell lung cancer reported upregulated level in patients compared with normal healthy control, and overexpressed circulating miR-20a could confer an unfavorable factor for OS (HR = 1.71, 95% CIs: 1.43 -2.04, < 0.01) and DFS (HR = 1.90, 95% CIs: 1.45-2.49, < 0.01). As for tissue-based samples, 6 kinds of malignancies including colorectal cancer, salivary adenoid cystic carcinoma, gallbladder carcinoma, colon cancer, gastrointestinal cancer, and alveolar rhabdomyosarcoma revealed upregulated miR-20a expression level compared with paired nontumorous tissue, of which high expression of miR-20a was significantly associated with poor OS (HR = 2.74, 95% CIs: 1.38-5.42, < 0.01) and DFS (HR = 2.68, 95% CIs: 1.32-5.45, < 0.01); meanwhile, other 5 tumors containing breast cancer, cutaneous squamous cell carcinoma, hepatocellular carcinoma, oral squamous cell carcinoma, and epithelial ovarian cancer demonstrated downregulated miR-20a expression level compared with benign tissue, of which low miR-20a expression was significantly related to shorter OS (HR = 3.48, 95% CIs: 2.00-6.06, < 0.01) and PFS/RFS (HR = 4.05, 95% CIs: 2.89-5.66, < 0.01).
CONCLUSION
Change of circulating and tissue-based miR-20a expression possesses vital prognostic implication for human cancers. Augmented expression of circulating miR-20a predicts poor survival outcome for patients with cancers. Tissue-based miR-20a level may be upregulated or downregulated depending on cancer types; in the former condition, high expression of tissue miR-20a is a risk factor for unfavorable prognosis and in the latter condition low expression of tissue miR-20a is associated with shorter survival.
Topics: Animals; Disease-Free Survival; Down-Regulation; Humans; MicroRNAs; Neoplasms; Prognosis; Up-Regulation
PubMed: 30596096
DOI: 10.1155/2018/6124927 -
Cancer Diagnosis & Prognosis 2022To systematically review the patient characteristics and management approaches of adenoid cystic carcinoma (ACC) infiltrating the skull base. (Review)
Review
BACKGROUND/AIM
To systematically review the patient characteristics and management approaches of adenoid cystic carcinoma (ACC) infiltrating the skull base.
MATERIALS AND METHODS
According to PRISMA guidelines, PubMed, Scopus, and Cochrane were searched to retrieve studies reporting management protocols and survival outcomes of patients with skull base ACCs. Patient characteristics, management strategies, and outcomes were investigated.
RESULTS
The review encompassed 17 studies involving 171 patients, with a female predominance (57.9%) and a mean age of 49±7.12 years. ACCs mostly infiltrated the paranasal sinus (22.2%), cavernous sinus (8.8%), and nasopharynx (7.1%). Perineural invasion was reported in 6.4% of cases. Facial pain, nasal obstruction, and facial paresthesia were the most common symptoms. Surgical resection (45.6%) was favored over biopsy (12.2%). Employing the free flap technique (4.7%), surgical reconstruction of the bony defect after resection was performed using abdominal and anterior thigh muscle grafts in 1.8% of patients each. As adjuvant management, 22.8% of cases had radiotherapy and 14.6% received chemotherapy. Recurrence of skull base ACCs occurred in 26.9% of cases during a mean follow up-time of 30.8±1.8 months.
CONCLUSION
Skull base ACCs pose a surgical challenge mainly due to their proximity to critical neurovascular structures and aggressive behavior. Surgical resection and radiotherapy are shown to be safe and effective treatment modalities. The dismal prognosis and limited data on non-surgical strategies highlight the need for further evaluation of the current management paradigm and upraising innovative therapies to improve patient mortality and quality of life.
PubMed: 36060029
DOI: 10.21873/cdp.10134 -
Head & Neck Apr 2016The primary treatment for head and neck adenoid cystic carcinoma (ACC) is surgery. Infrequently, however, ACC's propensity for perineural and base of skull invasion can... (Review)
Review
Definitive proton radiation therapy and concurrent cisplatin for unresectable head and neck adenoid cystic carcinoma: A series of 9 cases and a critical review of the literature.
BACKGROUND
The primary treatment for head and neck adenoid cystic carcinoma (ACC) is surgery. Infrequently, however, ACC's propensity for perineural and base of skull invasion can preclude definitive surgical management. We present our experience with proton radiation therapy (RT) and concurrent platinum-based chemotherapy.
METHODS
Nine patients with unresectable node-negative, nonmetastatic head and neck ACC received definitive proton RT and concurrent cisplatin. Outcomes and toxicities were recorded. A systematic review of the literature was performed.
RESULTS
Median follow-up was 27 months (range, 9.2-48.3 months). Four patients achieved complete response at the primary site, and an additional 4 patients achieved stabilization of local disease. Only 1 patient developed local disease progression. Four patients had 5 acute grade 3 (G3) toxicities, and 1 patient developed a chronic G4 optic nerve disorder.
CONCLUSION
Our preliminary results suggest proton RT and concurrent chemotherapy is a definitive treatment option for select patients with head and neck ACC. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1472-E1480, 2016.
Topics: Adult; Aged; Carcinoma, Adenoid Cystic; Chemoradiotherapy; Cisplatin; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Proton Therapy; Radiotherapy Dosage; Treatment Outcome
PubMed: 26561041
DOI: 10.1002/hed.24262 -
Journal of Clinical Sleep Medicine :... Jul 2022This review aimed to evaluate the association between craniofacial features in children and adolescents with pediatric obstructive sleep apnea (OSA). (Meta-Analysis)
Meta-Analysis
STUDY OBJECTIVES
This review aimed to evaluate the association between craniofacial features in children and adolescents with pediatric obstructive sleep apnea (OSA).
METHODS
Seven databases were searched to fulfill our research objectives. Clinical studies that included participants younger than 18 years with fully diagnosed OSA or without OSA and that evaluated skeletal, soft craniofacial features, or dental arch morphology were considered for this review. The risk of bias and certainty of evidence were assessed. A meta-analysis was performed when low methodological and clinical heterogeneity were detected. This review followed the protocols recommended by the Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA-2020) guidelines.
RESULTS
Nine studies were identified at the end of the selection process, from which 5 did not report differences. Four studies reported differences between craniofacial features when OSA was compared to an asymptomatic control group. Mandibular retrognathia, reduced anteroposterior linear dimensions of the bony nasopharynx (decreased pharyngeal diameters at the levels of the adenoids), longer facial profile, and a narrower intercanine width were described among children with OSA. A meta-analysis was performed considering the studies with a similar methodological approach, and no differences were observed in all the considered cephalometric angles (SNA, SNB, ANB, NSBa, U1-L1, U1-SN). All the included studies were considered at low risk of bias even though some limitations were noted.
CONCLUSIONS
Due to the very low to moderate level of certainty, neither an association nor a lack thereof between craniofacial morphology and pediatric OSA can be supported by these data.
CITATION
Fagundes NCF, Gianoni-Capenakas S, Heo G, Flores-Mir C. Craniofacial features in children with obstructive sleep apnea: a systematic review and meta-analysis. . 2022;18(7):1865-1875.
Topics: Adenoids; Adolescent; Cephalometry; Child; Humans; Pharynx; Sleep Apnea, Obstructive
PubMed: 35074045
DOI: 10.5664/jcsm.9904