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Acta Otorhinolaryngologica Italica :... Dec 2014Organ preservation treatment for advanced head and neck squamous cell carcinoma is associated with poor outcomes due to locoregional recurrences. Salvage surgery is the... (Review)
Review
Organ preservation treatment for advanced head and neck squamous cell carcinoma is associated with poor outcomes due to locoregional recurrences. Salvage surgery is the main therapeutic option for some of these patients. The aim of this study was to analyse the results of salvage surgery for advanced pharyngolaryngeal squamous cell carcinoma previously treated with radiochemotherapy. We performed a retrospective study on 38 patients (36 men, 2 women). The median age at diagnosis was 60 years with a mean follow-up period of 49.8 months. Recurrences were diagnosed at a mean of 395 days after finalising organ preservation treatment. Patients went under different salvage surgeries, including 22 total laryngectomies, 6 partial laryngectomies (3 transoral laser surgeries and 3 opened surgeries), 8 functional neck dissections and 2 tongue base surgeries. Nineteen patients had no postoperative complications after a mean hospital stay of 2 weeks. However, 5 patients died of significant recurrent bleedings. There were 4 salivary fistulas that responded to conservative management, while 7 patients had important pharyngostomas that required reconstruction with either regional or free flaps. The mean hospital stay was of 61.60 days for all patients. Five-year overall survival from diagnosis, overall survival after salvage surgery and survival after salvage surgery were 44.20, 37.90 and 45.70%, respectively. In summary, we conclude that salvage surgery is an optimal treatment for pharyngolaryngeal and regional recurrences and provides improvement in locoregional control and survival, despite the severe complications.
Topics: Carcinoma, Squamous Cell; Female; Humans; Laryngeal Neoplasms; Laryngectomy; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Neoplasms, Multiple Primary; Pharyngeal Neoplasms; Retrospective Studies; Salvage Therapy
PubMed: 25762829
DOI: No ID Found -
The Journal of Craniofacial Surgery Oct 2022Parapharyngeal space salivary gland tumors are very rare. The authors sought to examine the clinical features, treatment methods, and treatment results of parapharyngeal...
INTRODUCTION
Parapharyngeal space salivary gland tumors are very rare. The authors sought to examine the clinical features, treatment methods, and treatment results of parapharyngeal space salivary gland tumors in our hospital.
METHODS
The authors retrospectively enrolled 15 patients who were finally diagnosed as having parapharyngeal space salivary gland tumors from January 2010 to January 2021.
RESULTS
All parapharyngeal space salivary gland tumors arose from the prestyloid compartment. This study included 3 males and 12 females. The main symptoms were incidental diagnosis during imaging tests, followed by neck discomfort, oral mass, neck mass, and headache. Surgical methods for parapharyngeal space salivary gland tumors were performed in the following order: transcervical approach (n = 10), transcervical-parotid approach (n = 3), transoral approach (n = 1), and transparotid approach (n = 1). Pleomorphic adenoma was the most common tumor among parapharyngeal space salivary gland tumors.
CONCLUSIONS
In the surgery of parapharyngeal space salivary gland tumors, a transcervical or transcervical-parotid approach was mainly used by predicting the origin site through radiologic examinations.
Topics: Adenoma, Pleomorphic; Female; Humans; Male; Parapharyngeal Space; Parotid Gland; Pharyngeal Neoplasms; Retrospective Studies; Salivary Gland Neoplasms
PubMed: 35184104
DOI: 10.1097/SCS.0000000000008565 -
JAMA Otolaryngology-- Head & Neck... Dec 2018
Topics: Adult; Diagnosis, Differential; Hemangioma; Humans; Laryngoscopy; Magnetic Resonance Imaging; Male; Pharyngeal Neoplasms
PubMed: 30242327
DOI: 10.1001/jamaoto.2018.2248 -
Japanese Journal of Clinical Oncology Aug 2021
Topics: Age Factors; Humans; Incidence; Lip; Pharyngeal Neoplasms
PubMed: 34272942
DOI: 10.1093/jjco/hyab123 -
Brazilian Journal of Otorhinolaryngology 2022Confocal laser endomicroscopy is an optical imaging technique that allows in vivo, real-time, microscope-like images of the upper aerodigestive tract's mucosa. The...
INTRODUCTION
Confocal laser endomicroscopy is an optical imaging technique that allows in vivo, real-time, microscope-like images of the upper aerodigestive tract's mucosa. The assessment of morphological tissue characteristics for the correct differentiation between healthy and malignant suspected mucosa requires strict evaluation criteria.
OBJECTIVE
This study aims to validate an eight-point score for the correct assessment of malignancy.
METHODS
We performed confocal laser endomicroscopy between March and October 2020 in 13 patients. 197 sequences (11.820 images) originated from the marginal area of pharyngeal and laryngeal carcinomas. Specimens were taken at corresponding locations and analyzed in H&E staining as a standard of reference. A total of six examiners evaluated the sequences based on a scoring system; they were blinded to the histopathological examination. The primary endpoints are sensitivity, specificity, and accuracy. Secondary endpoints are interrater reliability and receiver operator characteristics.
RESULTS
Healthy mucosa showed epithelium with uniform size and shape with distinct cytoplasmic membranes and regular vessel architecture. Confocal laser endomicroscopy of malignant cells demonstrated a disorganized arrangement of variable cellular morphology. We calculated an accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 83.2%, 81.3%, 85.5%, 86.7%, and 79.7%, respectively, with a κ-value of 0.64, and an area under the curve of 0.86.
CONCLUSION
The results confirm that this scoring system is applicable in the laryngeal and pharyngeal mucosa to classify benign and malignant tissue. A scoring system based on defined and reproducible characteristics can help translate this experimental method to broad clinical practice in head and neck diagnosis.
Topics: Humans; Microscopy, Confocal; Reproducibility of Results; Pharyngeal Neoplasms; Squamous Cell Carcinoma of Head and Neck; Head and Neck Neoplasms; Lasers
PubMed: 34348858
DOI: 10.1016/j.bjorl.2021.06.002 -
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke... May 2018To investigate the key factors influencing the prognosis of hypopharyngeal carcinoma and the therapeutic methods improving the efficacy of treatments for hypopharyngeal...
To investigate the key factors influencing the prognosis of hypopharyngeal carcinoma and the therapeutic methods improving the efficacy of treatments for hypopharyngeal carcinoma. Two hundred and sixty-four cases of hypopharyngeal squamous cell carcinoma treated from May 2010 to May 2015 were analyzed retrospectively. There were 211 cases of pyriform sinus carcinoma, 37 cases of posterior pharyngeal wall carcinoma, and 16 cases of postcricoid carcinoma. According to UICC 2002 criteria, 2 cases were for stage Ⅰ, 14 for stage Ⅱ, 32 for stage Ⅲ and 216 for stage Ⅳ. Postoperative circumferential defects existed in 112 (42.4%) cases, and 86 of them were reconstructed with free jejunum transplantation. Among all cases, 54 patients (20.5%) had the preservation of laryngeal functions after surgery and 210 patients (79.5%) with total laryngectomy; 238 cases (90.2%) underwent bilateral cervical lymph node dissection and 203 patients received posterior pharyngeal lymph node exploration and dissection, with positive metastases for posterior pharyngeal lymph nodes in 36 cases (17.7%). Eight cases with cervical lymph node metastasis extensively involving the soft tissue, prevertebral fascia or encases carotid artery received preoperative radiotherapy of 50 Gy. After surgery 13 patients received concurrent radiotherapy and chemotherapy, 337 underwent adjuvant radiotherapy with a dose of 50-60 Gy each, and 14 patients did not receive radiotherapy or did not completed their radiotherapy programs. SPSS 13.0 saftware was used to analyze the data. All patients were followed up for more than 2 years. With Kaplan-Meier method, the 2-, 3- and 5-years survival rates were 69.6%, 62.8% and 51.3%, respectively. There were significant differences in 3-year survival rates between T1-2 group (75.5%) and T3-4 group (59.2%) (χ(2)=4.282 =0.039), N0 group (81.6%) and N+ group (58.2%) (χ(2)=6.802 =0.009), laryngeal functions preserved (81.8%) and unpreserved group (58.9%) (χ(2)=5.314 =0.021). Multivariate Logistic regression analysis showed that cervical lymph node metastasis was an independent prognostic factor (=0.027). The success rate of free jejunum transplantation was 98.8%. Local recurrence, cervical lymph node recurrence, second primary cancer, and distant metastasis accounted respectively for 11.2%, 18.8%, 12.5% and 45.0% of death cases. The prognosis-associated factors for hypopharyngeal carcinoma should be taken into account, including the evaluation of the carcinogenesis of the mucosal area, early screening of premalignant lesion or second primary cancer in the esophagus and dissection of the posterior pharyngeal lymph nodes, which will help to improve the local control rate and recent survival rate in patients with hypopharyngeal cancer.
Topics: Aged; Carcinoma, Squamous Cell; Humans; Hypopharyngeal Neoplasms; Laryngeal Neoplasms; Laryngectomy; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Male; Neck Dissection; Neoplasm Recurrence, Local; Neoplasms, Second Primary; Organ Sparing Treatments; Pharyngeal Neoplasms; Prognosis; Pyriform Sinus; Radiotherapy, Adjuvant; Retrospective Studies; Survival Rate
PubMed: 29764015
DOI: 10.3760/cma.j.issn.1673-0860.2018.05.004 -
Journal of Radiology Case Reports May 2023This case study presents a 66-year-old man referred to the Otolaryngology and Head and Neck Surgery department due to a one-history of persistent pain in the left...
This case study presents a 66-year-old man referred to the Otolaryngology and Head and Neck Surgery department due to a one-history of persistent pain in the left posterior cervical region. No abnormalities were detected in the oral and pharyngeal regions during clinical and endoscopic examinations. Subsequently, a magnetic resonance imaging revealed a lesion (14 × 12 × 14 mm) into the left parapharyngeal space, with high signal intensity on T2-weighted images, enhancement after contrast medium, restricted signal on diffusion weighted imaging and high vascularization on perfusion MRI. The histological examination of the lesion led to a diagnosis of myopericitoma. Post-surgery, no adjuvant therapy was administered. Myopericytomas are rare soft-tissue benign neoplasms, predominantly reported in extremities, with a limited number of cases in the head and neck region and almost never described in the literature with elective localization in the parapharyngeal space.
Topics: Humans; Male; Aged; Magnetic Resonance Imaging; Pharyngeal Neoplasms; Parapharyngeal Space; Myopericytoma; Contrast Media; Diagnosis, Differential
PubMed: 38828029
DOI: 10.3941/jrcr.v17i12.5186 -
Oral Oncology Dec 2015There is a lack of data from phase III randomized studies to support an ideal approach for locally advanced oral cavity cancer patients. In general, surgery,... (Review)
Review
There is a lack of data from phase III randomized studies to support an ideal approach for locally advanced oral cavity cancer patients. In general, surgery, radiotherapy and chemotherapy are valid treatment options, and combined approach is usually indicated given poor clinical outcomes with single modality therapy. The aim of this study is to review the current status and future perspectives of induction chemotherapy for locally advanced oral cavity cancer patients.
Topics: Clinical Trials as Topic; Humans; Induction Chemotherapy; Laryngeal Neoplasms; Mouth Neoplasms; Oropharyngeal Neoplasms; Pharyngeal Neoplasms; Treatment Outcome
PubMed: 26522693
DOI: 10.1016/j.oraloncology.2015.10.009 -
Acta Oto-laryngologica Feb 2022Evidence from observational studies shows that inflammatory bowel disease (IBD) [comprising ulcerative colitis (UC) and Crohn's disease (CD)] is a risk factor to Oral...
BACKGROUND
Evidence from observational studies shows that inflammatory bowel disease (IBD) [comprising ulcerative colitis (UC) and Crohn's disease (CD)] is a risk factor to Oral cavity and pharyngeal cancer (OC&PC) [comprising Oral cavity cancer (OCC) and Oropharyngeal cancer (OPC)], but it is unclear whether these diseases have potential causality.
OBJECTIVES
We aimed to explore the causal relationship between IBD and OC&PC.
MATERIALS AND METHODS
A mendelian randomized (MR) study was performed to estimate the causal relationship between IBD and OC&PC.
RESULTS
The potential causal relationship was statistically significant between IBD and OCC (OR = 1.14, 95% confidence interval (CI): 1.02-1.27, = .02), UC and OCC (OR = 1.13, 95% CI: 1.01-1.27, = .03), respectively. There was a universal null effect of IBD on OC&PC (IBD: OR = 1.01, 95%CI: 0.93-1.10, = .74; UC: OR = 1.00, 95%CI: 0.92-1.10, = .94; CD: OR = 1.02, 95%CI: 0.94-1.09, = .69), and IBD on OPC (IBD: OR = 0.93, 95%CI: 0.81-1.06, = 0.26; UC: OR = 0.90, 95%CI: 0.79-1.03, = .12; CD: OR = 1.04, 95%CI: 0.94-1.15, = .44).
CONCLUSIONS AND SIGNIFICANCE
MR analyses support new evidence indicating there may be a positive causal effect of IBD (including UC) on OCC. Further investigation of the potential biological mechanisms is necessary.
Topics: Colitis, Ulcerative; Humans; Inflammatory Bowel Diseases; Mendelian Randomization Analysis; Mouth Neoplasms; Pharyngeal Neoplasms
PubMed: 35195051
DOI: 10.1080/00016489.2022.2035431 -
Ear, Nose, & Throat Journal 2018Pleomorphic adenomas are considered the most common salivary gland tumors, although they rarely occur in the parapharyngeal space. To the best of our knowledge, this is... (Review)
Review
Pleomorphic adenomas are considered the most common salivary gland tumors, although they rarely occur in the parapharyngeal space. To the best of our knowledge, this is the first case report of a parapharyngeal parotid pleomorphic adenoma causing syncope. A 57-year-old man was admitted for left-sided blurred vision, left-sided weakness, dysarthria, lightheadedness, and syncope. Upon his admission, an electrocardiogram showed sinus bradycardia, and computed tomography of the neck with contrast showed a large parapharyngeal mass involving the prestyloid compartment, leading to compression of blood flow through the internal carotid artery. The mass was biopsied via intraoral fine-needle aspiration, which revealed cytology consistent with pleomorphic adenoma. The mass was resected via a transcervical approach, and a total parotidectomy was performed. The patient's hypotensive and bradycardic episodes disappeared after surgery. Surgical pathology showed a benign pleomorphic adenoma with a hemorrhagic and necrotic center and without capsular invasion or malignant transformation.
Topics: Adenoma, Pleomorphic; Humans; Male; Middle Aged; Pharyngeal Neoplasms; Salivary Gland Neoplasms; Syncope
PubMed: 29493727
DOI: 10.1177/0145561318097001-206