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Brazilian Journal of Otorhinolaryngology 2015Human papillomavirus has been associated with head and neck squamous cell carcinoma. However, there is no conclusive evidence on the prevalence of oral or pharyngeal... (Review)
Review
INTRODUCTION
Human papillomavirus has been associated with head and neck squamous cell carcinoma. However, there is no conclusive evidence on the prevalence of oral or pharyngeal infection by human papillomavirus in the Brazilian population.
OBJECTIVE
To determine the rate of human papillomavirus infection in the Brazilian population.
METHODS
Systematic review of published articles. Medline, The Cochrane Library, Embase, Lilacs (Latin American and Caribbean Health Sciences) and Scielo electronic databases were searched. The search included published articles up to December 2014 in Portuguese, Spanish and English. A wide search strategy was employed in order to avoid publication biases and to assess studies dealing only with oral and/or oropharyngeal human papillomavirus infections in the Brazilian population.
RESULTS
A total of 42 articles included 4066 enrolled patients. It was observed that oral or oropharyngeal human papillomavirus infections were identified in 738 patients (18.2%; IC 95 17.6-18.8), varying between 0.0% and 91.9%. The prevalences of oral or oropharyngeal human papillomavirus infections were respectively 6.2%, 44.6%, 44.4%, 27.4%, 38.5% and 11.9% for healthy people, those with benign oral lesions, pre-malignant lesions, oral or oropharyngeal squamous cell carcinoma, risk groups (patients with genital human papillomavirus lesions or infected partners) and immunocompromised patients. The risk of human papillomavirus infection was estimated for each subgroup and it was evident that, when compared to the healthy population, the risk of human papillomavirus infection was approximately 1.5-9.0 times higher, especially in patients with an immunodeficiency, oral lesions and squamous cell carcinoma. The rates of the most well-known oncogenic types (human papillomavirus 16 and/or 18) also show this increased risk.
CONCLUSIONS
Globally, the Brazilian healthy population has a very low oral human papillomavirus infection rate. Other groups, such as at-risk patients or their partners, immunocompromised patients, people with oral lesions and patients with oral cavity or oropharyngeal squamous cell carcinoma have a high risk of human papillomavirus infection.
Topics: Brazil; Carcinoma, Squamous Cell; Humans; Oropharyngeal Neoplasms; Papillomavirus Infections; Prevalence
PubMed: 26248966
DOI: 10.1016/j.bjorl.2015.04.001 -
World Journal of Surgery May 2015Lymph node metastases are relatively common in thyroid carcinoma, but retropharyngeal nodes (RPN) are rare. Management may be surgical or non-surgical, according to the... (Review)
Review
BACKGROUND
Lymph node metastases are relatively common in thyroid carcinoma, but retropharyngeal nodes (RPN) are rare. Management may be surgical or non-surgical, according to the context of the disease.
METHODS
Systematic review of cases reported in the literature and report of 5 cases.
RESULTS
Most case series report surgical management, via a cervical or transoral approach. RPN was the specific object of 26 case series, with a total of 85 patients, with surgery performed in 22/26 studies. Our 5 cases illustrated various strategies in the multidisciplinary management, with surgery for three patients (also with (131)I in one case), targeted therapy for one patient with concurrent distant metastases, and watch and wait for one elderly patient.
CONCLUSIONS
Management of RPN is not always surgical. Discussion of options in a multidisciplinary tumor board setting may optimize care.
Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Agents; Carcinoma; Female; Humans; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Multimodal Imaging; Neck; Pharynx; Positron-Emission Tomography; Thyroid Neoplasms; Thyroidectomy; Tomography, X-Ray Computed; Watchful Waiting
PubMed: 25585526
DOI: 10.1007/s00268-015-2947-2 -
JAMA Otolaryngology-- Head & Neck... Mar 2015Helicobacter pylori colonization contributes significantly to multiple disease states, but its role in the development of tonsillar infection is unclear. Understanding... (Meta-Analysis)
Meta-Analysis Review
IMPORTANCE
Helicobacter pylori colonization contributes significantly to multiple disease states, but its role in the development of tonsillar infection is unclear. Understanding the causes of chronic tonsillitis is important in clinical decision making of this commonly treated disease.
OBJECTIVE
To assess the correlation between H pylori colonization of tonsillar tissue in chronic tonsillitis and in noninfectious hyperplastic tonsils.
DATA SOURCES
We searched PubMed, MEDLINE, the Cochrane Trial Registry (through June 2014) and relevant article bibliographies.
STUDY SELECTION
Systematic review and meta-analysis of studies assessing the correlation between H pylori colonization in tonsillar tissues of patients undergoing tonsillectomy for either chronic tonsillitis or noninfectious causes. Included studies hypothesized that H pylori played a role in the development of chronic tonsillitis. All included studies investigated the presence of H pylori in tonsillar tissue removed for various indications. Included studies must have used an accepted method of testing for H pylori.
DATA EXTRACTION AND ANALYSIS
Studies were systematically reviewed by 2 independent reviewers for inclusion. Reported results of H pylori testing between tissues removed for infectious or noninfectious causes were systematically reviewed. The odds ratio of Hpylori colonization in tissue removed for chronic tonsillitis compared with tissue removed for noninfectious causes was calculated using a random-effects model.
RESULTS
Six studies met inclusion criteria and had suitable data for pooling (n = 436). Of these, 2 studies measured H pylori colonization of tonsillar tissue in pediatric populations. One study analyzed tissue in both adult and pediatric populations. Noninfectious indications for tonsillectomy included sleep apnea or sleep-related breathing disorder, obstruction, carcinoma, and tonsillar hypertrophy. Overall, tonsillar H pylori colonization was found not to be significantly present more often in tissue samples removed secondary to recurrent infection rather than to noninfectious indications. The odds ratio of H pylori colonization in the tonsils of patients with chronic tonsillitis was 1.993 (95% CI, 0.909-4.371) (P = .09).
CONCLUSIONS AND RELEVANCE
Helicobacter pylori colonization was not found to be more prevalent on tonsillar tissue with chronic or recurrent infections. The reviewed studies provide no evidence that H pylori infection plays a role in the pathogenesis or development of chronic tonsillitis.
Topics: Chronic Disease; Helicobacter Infections; Helicobacter pylori; Humans; Hyperplasia; Palatine Tonsil; Tonsillectomy; Tonsillitis
PubMed: 25541915
DOI: 10.1001/jamaoto.2014.3296 -
BMC Cancer Dec 2014Infection with human papillomavirus (HPV) is necessary for the development of cervical carcinoma. By contrast, the role of HPV in the pathogenesis of other malignancies,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Infection with human papillomavirus (HPV) is necessary for the development of cervical carcinoma. By contrast, the role of HPV in the pathogenesis of other malignancies, such as head and neck cancers, is less well characterised. This study aimed to address key information gaps by conducting a systematic review and meta-analysis of the prevalence of HPV infection in head and neck cancers, focusing on data for European populations.
METHODS
MEDLINE, Embase and grey literature sources were systematically searched for primary studies that were published in English between July 2002 and July 2012, and which reported on the prevalence of HPV infection in head and neck cancers in European populations. Studies on non-European populations, those not published in English, and those assessing patients co-infected with human immunodeficiency virus were excluded. Eligible studies were combined in a meta-analysis. In addition, the potential statistical association between the head and neck cancers and certain HPV types was investigated.
RESULTS
Thirty-nine publications met the inclusion criteria. The prevalence of HPV of any type in 3,649 patients with head and neck cancers was 40.0% (95% confidence interval, 34.6% to 45.5%), and was highest in tonsillar cancer (66.4%) and lowest in pharyngeal (15.3%) and tongue (25.7%) cancers. There were no statistically significant associations between the HPV types analysed and the geographical setting, type of sample analysed or type of primer used to analyse samples in head and neck cancers.
CONCLUSIONS
The prevalence of HPV infection in European patients with head and neck cancers is high but varies between the different anatomical sites of these malignancies. There appears to be no association between HPV type and geographical setting, type of samples analysed or type of primer used to analyse samples in such cancers.
Topics: Europe; Head and Neck Neoplasms; Humans; Papillomaviridae; Papillomavirus Infections; Prevalence; White People
PubMed: 25515630
DOI: 10.1186/1471-2407-14-968 -
Acta Oto-laryngologica Oct 2014The meta-analysis supported the proposition that the prevalence of gastroesophageal reflux disease (GERD) was associated with laryngeal cancer, particularly in the... (Meta-Analysis)
Meta-Analysis Review
CONCLUSION
The meta-analysis supported the proposition that the prevalence of gastroesophageal reflux disease (GERD) was associated with laryngeal cancer, particularly in the hospital-based control group and diagnosed by esophagogastroduodenoscopy (EGD) or esophageal pH monitoring. However, no significant association was found between GERD and pharyngeal carcinoma.
OBJECTIVES
A number of studies have been conducted to investigate the relationship between gastroesophageal reflux and laryngeal or pharyngeal carcinoma. The conclusions are still debated.
METHODS
We conducted a systematic review of studies associated with the prevalence of GERD in laryngeal or pharyngeal cancer, published up to November 2013.Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using random effects models or fixed effects models, according to heterogeneity I(2).
RESULTS
Ten studies were included in this meta-analysis. On average, GERD was significantly higher in the tumor tissue of the study group compared with normal tissue of the control group (OR = 2.17, 95% CI = 1.50, 3.14; random effects analysis). The pooled ORs for laryngeal carcinoma were 2.21 (95% CI = 1.53-3.19; I(2) = 97, random effects model) and 3.76 (95% CI = 0.21-67.48; I(2) = 94, random effects model) for pharyngeal carcinoma.
Topics: Carcinoma; Case-Control Studies; Confidence Intervals; Esophageal pH Monitoring; Esophagoscopy; Female; Gastroesophageal Reflux; Humans; Laryngeal Neoplasms; Laryngoscopy; Male; Odds Ratio; Pharyngeal Neoplasms; Precancerous Conditions; Prevalence; Prognosis; Prospective Studies; Risk Assessment
PubMed: 25131391
DOI: 10.3109/00016489.2014.927592 -
Head & Neck Nov 2015Pharyngocutaneous fistula (PCF) is the most common surgical complication after total laryngectomy. Controversy still remains regarding the multiple risk factors... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Pharyngocutaneous fistula (PCF) is the most common surgical complication after total laryngectomy. Controversy still remains regarding the multiple risk factors implicated. The purpose of this study was to evaluate the potential risk factors for PCF.
METHODS
The strategy for our literature survey included research in MEDLINE up to December 2013. The risk factors analyzed were age, sex, smoking habit, alcohol use, comorbidity, preoperative hemoglobin level, blood transfusion, preoperative tracheotomy, previous radiotherapy and chemoradiotherapy, primary tumor site, T classification, cartilage invasion, tumor grade, surgical margins, suture material, second layer of suture, reconstruction, tracheoesophageal prosthesis, and neck dissection.
RESULTS
The electronic search resulted in 311 studies from which 63 met the inclusion criteria.
CONCLUSION
Chronic obstructive pulmonary disease (COPD), previous hemoglobin <12.5g/dL, blood transfusion, previous radiotherapy or chemoradiotherapy, advanced primary tumors, supraglottic subsite, hypopharyngeal tumor site, positive surgical margins, and the performance of neck dissection were risk factors for PCF.
Topics: Age Factors; Aged; Comorbidity; Cutaneous Fistula; Female; Humans; Incidence; Laryngeal Neoplasms; Laryngectomy; Male; Middle Aged; Neck Dissection; Pharyngeal Diseases; Postoperative Complications; Prognosis; Risk Assessment; Sex Factors
PubMed: 24958209
DOI: 10.1002/hed.23804 -
Head & Neck Oct 2015Early oral feeding for patients who underwent total laryngectomy is still controversial. The purpose of this study was to evaluate the safety of initiating early oral... (Review)
Review
BACKGROUND
Early oral feeding for patients who underwent total laryngectomy is still controversial. The purpose of this study was to evaluate the safety of initiating early oral feeding after total laryngectomy regarding pharyngocutaneous fistula. The survey included research in MEDLINE, EMBASE, and LILACS.
METHODS
The intervention analyzed was early oral feeding (<5 days), whereas the control group received late oral feeding (>7 days) after total laryngectomy.
RESULTS
From 304 studies, 4 randomized clinical trials with 180 patients were selected. In the early oral feeding group, the incidence was 6.7%, whereas in the late oral feeding group it was 10%, with no statistically significant difference (IC95% -0.11 to 0.05; p = .42; I(2) = 0%). Four cohort studies with 490 patients were also selected. In the early oral feeding group, the incidence was 12.2%, whereas in the other group, it was 10.1%, with no statistically significant difference (IC95% -0.05 to 0.08; p = .67; I2 = 0%).
CONCLUSION
There is no increase in pharyngocutaneous fistula rates in patients who receive early oral feeding after total laryngectomy.
Topics: Constriction, Pathologic; Cutaneous Fistula; Enteral Nutrition; Female; Humans; Laryngeal Neoplasms; Laryngectomy; Male; Pharyngeal Diseases; Postoperative Care; Postoperative Complications; Surveys and Questionnaires; Time Factors
PubMed: 24816775
DOI: 10.1002/hed.23755 -
Head & Neck Sep 2014Carcinoma is a rare complication of pharyngeal diverticula. There is a paucity of information about its incidence, presentation, management, and treatment outcomes. A... (Review)
Review
BACKGROUND
Carcinoma is a rare complication of pharyngeal diverticula. There is a paucity of information about its incidence, presentation, management, and treatment outcomes. A systematic review and analysis of all reported cases has been carried out.
METHODS
A comprehensive literature search for pharyngeal diverticula carcinoma was performed from 1896 to 2008. Descriptive analyses were carried out by analyzing the absolute and relative frequencies. Comparison of groups was illustrated with Kaplan-Meier curves and tested statistically using the log-rank test. A cohort of 56 patients with benign pharyngeal diverticula was selected for comparison with the accumulated cohort of pharyngeal diverticula carcinoma, and a Fisher's exact test was carried out on the extracted clinical characteristics of this cohort to evaluate for differences between benign and malignant pharyngeal diverticula.
RESULTS
Forty-three articles reporting 60 cases satisfied the inclusion criteria. The mean age at presentation was 68.8 years (SD = 9.8 years). Five-year cancer-specific survival (CSS) rates for patients who underwent excision alone, excision + postoperative radiotherapy (PORT), and radiotherapy alone were 0.74 versus 0.63 versus 0.0, respectively (p = .39). Five-year CSS rates of patients <65 versus ≥65 years were 0.43 versus 0.78, respectively (p = .046).
CONCLUSION
Irregular symptoms in benign diverticula should raise suspicion of malignancy. Management consists of surgical excision ± PORT. © 2014 Wiley Periodicals, Inc. Head Neck 36: 1368-1375, 2014.
Topics: Carcinoma; Humans; Pharyngeal Neoplasms; Zenker Diverticulum
PubMed: 23996210
DOI: 10.1002/hed.23491