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European Annals of Otorhinolaryngology,... Apr 2019Based on a review of the medical literature, the authors document the key technical points, variants, technical errors to avoid and main functional results of lateral...
Based on a review of the medical literature, the authors document the key technical points, variants, technical errors to avoid and main functional results of lateral pharyngotomy for resection of cancers originating from the lateral oro and/or hypopharynx.
Topics: Anatomic Landmarks; Humans; Medical Illustration; Pharyngeal Neoplasms; Pharynx
PubMed: 30482706
DOI: 10.1016/j.anorl.2018.10.011 -
Radiologic Clinics of North America Sep 1998Imaging of the oral cavity and pharynx often is required in three settings: assessment of an inflammatory mass in association with odontogenic, tonsillar, or pharyngeal... (Review)
Review
Imaging of the oral cavity and pharynx often is required in three settings: assessment of an inflammatory mass in association with odontogenic, tonsillar, or pharyngeal infections; determination of the cause of a submucosal mass; and staging of squamous-cell carcinomas. Spread of infection from the oral cavity and pharynx can lead to abscesses in the masticatory space, the retropharyngeal compartment, and in a parapharyngeal location. Submucosal masses include congenital cysts (thyroglossal and dermoid), benign neoplasms (hemangioma, schwannomas, pleomorphic adenomas juvenile angiofibromas), inflammatory cysts (mucous retention cysts, ranulas), and pseudotumors (osteophytes, carotid arteries). Staging of squamous-cell carcinomas must focus on deep invasion, spread to the brain, nerves, mandible, prevertebral muscle, and pre-epiglottic fat.
Topics: Abscess; Bacterial Infections; Carcinoma, Squamous Cell; Cysts; Diagnostic Imaging; Focal Infection; Humans; Mouth; Mouth Diseases; Mouth Neoplasms; Neoplasm Invasiveness; Neoplasm Staging; Palatine Tonsil; Pharyngeal Diseases; Pharyngeal Neoplasms; Pharynx; Tooth Diseases
PubMed: 9747196
DOI: 10.1016/s0033-8389(05)70071-3 -
BMJ Case Reports Aug 2018A 17-year-old man initially presented to his primary care physician with throat pain for 1 week and was started on amoxicillin. After four additional days of ongoing...
A 17-year-old man initially presented to his primary care physician with throat pain for 1 week and was started on amoxicillin. After four additional days of ongoing pain and difficulty swallowing with decreased oral intake, he presented to the emergency department. Exam showed fullness to the right posterior oropharynx and palpable mass in the right neck without stridor. Initial imaging was soft tissue neck CT with contrast, which showed cystic 8 cm mass in the parapharyngeal space. Patient additionally underwent MRI, which showed an 8.6 cm mass in the right posterior oropharynx with obliteration of the vallecula. Differential diagnosis included abscess; therefore, ear, nose, and throat (ENT) specialist was consulted for possible drainage. Intraoperatively, there was no abscess; alternatively a biopsy was obtained, which was identified by pathology as a ganglioneuroma. Patient was referred to paediatric ENT specialist, underwent extensive resection confirming diagnosis of ganglioneuroma and did well postoperatively.
Topics: Adolescent; Deglutition Disorders; Diagnosis, Differential; Ganglioneuroma; Humans; Male; Neck; Oropharynx; Pharyngeal Neoplasms; Pharyngitis
PubMed: 30131403
DOI: 10.1136/bcr-2018-225763 -
Archives of Pathology & Laboratory... Dec 2013Lymphangioma of the palatine tonsil is a rare, benign lesion that presents as a tonsillar outgrowth and causes symptoms related to irritation and airway obstruction.... (Review)
Review
Lymphangioma of the palatine tonsil is a rare, benign lesion that presents as a tonsillar outgrowth and causes symptoms related to irritation and airway obstruction. Histologically, the mass has abundant dilated lymphatic channels amid a fibrous stroma with lymphoid and adipose elements. There are several theories regarding the pathogenesis of these lesions, and the appropriate diagnostic classification is controversial. Because a lymphangioma may resemble a true neoplasm of the palatine tonsil clinically, the lesion must be removed for accurate histologic diagnosis and to rule out malignancy. Lymphangioma of the palatine tonsil is treated with surgical excision and has no recurrence once completely resected.
Topics: Diagnosis, Differential; Humans; Incidence; Lymphangioma; Neoplasm Recurrence, Local; Palatine Tonsil; Pharyngeal Neoplasms; Tonsillectomy
PubMed: 24283866
DOI: 10.5858/arpa.2012-0678-RS -
BMC Cancer Mar 2022Cancers of the oral cavity and pharynx encompass a heterogeneous group of cancers for which known risk factors include smoking, alcohol consumption and human papilloma...
BACKGROUND
Cancers of the oral cavity and pharynx encompass a heterogeneous group of cancers for which known risk factors include smoking, alcohol consumption and human papilloma virus (HPV) infection but their influence is site-specific with HPV mainly influencing oropharyngeal cancer. Their incidence and survival rates are not well known over extended periods of time.
PATIENTS/METHODS
Data were obtained for Finnish (FI) and Swedish (SE) patients from the Nordcan database recently updated through 2019. Age-adjusted incidence trends (FI from 1953, SE from 1960) and relative survival rates for years 1970 through 2019 were calculated.
RESULTS
We observed a prominent increase in oral and oropharyngeal cancers in FI and SE men and women but the trend for oral cancer was interrupted for SE men in 1985 and possibly also for FI and SE women in 2015. The trend changes in male and female oral cancer was confirmed in data for Denmark and Norway. Relative survival for these cancers has improved overall but they differed for one cluster of oral, oropharyngeal and nasopharyngeal cancers with 60-70% 5-year survival in the last period and hypopharyngeal cancer with 25% male survival. In all these cancers, survival for old patients was unfavorable.
DISCUSSION/CONCLUSION
We hypothesize that reduction in smoking prevalence helped to stop the increase in oral cancer especially in men. As the prevalence of smoking is decreasing, HPV is becoming a dominant risk factor, particularly for the increasing oropharyngeal cancer. Prevention needs to emphasize sexual hygiene and HPV vaccination.
Topics: Aged; Alcohol Drinking; Female; Finland; Humans; Incidence; Male; Middle Aged; Mouth Neoplasms; Oropharyngeal Neoplasms; Papillomavirus Infections; Pharyngeal Neoplasms; Registries; Risk Factors; Smoking; Sweden
PubMed: 35236321
DOI: 10.1186/s12885-022-09337-2 -
European Journal of Cancer Prevention :... Nov 2010Evidence for the human carcinogenic effects of alcohol consumption on the risk of cancers of the oral cavity and pharynx has been considered sufficient in the... (Review)
Review
Evidence for the human carcinogenic effects of alcohol consumption on the risk of cancers of the oral cavity and pharynx has been considered sufficient in the International Agency for Research on Cancer Monograph 44 on alcohol and cancer in 1988. We evaluated human carcinogenic evidence related to the risk of oral and pharyngeal cancers based on cohort and case-control studies published from 1988 to 2009. A large body of evidence from epidemiological studies of different designs and conducted in different populations has consistently supported the fact that alcohol consumption is strongly associated with an increase in the risk of oral and pharyngeal cancers. The relative risks are 3.2-9.2 for more than 60 g/day (or more than four drinks/day) when adjusted for tobacco smoking and other potential confounders. A strong dose-response effect on the intensity of alcohol use is reported in most of the studies. However, no apparent association is observed for the duration of alcohol use. Compared with current alcoholics, a decreased risk of approximately 10 to 15 years is associated with alcohol cessation. Similar associations have been observed among nonsmokers in over 20 studies. In general, the dominant type of alcohol consumption in each population is associated with the greatest increase in risk. A large number of studies on joint exposure to alcohol and tobacco consumption show a greater than multiplicative synergistic effect.
Topics: Alcohol Drinking; Case-Control Studies; Cohort Studies; Humans; Mouth Neoplasms; Pharyngeal Neoplasms; Risk; Smoking
PubMed: 20679896
DOI: 10.1097/CEJ.0b013e32833d936d -
Acta Otorhinolaryngologica Italica :... Aug 2016The purpose of the present study was to evaluate the advantages of a video-assisted, minimally invasive transcervical approach to benign and malignant parapharyngeal... (Review)
Review
The purpose of the present study was to evaluate the advantages of a video-assisted, minimally invasive transcervical approach to benign and malignant parapharyngeal space (PPS) tumours. Ten patients affected by benign and malignant PPS neoplasms underwent a combined transcervical and video-assisted minimally invasive approach, using Hopkins telescopes. We describe the operative technique and perform a review of the literature. Definitive histology revealed 3 pleomorphic adenomas, 2 schwannomas, 2 metastatic papillary thyroid carcinomas, one carcinoma ex pleomorphic adenoma, one cavernous haemangioma and one basal cell adenoma. Mean tumour size was 37.2 mm (range: 19-60). Operation time ranged from 75 min to 185 min (mean: 146.7). One case was converted to transcervical-transparotid approach. Patients were discharged on postoperative day 2-5. One patients presented hypoglossal nerve paresis. The minimally invasive video-assisted transcervical approach is safe and feasible for selected benign and malignant PPS tumours. Furthermore, it offers harmless dissection in a deep and narrow space, accurate haemostasis and continuous control of critical anatomic structures.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Neck; Pharyngeal Neoplasms; Video-Assisted Surgery
PubMed: 27734977
DOI: 10.14639/0392-100X-709 -
Current Oncology (Toronto, Ont.) Dec 2022Different surgical techniques have been proposed for parapharyngeal space tumors, including transcervical, transparotid, trans-mandibular, infratemporal, and transoral.... (Review)
Review
Different surgical techniques have been proposed for parapharyngeal space tumors, including transcervical, transparotid, trans-mandibular, infratemporal, and transoral. The choice of the correct approach depends on the size, localization and nature of the tumor. The transoral approach can be used for benign prestyloid masses, such as tumors of the deep lobe of the parotid gland. It guarantees a short hospitalization without skin scars. The narrowed access represents the main limitation of this technique. This review will summarize and analyze the current knowledge about the transoral approach to parotid lesions. Thirty-seven studies were included in a qualitative and quantitative synthesis. The novelty of this review is the quantitative analyses of the clinical data reported in the included studies.
Topics: Humans; Pharyngeal Neoplasms; Parotid Neoplasms; Retrospective Studies; Hospitalization
PubMed: 36547154
DOI: 10.3390/curroncol29120740 -
Medical Sciences (Basel, Switzerland) Oct 2023Malnutrition in esophageal and pharyngeal cancer patients constitutes a common and serious concern, which significantly reduces patients' prognoses. Cancers of the... (Review)
Review
May Nutritional Status Positively Affect Disease Progression and Prognosis in Patients with Esophageal and Pharyngeal Cancers? A Scoping Review of the Current Clinical Studies.
BACKGROUND
Malnutrition in esophageal and pharyngeal cancer patients constitutes a common and serious concern, which significantly reduces patients' prognoses. Cancers of the esophagus and the pharynx can considerably impair feeding in patients, resulting in severe undernutrition. This is a scoping review that intends to critically analyze the most well-designed clinical studies investigating the potential beneficial impact of diverse nutritional assessment tools on the prognosis of patients with esophageal and pharyngeal cancers.
METHODS
The most accurate and remarkable scientific databases were comprehensively explored utilizing relative keywords to detect clinical studies that investigate whether nutritional status may affect disease prognosis.
RESULTS
Several assessment tools have evaluated and highlighted the potential beneficial impact of nutritional status on disease progression and patients' prognosis in both esophageal and pharyngeal cancers. Regarding esophageal cancer, CONUT, PNI, PG-SGA, and NRS-2002 are more commonly used, while albumin is also frequently evaluated. Regarding pharyngeal cancers, fewer studies are currently available. PNI has been evaluated, and its significance as a factor for shorter survival' times has been highlighted. The Comprehensive Nutritional Index has also been evaluated with positive results, as well as NRS 2002, GPS, and body-weight status. However, there is currently a lack of studies with an adequate number of women with cancer. An international literature gap was identified concerning follow-up studies with adequate methodology.
CONCLUSIONS
Nutritional status may significantly affect disease progression and patients' survival, highlighting the significance of a great nutritional status in individuals with esophageal and pharyngeal cancers. Further large-scale and well-designed prospective surveys should be performed to verify the potential beneficial effects of adequate nourishment in people suffering from cancer of the esophagus and pharynx.
Topics: Humans; Female; Nutritional Status; Prospective Studies; Prognosis; Disease Progression; Esophageal Neoplasms; Pharyngeal Neoplasms
PubMed: 37873749
DOI: 10.3390/medsci11040064 -
Ear, Nose, & Throat Journal Dec 2021The transoral approach for parapharyngeal space tumors has been criticized due to its restrictive exposure and increased rate of vascular and nerve injuries. However,...
OBJECTIVES
The transoral approach for parapharyngeal space tumors has been criticized due to its restrictive exposure and increased rate of vascular and nerve injuries. However, for certain tumors-namely those that are prestyloid, benign, and well-encapsulated-the transoral approach reduces overall morbidity while providing direct access. Transoral surgeons can rely on this approach for select tumors seen clearly on intraoral examination in the bulging lateral pharynx. In this article and with a supplemental operative technique video, we demonstrate our transoral approach in these select patients.
METHODS
We reviewed our 26 cases using this approach and chose a representative case of a 50-year-old man who presented with a large, prestyloid, encapsulated parapharyngeal mass affecting his voice and swallowing. A transoral approach to the parapharyngeal tumor is illustrated.
RESULTS
A vertical curvilinear incision is completed from the hamulus to below the inferior extent of the tumor. Blunt dissection of the tumor capsule proceeds inferiorly. Controlled violation of the tumor capsule can aid in visualization. After tumor delivery, the wound is irrigated and closed.
CONCLUSIONS
In our experience, the transoral approach is an effective method to access well-encapsulated, prestyloid parapharyngeal space tumors. Patient selection is important when considering a transoral approach.
Topics: Humans; Male; Middle Aged; Natural Orifice Endoscopic Surgery; Otorhinolaryngologic Surgical Procedures; Pharyngeal Neoplasms; Retrospective Studies; Salivary Gland Neoplasms
PubMed: 32425121
DOI: 10.1177/0145561320923171