Most Downloaded Articles

   
 
REVIEW ARTICLE
Mina N Le, Erica Lee, Bhuvanesh Singh

The Evolution of Staging of Cutaneous Squamous, Cell Carcinomas: A Structured Review

[Year:2017] [Month:April-June] [Volumn:8 ] [Number:2] [Pages:51] [Pages No:57-63][No of Hits : 898]


ABSTRACT

Among non-melanoma skin cancers, cutaneous squamous cell carcinoma entails the highest morbidity and mortality, and yet there is little guidance on how to identify the subset of cutaneous squamous cell carcinomas that behave aggressively. The staging of non-melanoma skin cancers is meant to provide this guidance, by dividing patients into groups for which survival differs between groups, is similar within each group, and consistently decreases with each increasing stage group. In the present review, we explore the history of how the staging of nonmelanoma skin cancers, focusing on cutaneous squamous cell carcinomas, has evolved over time. We describe the common criticisms leveled at the American Joint Committee on Cancer (AJCC) staging rubric. We discuss alternative staging systems that have recently been proposed, and how they have stood up to validation. Finally, we preview the AJCC staging changes that will go into effect next year and lay out some future directions for the improvement of skin cancer staging.

Keywords: Cutaneous squamous cell carcinoma, Non-melanoma skin cancer, Prognostic factors, TNM staging.

How to cite this article: Le MN, Lee E, Singh B. The Evolution of Staging of Cutaneous Squamous Cell Carcinomas: A Structured Review. Int J Head Neck Surg 2017;8(2):57-63.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Natalya Chernichenko

Critical Update on Malignant Salivary Gland Neoplasms

[Year:2017] [Month:April-June] [Volumn:8 ] [Number:2] [Pages:51] [Pages No:71-75][No of Hits : 861]


ABSTRACT

Salivary gland neoplasms are relatively rare tumors with a wide range of biologic behavior. Early low-grade malignancies could be adequately treated with surgery alone, while larger locally advanced tumors will require adjuvant radiation therapy. The role of chemotherapy remains palliative. The goal of this article is to provide a critical review of recent literature on diagnosis and management of salivary neoplasms.

Keywords: Head and neck cancer, Perineural invasion, Salivary neoplasm.

How to cite this article: Chernichenko N. Critical Update on Malignant Salivary Gland Neoplasms. Int J Head Neck Surg 2017;8(2):71-75.

Source of support: Nil

Conflict of interest: None


 
LITERATURE REVIEW
Bahbak Shariat-Madar, Jeffrey C Liu

Role of Depth of Invasion in Evaluation and Management of Early-stage Oral Cavity Squamous Cell Carcinoma

[Year:2017] [Month:April-June] [Volumn:8 ] [Number:2] [Pages:51] [Pages No:84-88][No of Hits : 596]


ABSTRACT

Aim: To evaluate the existing body of literature and impact of depth of invasion (DOI) in early-stage oral cavity squamous cell carcinoma (OCSCC) and its role in predicting occult cervical lymph node metastases.

Background: The prognosis for early-stage T1 to T2 disease OCSCC is relatively poor compared with other mucosal subsites within the head and neck. Primary tumor DOI can help prognosticate high-risk tumors for additional treatment.

Review results: There are unequivocal management implications in the literature demonstrating a role for elective neck dissection in early-stage OCSCC based on DOI. Following appropriate patient selection, there may be a role for sentinel lymph node biopsy in regional lymph node staging in earlystage OCSCC.

Conclusion: There are a multitude of studies demonstrating novel strategies to appropriately treat early-stage OCSCC, which are increasingly becoming standard of care. These strategies are altering the overall and disease-free survival of early-stage OCSCC. Despite advances, locoregional recurrence remains a challenge in this disease.

Clinical significance: Herein, the authors highlight a number of advances in the management of early-stage OCSCC as described in the literature, which are having an impact on disease-free and overall survival.

Keywords: Carcinoma, Cavity, Cell, Cervical, Depth, Invasion, Lymphatic, Metastases, Oral, Squamous.

How to cite this article: Shariat-Madar B, Liu JC. Role of Depth of Invasion in Evaluation and Management of Early-stage Oral Cavity Squamous Cell Carcinoma. Int J Head Neck Surg 2017;8(2):84-88.

Source of support: Nil

Conflict of interest: None


 
INVITED REVIEW
C Fitzgerald, James Paul O'Neill

High-risk Cutaneous Squamous Cell Carcinoma

[Year:2017] [Month:April-June] [Volumn:8 ] [Number:2] [Pages:51] [Pages No:37-44][No of Hits : 572]


ABSTRACT

Cutaneous squamous cell carcinoma (cSCC) is the second most common nonmelanoma skin cancer worldwide. Cutaneous squamous cell carcinoma can potentially be treated fully with minimal morbidity when detected early; however, certain subtypes of cSCC have been shown to confer a poorer prognosis for patients. In these high-risk tumors, increased incidence of recurrence, as well as metastasis to local lymph nodes and distant sites, is seen as a result of certain patient characteristics and pathological features. While guidelines regarding the management of high-risk cSCC have been produced, no clear consensus management or prognostic algorithms exist. In this review, we discuss current definitions of high-risk cSCC, recommendations regarding the management of cSCC, and current guidelines.

Keywords: Clinical guidelines, High-risk, Oncology, Squamous cell carcinoma.

How to cite this article: Fitzgerald C, O'Neill JP. High-risk Cutaneous Squamous Cell Carcinoma. Int J Head Neck Surg 2017;8(2):37-44.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Evangelia Katsoulakis, Natalya Chernichenko, David Schreiber

Proton Therapy in the Treatment of Head and Neck Cancer

[Year:2017] [Month:April-June] [Volumn:8 ] [Number:2] [Pages:51] [Pages No:45-48][No of Hits : 539]


ABSTRACT

Aim: To examine the value of proton therapy in relation to other treatment modalities in head and neck cancer.

Review: Proton therapy has evolved into more sophisticated and costly intensity-modulated proton therapy and has resulted in even greater dose reduction to normal critical structures at risk as compared with photon therapy. Early clinical studies in head and neck cancers, especially for tumors of the skull base and paranasal sinuses, suggest that proton therapy is excellent in terms of local control and is comparable to intensity-modulated radiation therapy photons but with lower rates of morbidity.

Results: There are many potential advantages to radiation therapy with protons. While there are many single institution studies examining the added value of protons to photon therapy, the value of proton therapy must be examined in prospective randomized clinical studies and across many subsites of head and neck cancer. Additional evidence is necessary to guide efficient clinical practice, patient selection, and tumors that are most likely to benefit from this treatment modality and justify proton therapy use given its significant cost.

Keywords: Head and neck cancer, Proton therapy, Radiation therapy.

How to cite this article: Katsoulakis E, Chernichenko N, Schreiber D. Proton Therapy in the Treatment of Head and Neck Cancer. Int J Head Neck Surg 2017;8(2):45-48.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Lee J Kaplowitz, Eric M Joseph

A Practical Approach for Learning Rhinoplasty Surgery

[Year:2016] [Month:January-March] [Volumn:7 ] [Number:1] [Pages:56] [Pages No:33-46][No of Hits : 3300]


ABSTRACT

Rhinoplasty surgery is a procedure well suited for otolaryngology residents to incorporate in their training and subsequent practices of medicine. We detail a practical approach for learning rhinoplasty which may commence during residency. The resident learns to conduct a proper consultation, preoperative evaluation, surgical procedure, and follow-up care for the prospective rhinoplasty patient. The history of rhinoplasty, and modern rhinoplasty techniques is discussed, and suggestions are made for residents to successfully incorporate learning rhinoplasty surgery during their otolaryngology training.

Keywords: Otolaryngology, Residency, Rhinoplasty.

How to cite this article: Kaplowitz LJ, Joseph EM. A Practical Approach for Learning Rhinoplasty Surgery. Int J Head Neck Surg 2016;7(1):33-46.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
John Nathan, Lynda Asadourian, Mark A Erlich

A Brief History of Local Anesthesia

[Year:2016] [Month:January-March] [Volumn:7 ] [Number:1] [Pages:56] [Pages No:29-32][No of Hits : 1053]


ABSTRACT

Mankind has, throughout its existence, been engaged in the quest to control the pain associated with disease and trauma. Evidence from over 4500 years ago demonstrates the Egyptians use of methods to compress peripheral nerves. Homer’s Iliad relates the use of herbal remedies for pain control. Other early writings describe the use of electricity generated by the Torpedo ray for pain control as well as cold water and ice for pain reduction. These techniques, in their various incarnations, comprised the main armamentarium of local pain control until the early 1800’s when the early framework for the hypodermic syringe emerged in America. Cocaine, noted for its stimulant effect as well as numbing properties, was first brought to Europe by Vespucci. The combination of a workable syringe and the purification of Cocaine by Niemann essentially gave birth to modern local anesthesia. Halsted would perform the first injections of cocaine via hypodermic syringe into a proximal nerve for distal pain control, introducing modern conduction local anesthesia. All that remained was the introduction of numerous blockers of nerve depolarization, combined with vasoconstrictors, to minimize systemic toxicity, and we arrive at the modern state of local anesthesia.

Keywords: Local anesthesia, Nerve depolarization, Pain control, Vasoconstriction.

How to cite this article: Nathan J, Asadourian L, Erlich MA. A Brief History of Local Anesthesia. Int J Head Neck Surg 2016; 7(1):29-32.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Payam Sajedi, Narendra Shet

Imaging of Pediatric Neck Masses

[Year:2016] [Month:April-June] [Volumn:7 ] [Number:2] [Pages:91] [Pages No:89-96][No of Hits : 1051]


ABSTRACT

Pediatric neck masses comprise a wide spectrum of entities, benign and malignant. The role of imaging is to characterize these lesions, in order to better determine which can be expectantly managed and which require immediate intervention. An important consideration in the pediatric population is ionizing radiation; while X-ray and CT can be useful, radiation can have harmful effects, particularly in children. In this article, we review imaging feature of common pediatric neck masses, with emphasis on radiation sparing modalities (ultrasound and MRI) when possible.

Keywords: Computed tomography, Magnetic resonance imaging, Neck mass, Pediatric, Ultrasound.

How to cite this article: Sajedi P, Shet N. Imaging of Pediatric Neck Masses. Int J Head Neck Surg 2016;7(2):89-96.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Jessica W Scordino, Frederick J Stucker

Management of the Crooked Nose

[Year:2016] [Month:July-September] [Volumn:7 ] [Number:3] [Pages:42] [Pages No:168-172][No of Hits : 1046]


ABSTRACT

Aim: To describe an approach for the diagnosis and management of patients presenting with crooked nose.

Background: Patients with crooked nose suffer from functional ailments, most significant nasal obstruction, as well as esthetic concerns which may impact their self-image as well as others’ perception of them. As such, management of the crooked nose is an especially challenging task in that it demands careful attention to both nasal function and appearance. There are a plethora of surgical techniques which may be utilized, and the surgeon’s approach must be tailored to each individual patient’s presentation.

Technique: Accurate diagnosis is imperative for a successful outcome and relies on a thorough history and careful physical examination. Surgical intervention may be addressed by either an endonasal or open approach based on the location and severity of the deformity. It is helpful to break down the nose in vertical thirds when planning your surgical approach. Different techniques are used to address the upper third comprising the nasal bones, middle third composed of the upper lateral cartilages and septum, and the lower third composed of the lower lateral cartilages and caudal septum.

Conclusion: Management of the crooked nose is a technically challenging endeavor that highlights the need to address both form and function for a successful outcome. Effective treatment can significantly improve a patient’s quality of life leading to a high level of satisfaction for both the patient and the surgeon.

Keywords: Crooked nose, Deviated nose, Nasal trauma, Rhinoplasty.

How to cite this article: Scordino JW, Stucker FJ. Management of the Crooked Nose. Int J Head Neck Surg 2016;7(3):168-172.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Saurabh Sharma, Steven Andreoli, Gary D Josephson

Tonsillectomy and Adenoidectomy: Current Techniques and Outcomes

[Year:2016] [Month:April-June] [Volumn:7 ] [Number:2] [Pages:91] [Pages No:104-108][No of Hits : 998]


ABSTRACT

Tonsillectomy and Adenoidectomy continues to be one of the most commonly performed surgical procedures in the pediatric population with over 500,000 procedures performed annually. Decreasing pain, maintaining hydration, and minimizing the risk of post operative hemorrhage has brought attention to novel surgical technique and instrumentation. Electro-cautery remains the most common technique used across the United States, however newer technologies have evolved claiming improved recovery with expedited return to normal activity and diet. The current literature remains of significant debate as to the modality that offers the best outcomes. In this review, we describe some of the newer technologies and more common modalities used in practice and discuss the current literature findings.

Keywords: Adenoidectomy, Hemorrhage, Pain, Tonsillectomy.

How to cite this article: Sharma S, Andreoli S, Josephson GD. Tonsillectomy and Adenoidectomy: Current Techniques and Outcomes. Int J Head Neck Surg 2016;7(2):104-108.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Evren Erkul, Krishna G Patel, Terry Day

Surgical Planning for Resection and Reconstruction of Facial Cutaneous Malignancies

[Year:2016] [Month:July-September] [Volumn:7 ] [Number:3] [Pages:42] [Pages No:149-164][No of Hits : 872]


ABSTRACT

Skin cancer can be categorized into cutaneous melanoma and nonmelanoma skin cancer (NMSC). The latter includes such histologies as Merkel cell carcinoma (MCC), basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). Of these, BCC and SCC are the most common skin cancers of the head and neck while malignant melanoma is the most aggressive. Sunscreen protection and early evaluation of suspicious areas remain the first line of defense against all skin cancers. When prevention fails, the gold standard of skin cancer management involves a multidisciplinary approach which takes into account tumor location, stage and biology of disease, and availability of resources. Proper diagnosis, staging, and treatment planning must all be addressed prior to initiating interventions. When surgery is indicated, facial reconstruction is a key aspect of the overall treatment plan and requires informed forethought as well as experience and skill. Here, we present an overview of surgical reconstruction recommendations and considerations for the subsites involved in head and neck skin cancer.

Keywords: Cutaneous, Facial, Reconstruction, Skin cancer, Surgical, Treatment.

How to cite this article: Erkul E, Patel KG, Day T. Surgical Planning for Resection and Reconstruction of Facial Cutaneous Malignancies. Int J Head Neck Surg 2016;7(3):149-164.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Oshri Wasserzug, Ari DeRowe

Subglottic Stenosis: Current Concepts and Recent Advances

[Year:2016] [Month:April-June] [Volumn:7 ] [Number:2] [Pages:91] [Pages No:97-103][No of Hits : 723]


ABSTRACT

Subglottic stenosis is considered one of the most complex and challenging aspects of pediatric otolaryngology, with the most common etiology being prolonged endotracheal intubation. The surgical treatment of SGS can be either endoscopic or open, but recent advances have pushed the limits of the endoscopic approach so that in practice an open laryngotracheal surgical approach is considered only after failed attempts with an endoscopic approach. In this review we discuss these advances, along with current concepts regarding the diagnosis and treatment of subglottic stenosis in children. .

Keywords: Direct laryngoscopy, Endoscopic surgery, Laryngotracheal surgery, Prolonged intubation, Subglottic stenosis.

How to cite this article: Wasserzug O, DeRowe A. Subglottic Stenosis: Current Concepts and Recent Advances. Int J Head Neck Surg 2016;7(2):97-103.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Sandra Ho, David J Kay

Tympanostomy Tube Selection: A Review of the Evidence

[Year:2016] [Month:January-March] [Volumn:7 ] [Number:1] [Pages:56] [Pages No:17-22][No of Hits : 671]


ABSTRACT

Tympanostomy tube (TT) insertion for ventilation of the middle ear is one of most commonly performed procedures in the United States. Indications for tube insertion include otitis media with effusion, recurrent acute otitis media, hearing loss caused by middle ear effusion and persistent acute otitis media. In general, TTs are divided into two categories, short-term tubes and long-term tubes. Depending on the indications for tube placement and surgeon experience with the TT, different tubes can be used. A myriad of tubes have been created since their first documented use in 1845 in attempts to provide better middle ear ventilation, improve ease of placement and prevent complications, such as post-tube otorrhea, persistent perforation and tube occlusion. In order for a tube to be effective, it should be biocompatible with the middle ear to minimize a foreign body reaction. Teflon and silicone remain two of the most commonly used materials in TTs. In addition, the tube design also plays a role for insertion and retention times of TTs. Lastly, TTs can also be coated with various substances, such as silver-oxide, phosphorylcholine and more recently, antibiotics and albumin, in order to prevent biofilm formation and decrease the rate of post-TT otorrhea. Persistent middle ear effusion affects many children each year and can impact their quality of life as well as hearing and language development. With nearly 1 out of every 15 children by the age of 3 years receiving TTs, it is imperative that the right tube be chosen to facilitate optimal ventilation of the middle ear while minimizing complications.

Keywords: Biofilm, Extrusion, Long-term tubes, Otorrhea, Perforation, Retention, Short-term tubes, Silicone, Tympanostomy tube.

How to cite this article: Ho S, Kay DJ. Tympanostomy Tube Selection: A Review of the Evidence. Int J Head Neck Surg 2016;7(1):17-22.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Si Chen, Andrea Hebert, Ramzi Younis

Pediatric Sinus Surgery: Indications, Techniques, and Outcomes

[Year:2016] [Month:April-June] [Volumn:7 ] [Number:2] [Pages:91] [Pages No:124-129][No of Hits : 635]


ABSTRACT

Pediatric sinus surgery is indicated in patients with rhinosinusitis that does not respond medical therapy after controlling of predisposing factors such as allergic rhinitis, adenoiditis, environmental irritants, and gastroesophageal reflux. Orbital and intracranial extensions from rhinosinusitis requires aggressive medical management and expedient surgical intervention. There is an armamentarium of techniques to address the pediatric sinuses, including maxillary antral lavage, septoplasty, turbinate reduction, balloon sinuplasty, and functional endoscopic sinus surgery. Surgeries for pediatric rhinosinusitis have favorable outcomes in general, with low complication rates.

Keywords: Balloon sinuplasty, Functional endoscopic sinus surgery, Maxillary antral lavage, Pediatric rhinosinusitis, Pediatric sinus surgery.

How to cite this article: Chen S, Hebert A, Younis R. Pediatric Sinus Surgery: Indications, Techniques, and Outcomes. Int J Head Neck Surg 2016;7(2):124-129.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Mary Worthen, Swapna Chandran

Hoarseness in Children

[Year:2016] [Month:April-June] [Volumn:7 ] [Number:2] [Pages:91] [Pages No:130-135][No of Hits : 598]


ABSTRACT

Background: The prevalence of pediatric dysphonia ranges from 6-23%. Chronic dysphonia can negatively affect the lives of children physically, socially, and emotionally. The body of literature continues to grow regarding the pathophysiology and management of dysphonic children.

Methods: This article presents a relevant literature review of vocal fold pathology leading to hoarseness and recent advances in diagnosis and management. Articles were retrieved using a selective search in PubMed employing the terms such as “hoarseness in children,” “pediatric dysphonia.”

Results: 42 articles from the past decade were reviewed that include information regarding the etiology, assessment, and treatment of children with dysphonia.

Conclusion: The care of a child with a voice disorder can be complex and requires a multi-disciplinary approach. Current technological, pharmaceutical, and therapeutic advances have improved the treatment of children with dysphonia.

Keywords: Hoarseness in children, Pediatric dysphonia, Pediatric hoarseness.

How to cite this article: Worthen M, Chandran S. Hoarseness in Children. Int J Head Neck Surg 2016;7(2):130-135.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Soham Roy, Syed HS Naqvi, Ron J Karni

Medrobotics Flex System for Laryngeal Surgery: A Feasible Study in Two Cadavers

[Year:2016] [Month:October-December] [Volumn:7 ] [Number:4] [Pages:37] [Pages No:204-206][No of Hits : 574]


ABSTRACT

Objective: To report the feasibility of Medrobotics Flex® System for laryngeal surgery.

Materials and methods: Cadaver study in research laboratory.

Results: The Medrobotics Flex System was utilized with the Medrobotics Flex Retractor to evaluate robotic laryngeal surgery in a cadaver model. Two surgeons using two cadavers tested the robotic system to expose the larynx and facilitate robotic airway surgery using the Flex Instruments. In both cadavers, these procedures were performed transorally with excellent visualization: supraglottoplasty, arytenoidectomy, epiglottectomy, vocal cord lesion excision, posterior cordotomy, hemilaryngectomy, and endoscopic anterior/posterior cricoid split. Laryngeal cleft repair was limited by availability of suture to close the interarytenoid band. Laryngeal exposure was rated as “excellent” by both surgeons using the robotic platform.

Conclusion: Robotic surgery for the head and neck, while still in relative infancy, remains one of the newest platforms for the otolaryngologist. Currently available robotic platforms, while adapted to head and neck and airway surgery, were not designed for this purpose and pose challenges in size and accessibility to the larynx. The Flex System is specifically designed for head and neck and laryngeal surgery. This system provides outstanding visualization of hard to access areas in the larynx and hypopharynx. The flexible surgical instruments used with the Flex System allow for reasonable surgical exposure and technique. The Flex System may provide an improved robotic experience for transoral laryngeal and head and neck surgery.

Keywords: Laryngeal surgery, Medrobotics flex® system, Transoral.

How to cite this article: Roy S, Naqvi SHS, Karni RJ. Medrobotics Flex System for Laryngeal Surgery: A Feasible Study in Two Cadavers. Int J Head Neck Surg 2016;7(4):204-206.

Source of support: Medrobotics provided the Flex System for evaluation and cadavers for testing, along with a facility to perform the study.

Conflict of interest: None


 
ORIGINAL ARTICLE
Timothy S Lian, Richard W Thompson

Management of Rhinophyma

[Year:2016] [Month:July-September] [Volumn:7 ] [Number:3] [Pages:42] [Pages No:188-191][No of Hits : 568]


ABSTRACT

Rhinophyma is a condition that can cause significant disfigurement as well as functional impairment of the nose. It results from hypertrophy and hyperplasia of the sebaceous glands and can be a manifestation of advanced staged rosacea. If left untreated, not only can it cause disfigurement, rhinophyma can also result in nasal airway obstruction by marked ptosis and collapse of the external nasal valve. Surgical excision is the definitive treatment as rhinophyma does not spontaneously regress. Though various surgical techniques are available for the treatment of rhinophyma, a specific technique using tumescent anesthesia, sharp dissection, and argon beam coagulation has been found to be most efficacious. This technique and its advantages are described.

Keywords: Epinephrine, Rhinophyma, Surgical excision.

How to cite this article: Lian TS, Thompson RW. Management of Rhinophyma. Int J Head Neck Surg 2016;7(3):188-191.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Melissa Hu

External Approach for the Treatment of the Aging Nasal Tip

[Year:2016] [Month:July-September] [Volumn:7 ] [Number:3] [Pages:42] [Pages No:165-167][No of Hits : 553]


ABSTRACT

Changes seen in the nose from increased skin elasticity, weakened nasal cartilages, and detachment of ligaments can lead to cosmetic and functional impairment. Esthetically, the nasal tip droops, the nose lengthens, the columella shortens, and the ala collapse. Functionally, the internal and external nasal valves weaken, the anterior nares narrow, and airway turbulence increases, thus contributing to the effect of nasal obstruction. Skin redundancy of the elderly nose may compromise outcomes when typical rhinoplasty techniques are applied. Herein is described a technique pioneered by Fred Stucker, involving a direct external approach to address the aging nasal tip. The technique can be performed under local anesthesia and in combination with other procedures for the aging nose, such as rhinophyma excision or septoplasty for the aging nose.

Keywords: Aging nose, External approach, Nasal tip ptosis, Rhinolift.

How to cite this article: Hu M. External Approach for the Treatment of the Aging Nasal Tip. Int J Head Neck Surg 2016;7(3):165-167.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Kate A Stephenson, Michelle E Wyatt

Neonatal Tracheostomy

[Year:2016] [Month:April-June] [Volumn:7 ] [Number:2] [Pages:91] [Pages No:136-142][No of Hits : 544]


ABSTRACT

Tracheostomy is an established and widely practiced surgical technique. Neonates and young children represent a special population with unique tracheostomy-related concerns. A tracheostomy may be of substantial benefit to the child but is associated with significant morbidity and potential mortality risk. We describe surgical techniques, review pediatric tracheostomy tubes, and discuss relevant care issues.

Keywords: Neonatal, Pediatric, Tracheostomy, Tracheotomy.

How to cite this article: Stephenson KA, Wyatt ME. Neonatal Tracheostomy. Int J Head Neck Surg 2016;7(2):136-142.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Vikas Mehta, Trisha Thompson, Runhua Shi

Predictors of Survival in Early-stage Laryngeal Cancer by Treatment Modality

[Year:2016] [Month:July-September] [Volumn:7 ] [Number:3] [Pages:42] [Pages No:173-181][No of Hits : 517]


ABSTRACT

Aim: Our investigation attempts to identify factors associated with improved survival for early-stage laryngeal cancer based on primary therapy using the National Cancer Database (NCDB).

Materials and methods: This is a retrospective cohort with data abstracted from the NCDB. Patients with T1 or T2N0M0 laryngeal cancer from 1998 to 2011 who received radiation only, laser surgery, or laser surgery with adjuvant radiation were included. Chi-square analysis was used to assess and investigate the association between treatment and factors. Overall survival (OS) was assessed via Kaplan-Meier method. Log-rank methods were used to determine factors significant for survival, and a multivariable Cox regression model was performed.

Results: There were 14,276 patients from the NCDB eligible for this study. The majority (91.2%) of patients received primary radiation, 4.7% laser resection, and 4.0% laser resection with radiation. Five-year survival for laser surgery was 78.8% [95% confidence interval (CI) 75.5-82.1%] vs 67.2% (95% CI 66.4-68.1%) for radiation alone. Multivariate analysis demonstrated advanced age, increased comorbidities, public or uninsured, T2 stage, supraglottic subsite to be independently associated with worse survival. Treatment with laser only and laser with adjuvant radiation demonstrated a hazard ratio of 0.77 (p = 0.055) and 0.65 (p = 0.001) when compared with primary radiation.

Conclusion and clinical significance: Survival analysis on early-stage glottic patients in the NCDB showed multiple factors to be independently associated with survival. Outcomes based on treatment suggest an improved survival when utilizing endoscopic surgery as the primary treatment modality.

Keywords: Early stage laryngeal cancer, Survival outcomes, Transoral laser, Treatment.

How to cite this article: Mehta V, Thompson T, Shi R. Predictors of Survival in Early-stage Laryngeal Cancer by Treatment Modality. Int J Head Neck Surg 2016;7(3):173-181.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL RESEARCH
A Nanjundappa, Sudhir M Naik, Rajshekar Halkud, Purshottam Chavan, KT Siddappa, Siddharth Biswas

Synovial Sarcoma of the Floor of the Mouth: A Rare Clinical Entity with Review of Literature

[Year:2015] [Month:April-June] [Volumn:6 ] [Number:2] [Pages:57] [Pages No:49-52][No of Hits : 1606]


ABSTRACT

Background: Head and neck synovial sarcoma (SS) amounts to 6.8% of all total body SS, with high incidences in the hypopharynx, postpharyngeal region and the parapharyngeal space. Also, incidences of SS in the tongue, soft palate, mandible, buccal mucosa, floor of the mouth, lungs, thymus, trunk and posterior peritoneum are reported.

Case report: We report a case of 12-year-old girl with swelling in the floor of the mouth for 2 months. The patient had difficulty in speech, tongue movements, poor oral hygiene due to food residue collecting around the tumor in the floor of the mouth. A smooth 4 × 4 cm globular mass arising from the floor of the mouth with the fine needle aspiration cytology (FNAC) as spindle cell neoplasm. Wide excision and immunohistology confirmed it as calcified synovial sarcoma, hence postoperative chemotherapy was given. There is no recurrence for the past 3 years.

Conclusion: Synovial sarcoma is a rare tumor in the oral cavity, which is slow growing and of variable aggressiveness. Immunohistological analysis confirming the diagnosis and wide surgical excision with adjuvant chemotherapy is the modality preferred in these cases. Recurrence is common in the first 2 years of therapy but can occur later also.

Keywords: floor of the mouth, metastasis, recurrence, Synovial sarcoma.

How to cite this article: Nanjundappa A, Naik SM, Halkud R, Chavan P, Siddappa KT, Biswas S. Synovial Sarcoma of the Floor of the Mouth: A Rare Clinical Entity with Review of Literature. Int J Head Neck Surg 2015;6(2):49-52.

Source of support: Nil

Conflict of interest: None


 
Case Report
Anju Mathai, Satheesan Balasubramanian, Sajith Babu

Oral Commissure Defect Reconstruction with Modified Biflanged Submental Artery Island Flap

[Year:2015] [Month:January-March] [Volumn:6 ] [Number:1] [Pages:44] [Pages No:38-40][No of Hits : 1355]


ABSTRACT

Reconstruction of defects in the commissure region with buccal and lip defects is difficult to reconstruct with regional flap. A case report of a case reconstructed with a new design of the submental flap is described with its advantages.

Keywords: Oral cancer, Commissure, Submental flap.

How to cite this article: Mathai A, Balasubramanian S, Babu S. Oral Commissure Defect Reconstruction with Modified Biflanged Submental Artery Island Flap. Int J Head Neck Surg 2015;6(1):38-40.

Source of support: Nil

Conflict of interest: None