The Impact of Surgical Telementoring on Reducing the Complication Rate in Endoscopic Endonasal Surgery of the Skull Base.

Background: Pituitary adenomas represent the most common pituitary disorder, with an estimated prevalence as high as 20%, and they can manifest with hormone hypersecretion or deficiency, neurological symptoms from mass effect, or incidental findings on imaging. Transsphenoidal surgery, performed either microscopically or endoscopically, allows for a better extent of resection while minimising the associated risk in comparison to the transcranial approach. Endoscopy allows for better visualisation and improvement in tumour resection with an improved working angle and less nasal morbidity, making it likely to become the preferred surgical treatment for pituitary neoplasms.

Gene Expression Profiles of Methyltransferases and Demethylases Associated with Metastasis, Tumor Invasion, CpG73 Methylation, and HPV Status in Head and Neck Squamous Cell Carcinoma.

Epigenetic studies on the role of DNA-modifying enzymes in HNSCC tumorigenesis have focused on a single enzyme or a group of enzymes. To acquire a more comprehensive insight into the expression profile of methyltransferases and demethylases, in the present study, we examined the mRNA expression of the DNA methyltransferases DNMT1, DNMT3A, and DNMT3B, the DNA demethylases TET1, TET2, TET3, and TDG, and the RNA methyltransferase TRDMT1 by RT-qPCR in paired tumor-normal tissue samples from HNSCC patients. We characterized their expression patterns in relation to regional lymph node metastasis, invasion, HPV16 infection, and CpG73 methylation.

Management of Choanal Atresia: National Recommendations with a Comprehensive Literature Review.

Choanal atresia is the most common congenital anatomical abnormality of the nasal cavities, manifested with a clinical picture of neonatal respiratory distress. The treatment requires interdisciplinary management based mainly on tertiary referral centre experiences. However, there is a lack of high-quality evidence in the available literature.

Neuroendocrine Carcinoma of the Larynx and Pharynx: A Clinical and Histopathological Study.

Neuroendocrine carcinomas (NECs) of the head and neck are rare and the experience scanty. The Cancer Registry of Slovenia database was used to identify cases of laryngeal and pharyngeal NECs diagnosed between 1995-2020. Biopsies were analyzed for the expression of standard neuroendocrine markers (synaptophysin, chromogranin, CD56), INSM1, Ki-67, p16, and PD-L1 (using the combined positive score, CPS).

Surgeon-performed ultrasound with fine-needle aspiration biopsy for the diagnosis of parotid gland tumors.

Background: Ultrasound (US) with or without fine-needle aspiration cytology (FNAC) are readily available and can offer in office and rapid diagnosis of parotid lumps.

Methods: We analyzed 398 of patients who underwent blind FNAC or US with FNAC performed by an operating head and neck surgeon. Specificity, sensitivity, as well as accuracy were calculated for US alone, FNAC alone, and US-FNAC combined.

Endoscopic Endonasal Approaches to the Clival Region.

Objective: Our main objectives were to analyze and determine the safety, risk of post-operative complications, and surgical outcome of the endoscopic endonasal approach to the clival region.

Methods: From May 2011 to May 2019, we operated on 19 patients using the endoscopic endonasal approach to the clival region. Their pathologies were diverse: pituitary macroadenoma, craniopharyngioma, metastasis, and a prepontine neurenteric cyst.

Mycotic Aneurysm of the Extracranial Internal Carotid Artery Following Otitis Media.

Mycotic aneurysm of the internal carotid artery following otomastoiditis can manifest as a nasopharyngeal mass. This is a very rarely described condition. The case of a patient diagnosed with a retropharyngeal mycotic aneurysm of the left internal carotid artery following otitis media, treated with exclusion of the mycotic aneurysm from the circulation and transnasal drainage.

Different branching patterns of the spinal accessory nerve: impact on neck dissection technique and postoperative shoulder function.

Purpose Of Review: Despite nerve-sparing surgery, postoperative shoulder morbidity remains high and significantly impacts patient's quality of life. This review will focus on recent findings of anatomical nuances of the cranial nerve XI (CN XI) along its course in the neck and possible reasons for postoperative morbidity.

Recent Findings: The most recent studies identified three different branching patterns of the CN XI in the neck.

Hypophyseal metastases: A report of three cases and literature review.

Metastatic tumours to the pituitary gland are rare. The most frequent are metastases from breast and lung. We describe three patients with metastatic tumours: (I) a 54-year-old patient with metastatic renal clear-cell carcinoma and consequent disturbances in visual acuity, cranial nerve paresis and panhypopituitarism, (II) a 60-year-old patient with a diffuse large B-cell lymphoma with panhypopituitarism and diabetes insipidus and (III) a 57-year-old patient with metastasis of breast cancer and panhypopituitarism, visual impairment and cranial nerve paresis.

Mucosal melanoma of the head and neck: a population-based study from Slovenia, 1985-2013.

Objectives: To assess the incidence and to review experience with the treatment of mucosal melanoma of the head and neck (MMHN) in Slovenia between 1985 and 2013.

Methods: The National Cancer Registry database and clinical records with outcome data of identified patients treated during the period 1985-2013 in Slovenia were reviewed.

Results: In a 29-year period, 61 patients with MMHN were identified, representing 0.

Squamous cell carcinoma of unknown primary tumor metastatic to neck nodes: role of elective irradiation.

In patients with squamous cell carcinoma (SCC) metastases to neck lymph nodes and unknown primary tumor, the role of elective irradiation of uninvolved neck and potential mucosal primary sites is yet to be determined. The aim of this study was to review the experience treating SCC of unknown primary metastatic to neck nodes with surgery and postoperative radiotherapy (PORT) in Slovenia between 1995 and 2010 and to determine the importance of the extent of irradiated volume. For this purpose, the nationwide Cancer Registry of Slovenia database was used for identifying patients.

The impact on post-operative shoulder function of intraoperative nerve monitoring of cranial nerve XI during modified radical neck dissection.

Intraoperative monitoring of the cranial nerve XI (CN XI) may decrease shoulder disability following modified radical neck dissection. Prospective study was designed comparing results of Constant Shoulder Score (CSS), Shoulder Pain and Disability Index (SPADI) and EMG score of the trapezius muscle (mT) before and after surgery. One side of the neck was monitored during surgery with intraoperative nerve monitor.

Surgical telementoring: A new model for surgical training.

Objectives/hypothesis: To assess the efficacy of a surgical telementoring program for endoscopic skull base surgery.

Study Design: Prospective case series with surveys of surgeons.

Methods: A surgical telementoring program was established for mentoring of a skull base team at the University of Maribor in Slovenia by an experienced skull base team at the University of Pittsburgh Medical Center in Pennsylvania.

Electrophysiologic analysis of injury to cranial nerve XI during neck dissection.

Background: Despite preservation of the accessory nerve, a considerable number of patients report partial nerve damage after modified radical neck dissection (MRND) and selective neck dissection.

Methods: Accessory nerve branches for the trapezius muscle were stimulated during neck dissection, and the M wave amplitude was measured during distinct surgical phases.

Results: The accessory nerve was mapped in 20 patients.

Incidence trends in head and neck squamous cell carcinoma in Slovenia, 1983-2009: role of human papillomavirus infection.

An increase in the incidence of oropharyngeal squamous cell carcinoma (OPSCC) was observed in several population-based registries and has been attributed to human papillomavirus (HPV) infection. In the present study, we aimed to assess the contribution of HPV infection to the burden of mucosal head and neck squamous cell carcinoma (HNSCC) in Slovenia. For this purpose, data from the nationwide Cancer Registry of Slovenia for cases diagnosed between 1983 and 2009 were analyzed to determine time trends of age-adjusted incidence rates and survival in terms of annual percentage change (APC) for HNSCC in potentially HPV-related and HPV-unrelated sites.

Identification of three anatomical patterns of the spinal accessory nerve in the neck by neurophysiological mapping.

Background: In spite of preservation of the accessory nerve there is still considerable proportion of patients with partial nerve damage during modified radical neck dissection (MRND).

Methods: The nerve was identified during the surgery and its branches for the trapezius muscle mapped with nerve monitor.

Results: The accessory nerve was mapped during 74 hemineck dissections and three patterns were identified.

An evaluation of SOX2 and hTERC gene amplifications as screening markers in oral and oropharyngeal squamous cell carcinomas.

Background: Oral and oropharyngeal squamous cell carcinomas (OSCC) are among the most common cancers. The poor survival rate among oral cancer patients can be attributed to several factors, one of them being lack of early detection. A key approach to this problem would be to detect potentially malignant lesion at their early stage.

Cervical lymph node metastasis of squamous cell carcinoma from unknown primary tumor.

The first aim of the study was to determine the survival rate of the patients with Carcinoma of the Unknown Primary (CUP) in relation to lymph node status and eventual later identification of the primary tumor. To second one was to investigate the impact of PET-CT on identification of the primary tumor. We studied 97 patients sent to our University Medical Center with diagnosis of metastasis of unknown primary tumor between 1.

Necrotizing fasciitis of the head and neck: 34 cases of a single institution experience.

We analyzed 34 patients with necrotizing fasciitis (NF) of the head and neck. According to the clinical presentation, we classified NF into the cervical and cranial type. Infection can spread along the superficial lamina or along the pretracheal lamina of the deep cervical fascia.

Sphenoclival intraosseus lipoma: case report and literature review.

Objective: To present the case of a rare tumor in the sphenoidoclival area and discuss potential pitfalls in diagnosis and management.

Design: Case report with literature review.

Setting: Tertiary referral center.

First branchial cleft anomaly, a case for misdiagnosis.

First branchial cleft anomaly is a rare condition that is often misdiagnosed and falsely mistreated before complete and definitive surgical treatment. Its origin is uncertain and the presence of ectodermal and sometimes also mesodermal elements has led some authors to the conclusion that it represents buried nests of cells forming the first branchial cleft and the underlying mesoderm. First branchial cleft anomaly can be presented as a cystic lesion, fistula or sinus extending towards the membranous external ear canal.

Solitary fibrous tumor of the parapharyngeal space.

Solitary fibrous tumors are rare tumors originating from the mesenchymal tissue. In most cases they arise from the subpleural tissue but have also been described in other locations in the body. Most such tumors in the head and neck region occur in the orbit.