Publications by authors named "Carlos-Miguel Chiesa-Estomba"

Objective: To propose a European consensus for managing and treating laryngopharyngeal reflux disease (LPRD) to guide primary care and specialist physicians.

Methods: Twenty-three European experts (otolaryngologists, gastroenterologists, surgeons) participated in a modified Delphi process to revise 38 statements about the definition, clinical management, and treatment of LPRD. Three voting rounds were conducted on a 5-point scale and a consensus was defined a priori as agreement by 80% of the experts.

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This study evaluates the quality and readability of informed consent documents generated by AI platforms ChatGPT-4 and Bard Gemini Advanced compared to those written by a first-year oral surgery resident for common oral surgery procedures. The evaluation, conducted by 18 experienced oral and maxillofacial surgeons, assessed consents for accuracy, completeness, readability, and overall quality. ChatGPT-4 consistently outperformed both Bard and human-written consents.

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Article Synopsis
  • Benign neck masses are common in head & neck clinics and are often diagnosed using fine needle aspiration cytology (FNAC) and core needle biopsy (CNB), which are effective and can reduce the need for surgery.
  • A study analyzed data from 192 patients undergoing ultrasound-guided FNAC or CNB for benign neck conditions, finding that most complications were minor, with infections being the most frequent.
  • The results indicate that both FNAC and CNB are safe procedures for diagnosing neck lumps, but doctors should be cautious of potential risks, especially in specific conditions like branchial cleft cysts.
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Article Synopsis
  • Non-melanoma skin cancers like basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) are increasingly common, necessitating better diagnostic tools.
  • A prospective study evaluated a CE-certified deep learning-based medical device for diagnosing skin lesions in a head & neck outpatient clinic, involving 135 patients with a focus on BCC, cSCC, and benign lesions.
  • The device showed over 90% accuracy in identifying malignant lesions as one of the top-5 diagnoses, indicating its potential for early detection and treatment of skin cancers, and further research is recommended to explore its applications in various medical settings.
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Introduction: Juvenile recurrent parotitis is a rare disease characterized by repeated episodes of inflammation affecting, unilaterally or bilaterally, the parotid glands during childhood.

Material And Methods: Retrospective study including patients diagnosed with juvenile recurrent parotitis between January 2010 and September 2020 at a tertiary level hospital, with the aim of evaluating the results of medical treatment and sialendoscopy.

Results: A total of 48 patients met the inclusion criteria and had a mean follow-up of 4 years (SD = 3; Min: 2/Max: 12).

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Objectives: To evaluate the ChatGPT-4 performance in oncological board decisions.

Methods: Twenty medical records of patients with head and neck cancer were evaluated by ChatGPT-4 for additional examinations, management, and therapeutic approaches. The ChatGPT-4 propositions were assessed with the Artificial Intelligence Performance Instrument.

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 Oral cavity squamous cell carcinoma (OCSCC) is the most common malignancy in the oral cavity. Two types of mandibular resections have been described: the segmental mandibulectomy and the marginal mandibulectomy. Both may have a different impact over the quality of life, oncological prognosis, and functional or aesthetic result.

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Objective: To investigate the accuracy of Chat-Based Generative Pre-trained Transformer (ChatGPT) in answering questions and solving clinical scenarios of head and neck surgery.

Study Design: Observational and valuative study.

Setting: Eighteen surgeons from 14 Italian head and neck surgery units.

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Introduction: The aim of this study is to assess the impact of lymph node ratio (LNR) and number of positive lymph nodes (NPLN) on mortality and recurrence rates in patients with laryngeal squamous cell carcinoma.

Materials And Methods: We conducted a retrospective multicenter international study involving 24 Otorhinolaryngology-Head and Neck Surgery divisions. Disease-specific survival (DSS) and disease-free survival (DFS) were evaluated as the main outcomes.

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Objectives: Tracheoesophageal puncture (TEP) is considered the gold standard for voice rehabilitation after total laryngectomy. One of the main causes of treatment failure, and a potentially serious complication, is the TEP enlargement and/or leakage around the voice prosthesis. The injection of biocompatible material to increase the volume of the puncture surrounding tissue has been studied as a popular option for conservative treatment of enlarged tracheoesophageal fistula.

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Metastatic carcinoma of unknown primary (CUP) to cervical lymph nodes represents less than 5% of all head and neck malignancies. Recent publications support the use of transoral surgery during the diagnosis work-up, and transoral endoscopic ultrasonic surgery represent a recently described alternative technique in transoral surgery. A pilot study to assess the feasibility of trans-oral ultrasonic base of tongue (BOT) mucosectomy and bilateral tonsillectomy approach in CUP diagnosis work-up was conducted.

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Introduction: The gracilis muscle free flap has gained popularity in head and neck reconstruction due to minimal donor-site morbidity, reliable vascular pedicle, strong muscular component, and possibility to perform nerve coaptation. However, almost all the existing evidence in the literature is related to its use for facial palsy reanimation. The aim of this study was therefore to review and provide a comprehensive summary of all the possible indications and outcomes of this versatile free flap in head neck reconstructive surgery.

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Introduction: Nowadays, 70% of patients in Europe and the USA are affected by a p16 + , potentially HPV driven oropharyngeal squamous cell carcinoma. However, despite the improved survival rate in this group, the quality-of-life remains low in cases which neck dissection took place. In this vein, in recent years, some surgeons have considered to avoid dissection of level IIB, proposing a supra-selective non-IIb neck dissection.

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Salivary gland tumors are a heterogeneous group of tumors originating from the major and minor salivary glands. The pleomorphic adenoma (PA), which is the most common subtype, is a benign lesion showing a remarkable morphologic diversity and that, upon recurrence or malignant transformation, can cause significant clinical problems. Cytogenetic studies of >500 PAs have revealed a complex and recurrent pattern of chromosome rearrangements.

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Introduction: Head & neck surgery encompasses a variety of surgical approaches for benign and malignant conditions. Due to the complexity in treating patients with head and neck pathology, it is necessary to adhere to basic surgical principles to decrease complications. Among them, surgical site infection can be prevented using a surgery quality protocol including the correct use of antibiotics and optimization of nutritional status.

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Over the last decade, technological growth has developed new devices for more precise surgery based on improved maneuverability, minimally invasive approaches, and magnification of the operating field. In this context, the exoscope has opened a new phase for more accurate and safer microsurgery, improving the perception of the volume of objects and the depth of structures for planning, targeting, and controlling fine movements. The exoscope could be used for middle ear, transcanal, transmastoid, and craniotomy procedures that require two-handed dissection, both to perform both totally VITOM-based techniques and coupled to traditional procedures with an operating microscope or endoscope.

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Introduction: There are no previously described training models for learning or teaching how to remove lithiasis from the salivary ducts. Therefore, we present a new simulation model to enable us to faithfully represent the process of endoscopic lithiasis extraction by sialoendoscopy.

Materials And Methods: A simulation model was developed using a pig's head, omeprazole spheres were used to simulate lithiasis in the various ducts of each salivary gland and a Dormia basket was used to train in extraction of the lithiasis model.

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 Head and neck surgery remains a complex field; the patients can suffer important functional or life-threating complications after treatment that need unplanned readmissions, increasing the cost related to the treatment.  To evaluate the incidence risk factors and causes associated with 30-day unplanned hospital readmission and visit to the emergency room (ER) after surgery for head and neck cancer.  Prospective, longitudinal, nonrandomized study.

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 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has represented a major challenge for healthcare systems worldwide, changing the habits of physicians. A reorganization of healthcare activity has been necessary, limiting surgical activity to essential cases (emergencies and oncology), and improving the distribution of health resources.  To analyze the impact of the COVID-19 pandemic on head and neck cancer surgery management in Spain.

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