The impact of surgical margins in managing regional metastases in cutaneous squamous cell carcinoma of the head and neck.

Background: Regional metastasis occurs in 5% of cutaneous squamous cell carcinoma (cSCC). The aim of this study is to assess the impact of margin status of regional metastases on survival.

Methods: A retrospective review of 401 patients with nodal metastases from cSCC.

Health Care Utilisation and Unmet Needs in Survivors of Head and Neck Cancer in Regional Australia: A Cross-Sectional Survey.

Background: The post-treatment survivorship period marks the transition away from acute care and poses distinct challenges for individuals with head and neck cancer (HNC). This can be especially challenging for people in regional areas who travel long distances to access care and experience unique challenges in accessing health services.

Aim: To investigate unmet needs and healthcare utilisation of survivors of HNC in regional areas.

A review of submandibular gland extirpation in an Australian quaternary referral centre: aetiologies and trends over 35 years.

Background: Submandibular gland pathology is common but rarely reported. This study was performed to evaluate demographic, pathological, and survival outcomes associated with submandibular gland extirpation.

Methods: Retrospective analysis of patients treated in a single quaternary-care institution between 1989 and 2022 was performed.

The Impact of Preoperative Facial Nerve Weakness and Facial Nerve Outcomes in the Management of Patients With Parotid Metastases of Cutaneous Squamous Cell Carcinoma.

Background: Cutaneous squamous cell carcinomas (cSCC) metastasizing to the parotid gland can cause facial nerve (FN) dysfunction secondary to direct invasion, perineural spread, or surgical ablation. This study aims to characterize the prevalence of preoperative FN involvement in metastatic cSCC to the parotid and identify risk factors resulting in FN sacrifice.

Methods: Patients with parotid metastases from cSCC, treated surgically with parotidectomy with curative intent were identified through a retrospective cohort analysis of a prospectively maintained Sydney Head and Neck database from 1992 to 2021.

Quality of life outcomes in patients receiving dental implants in vascularised bone flaps for mandibular reconstruction.

Resection, reconstruction, and rehabilitation of the mandible impact function and health related quality of life (HRQOL). In this study, we aimed to understand the impact of delayed versus immediate dental implant placement. A cross-sectional and prospective study was conducted including patients who underwent reconstruction of the mandible via osseous vascularised bone flaps and dental implants.

Survivorship Needs in Patients With Head and Neck Cancer in Regional, Rural and Remote Areas: A Systematic Review.

Objective: Understanding survivorship issues among people with head and neck cancer (HNC) is important as survival rates increase. Most research has focused on urban patients, leaving a gap in understanding the challenges faced by those in rural areas. This study aims to summarise the literature on survivorship needs for people with HNC in rural areas.

A qualitative exploration of the pathway to diagnosis and treatment of cutaneous squamous cell carcinoma of the head and neck with perineural spread.

Background: Perineural spread (PNS) is associated with a poor prognosis in cutaneous squamous cell carcinoma of the head and neck (cSCCHN). Hence, investigating facilitators and barriers of early diagnosis and treatment of PNS in cSCCHN may improve outcomes.

Methods: Patients were recruited from an institutional database.

Jaw in a day surgery: early experience with 19 patients at an Australian tertiary referral center.

Background: The Jaw-in-a-Day (JIAD) procedure aims to achieve immediate functional occlusion via a single-stage approach to maxillofacial reconstruction. While JIAD has gained popularity since its inception by Levine and colleagues, efficacy and outcome data remain limited. In this report, we discuss our experience with the JIAD technique at an Australian tertiary referral centre.

Presence of postlaryngectomy pseudodiverticulum on barium swallow does not affect early dietary progression.

Background: The presence of a pseudodiverticulum of the anterior pharyngeal wall, or prominent "pharyngeal bar," is a well-known phenomenon that occurs following total laryngectomy, which can be visualized by nasolaryngoscopy or videofluoroscopy. Among the different techniques of pharyngeal reconstruction, there is higher incidence following primary vertical multilayered closure. It has been postulated to cause dysphagia and lack of dietary progression despite a paucity of data.

Models of survivorship care in patients with head and neck cancer in regional, rural, and remote areas: a systematic review.

Purpose: Rural people with head and neck cancers (HNC) are likely to experience poorer health outcomes due to limited access to health services, so many benefit from models of care that account for rurality. The aim of this review was to synthesise literature on models of care in this population.

Methods: Studies were identified using seven databases: PubMed, PsycINFO, Scopus, Embase, CINAHL, Medline, and Web of Science.

Use of THRIVE for Apneic Oxygenation in Transoral Laser Microlaryngeal Surgery: A Scoping Review.

Objectives: Trans-nasal humidified rapid insufflation ventilatory exchange (THRIVE) has demonstrated utility in extending the apneic window in the perioperative setting. Its benefits in facilitating tubeless anesthesia are recognized during elective laryngotracheal surgeries. The use of THRIVE and administering higher fractional inspired oxygen concentrations in laser laryngeal surgery (LLS) remains controversial due to the theoretical risk of airway fires.

Primary Management of Operable Locally Advanced Oral Cavity Squamous Cell Carcinoma: Current Concepts and Strategies.

Introduction: Locally advanced oral cavity carcinoma (LAOCSCC) is primarily treated with surgery followed by radiotherapy with or without chemotherapy.

Methods: A review of literature using PubMED was performed for studies reporting the management of LAOCSCC. Based on the reviewed literature and opinions of experts in the field, recommendations were made.

When should patients with T1N0 oral squamous cell carcinoma be considered for elective neck dissection?

Aims: To identify adverse pathological features (APF) predicting nodal failure in clinically node negative T1 oral squamous cell carcinoma (OSCC).

Methodology: This study evaluated patients with T1N0 (≤5 mm depth of invasion (DOI) and ≤2 cm diameter) oral cancers from a prospectively maintained database between 1988 and 2020. All patients underwent surgical excision of the primary lesion without neck dissection.

Prognostic and predictive biomarkers in head and neck cancer: something old, something new, something borrowed, something blue and a sixpence in your shoe.

A biomarker is a measurable indicator of biological or pathological processes or the response to an exposure or intervention and is used to guide management decisions. In head and neck pathology, biomarkers are assessed by histological criteria and immunohistochemical and molecular studies. Surgical resection remains the mainstay of management of many head and neck malignancies.

Associations between patient-level health literacy and diagnostic time intervals for head and neck cancer: A prospective cohort study.

Background: Health literacy (HL) comprises skills and knowledge required to understand, access, and make decisions about healthcare. Our aim was to examine associations between patient HL and time intervals (defined in the Aarhus statement) along the pathway to treatment of head and neck cancer (HNC).

Methods: A prospective cohort study was conducted from October 2018 to March 2020.

Ex vivo tissue modelling informs drug selection for rare cancers.

The identification and therapeutic targeting of actionable gene mutations across many cancer types has resulted in improved response rates in a minority of patients. The identification of actionable mutations is usually not sufficient to ensure complete nor durable responses, and in rare cancers, where no therapeutic standard of care exists, precision medicine indications are often based on pan-cancer data. The inclusion of functional data, however, can provide evidence of oncogene dependence and guide treatment selection based on tumour genetic data.

Management of Parastomal Recurrence Following Total Laryngectomy.

Parastomal recurrence occurs in around 5% of patients undergoing total laryngectomy for laryngeal squamous cell carcinoma. It carries a poor prognosis which has changed little over the last 50 years, and poses a significant challenge to the head and neck surgeon. At present, surgical excision offers the only realistic chance of cure, although patients must be selected carefully following thorough work-up and in-depth multidisciplinary team discussion.

Patient-reported experiences and satisfaction with head and neck surgery outreach clinics in regional New South Wales, Australia: A cross-sectional survey.

Rationale: Head and neck surgery services are increasingly being centralised in Australia. Outreach models can overcome burdens of travel that patients in regional and rural areas experience when attending routine appointments, by providing services closer to home.

Aim: To explore patient-reported experiences and satisfaction with regional outreach services for head and neck surgery in Australia.

Persisting facial nerve palsy or trigeminal neuralgia - red flags for perineural spread of head and neck cutaneous squamous cell carcinoma (HNcSCC).

Background: Perineural spread (PNS) of head and neck cutaneous squamous cell carcinoma (HNcSCC) is a unique diagnostic challenge, presenting with insidious trigeminal (CN V) or facial nerve (CN VII) neuropathies without clinically discernible primary masses. These patients are often sub-optimally investigated and misdiagnosed as Bell's palsy or trigeminal neuralgia. This case series highlights the red flags in history and pitfalls that lead to delays to diagnosis and treatment.

Treatment of Early Glottic cancer with Transoral Laser Microsurgery: An Australian Experience.

Introduction: Early laryngeal carcinomas may be treated by transoral laser microsurgery (TLM) or external beam radiotherapy. We review our experience of surgical treatment of laryngeal pre-malignant and malignant lesions over the past 15 years in a high-volume head neck unit.

Methods: A review of a prospective patient database of patients with laryngeal SCC, who were treated with CO TLM between 2004 and 2019 was carried out.

Pathologically Negative Excision for Biopsy-Proven Early Glottic Carcinoma.

In certain instances, patients who underwent endoscopic laser excision (ELE) for biopsy-proven early glottic carcinoma do not show any evidence of carcinomatous cells on histopathologic analysis. Our study aims to determine the incidence of this phenomenon. A retrospective analysis of patients with biopsy-proven early glottic squamous cell carcinoma who underwent ELE was conducted.