Publications by authors named "Fakhry N"

Treatments for oral squamous cell carcinomas (OSCCs) often result in significant aesthetic and functional issues, impacting patients' quality of life (QoL). The COVID-19 pandemic's mask mandates may have provided psychosocial benefits by concealing facial disfigurements, potentially reducing stigma. This study aimed to assess the impact of mask-wearing on the QoL of patients surgically treated for OSCC.

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Introduction: It is debatable whether neck dissection is necessary in patients with advanced laryngeal carcinoma who are clinically node-negative (cN0). We assessed the effect of neck dissection on overall survival in patients with cN0 undergoing primary or salvage laryngectomy.

Materials And Methods: A retrospective evaluation of cN0 patients who underwent primary or salvage total/pharyngolaryngectomy at a French tertiary facility in 2008-2018, with or without neck dissection, was carried out.

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Article Synopsis
  • The study aimed to gather insights from international experts on the efficacy and challenges of two minimally invasive surgical techniques, transoral laser microsurgery (TLM) and transoral robotic surgery (TORS), for treating supraglottic laryngeal tumors.
  • A survey was conducted with 27 head and neck surgeons, finding that TLM generally took less setup time compared to TORS, although both techniques faced concerns about bleeding during surgery, particularly with TLM.
  • Experts viewed TLM and TORS as largely equal in effectiveness, but noted that TORS offered better control over bleeding and improved visibility during the procedure.
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  • Salivary gland Secretory Carcinoma (SC) is a rare tumor first described in 2010; a study analyzed 108 cases from the REFCOR database to evaluate diagnosis, treatment, and survival rates up to July 2021.
  • MRI was found to be ineffective for diagnosing malignancy, and while 79% of patients received a diagnosis after two histological readings, 21% needed molecular testing for confirmation.
  • Results showed high survival rates, with 91.4% overall survival and 89% recurrence-free survival at five years, suggesting a generally positive prognosis for SC patients.*
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Objectives: The management of the facial nerve (FN) is a major issue in parotid cancer, especially when there is no preoperative facial palsy and FN invasion is discovered intraoperatively. The aim of this study was to assess the impact of FN resection in patients with parotid cancer abutting the FN, without pretreatment facial palsy, using a propensity score matching.

Materials And Methods: Data from all patients treated between 2009 and 2020 for a primary parotid cancer abutting or invading the FN but without pretreatment facial palsy were extracted from the national multicentric REFCOR database.

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Background: The CO laser is frequently used during microlaryngeal surgery (MLS) for a variety of pathology including laryngeal malignancy and stenosis. Learning how to use the laser safely is part of the curriculum for every otolaryngology resident. However, assessment of laryngoscopy technical skills can be challenging for supervisors, making it difficult to adequately provide feedback to trainees.

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  • Salivary carcinomas of minor salivary glands, particularly in the tongue, are rare tumors that may require surgery and/or (chemo-)radiotherapy for treatment.
  • A study involving 103 patients diagnosed between 2009 and 2018 found that the most common types were adenoid cystic and mucoepidermoid carcinomas, with surgery being the primary treatment for most cases.
  • Results indicated that 5-year overall survival was 84.7%, while event-free survival was lower at 38.6%; nonsurgical treatment, alcohol use, and tumor location negatively impacted event-free survival, while nodal positivity was a key factor affecting overall survival.
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: Patients treated with definitive radiotherapy for nasopharyngeal carcinoma (NPC) develop severe dysphagia, affecting their quality of life. Traditional prognosis biomarkers are insufficient, leading to a search for new predictors like neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). : We retrospectively enrolled 44 NPC patients who underwent definitive radiotherapy between 2010 and 2018.

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Objective: Knowledge about voice prosthesis microbial colonization is vital in laryngectomized patients' quality of life (QoL). Herein, we aimed to explore the relationship between oral microbial patterns, demographic variables and voice prosthesis performance.

Methods: Thirty laryngectomy patients were assessed for microbial colonization in their voice prostheses and oral cavities.

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  • - Young European otolaryngologists (OTOs) were surveyed about their views on transoral robotic surgery (TORS), revealing a 26% response rate from participants.
  • - Key barriers to TORS adoption included robot availability (73%), high costs (69%), and insufficient training (37%), while the main advantages were better surgical visibility (64%), reduced hospital stays (62%), and improved post-op outcomes (61%).
  • - Despite these challenges, 67% of TORS practitioners felt adequately trained, and there was an overall positive perception of TORS among young OTOs, especially for specific cancer types and conditions.
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To provide an in-depth analysis of noninvasive methods for the early diagnosis of oral premalignant lesions, focusing on novel biomarkers and optical technologies, and to discuss their potential in improving the prognosis of patients with oral oncological diseases. This state-of-the-art review examines various noninvasive diagnostic techniques, including the utilization of salivary microRNAs and optical technologies such as Raman spectroscopy, elastic scattering spectroscopy, diffuse reflectance spectroscopy, narrow-band imaging, autofluorescence imaging, toluidine blue staining, and microendoscopy. Several noninvasive techniques have shown varying degrees of effectiveness in detecting oral cancer.

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  • The study aimed to identify typical clinical and radiological profiles of primary low-grade parotid cancers to improve treatment strategies.
  • A retrospective analysis of 57 patients was conducted, reviewing MRI and histopathology results to identify prognostic factors.
  • While several positive prognostic factors were identified, the study concluded that a reliable clinical and radiological profile for low-grade cancers could not be established, limiting the ability to tailor more conservative surgical approaches.
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Background: Rare cancers constitute less than 10% of head and neck cancers and lack sufficient evidence for standardized care. The French Rare Head and Neck Cancer Expert Network (REFCOR) as established a national database to collect data on these rare cancers. This study aims to describe patient and tumour characteristics in this database.

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Purpose: Parotid pleomorphic adenomas present a risk of recurrence, higher when the tumour is a hypocellular subtype. The aim of the study was to determine whether it is possible to characterize this histological subtype with diffusion and perfusion sequences of the preoperative MRI.

Methods: This retrospective study included 97 patients operated between 2010 and 2020.

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Article Synopsis
  • The management of upper aerodigestive tract cancers is intricate, prompting the creation of a reference framework to define optimal treatment principles, led by a multidisciplinary scientific committee.
  • A systematic literature review was conducted to develop evidence-based recommendations that account for various patient-specific factors and treatment quality criteria.
  • The comprehensive framework aims to standardize care, enhance decision-making in consultations, and ensure equitable treatment practices, with plans for future updates to maintain relevance.
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Objectives: To analyse prognostic factors and survival outcomes of malignant tumors of the external auditory canal, to investigate the role of regional surgery, and adjuvant radiotherapy in early stages and to investigate the role of surgery in operable T4 stage.

Setting: A retrospective analysis was conducted on all patients prospectively included in the national database of the French Expertize Network for Rare ENT Cancers (REFCOR) from January 2000 to December 2016.

Participants: 103 patients from 19 reference centers were included.

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Introduction: Laryngeal chondrosarcoma (LCS) is a rare tumor of slow evolution whose treatment is poorly codified. For a long time, a radical treatment by total laryngectomy (TL) was proposed. More recent studies tend to propose a conservative surgical approach of the larynx.

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  • The study investigates how otolaryngology and head and neck surgeons perceive, adopt, and are aware of transoral robotic surgery (TORS).
  • A survey of 359 surgeons revealed varied support for TORS among different subspecialties, with head and neck surgeons showing the most positive response, while laryngologists largely disagreed on its effectiveness.
  • Low adoption rates were largely attributed to concerns over the high costs associated with TORS, particularly among head and neck surgeons.
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Objective: To determine the therapeutic indications for systemic medical treatment in the management of adenoid cystic carcinoma (ACC) according to the clinical situation.

Materials And Methods: The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group, which drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group, according to the formal consensus method.

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Objective: To determine the indications for fine-needle cytology and the modalities of frozen section pathological analysis in the management of salivary gland cancer.

Material And Methods: The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group who drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group according to the formal consensus method.

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Objective: To determine the indications and modalities for resection in the management of primary sublingual and minor salivary gland cancer, and the specific features of each primary location.

Material And Methods: The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group who drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group, according to the formal consensus method.

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