The treatment guidelines for basal cell carcinoma (BCC) postulate complete surgical excision using microscopically controlled resection (MOHS) as the gold standard. The need to obtain a small safety margin in the complex anatomical area of the head and neck is very challenging due to the individual characteristics (localization, histology, and size) of tumors and the fact that the postoperative loss of quality of life depends on the surgical defect size. The R1 status is histopathologically defined when the safety margin is less than 1 mm even if there are no tumor cells actually infiltrating the resection margin.
View Article and Find Full Text PDFObjectives: Epistaxis is the most common otolaryngological emergency and one-third of epistaxis patients regularly take low-dose acetylsalicylic acid (ASA) for the prevention of cardiovascular disease (CVD). The shift in contemporary guidelines identifies little benefit of ASA intake in patients who have not previously had an infarction. Existing evidence confirms ASA intake as a factor for severe epistaxis, while the evidence concerning its impact on recurrence is ambiguous.
View Article and Find Full Text PDFBackground: Primary radio(chemo)therapy [R(C)T] is a treatment option for advanced oropharyngeal squamous cell carcinoma (OSCC). Nevertheless, early diagnostics of treatment failure is problematic. Cytokeratin fragment 19 (CYFRA 21-1), an established marker in the management of pulmonary cancer, might be helpful here.
View Article and Find Full Text PDFObjective: Epistaxis is the most common otolaryngological emergency and up to one third of patients in treated on an inpatient basis take oral anticoagulants (OAC). Direct oral anticoagulants (DOAC), an OAC subgroup, have been on the market since 2010 and are being increasingly prescribed due to the cardiological and haematological guidelines that favour them over vitamin K antagonists (VKA), the older of the OAC subgroups. The present study aims to investigate which subgroup of epistaxis patients taking OACs has a more favourable outcome.
View Article and Find Full Text PDFBackground: Reprocessing of flexible endoscopes (FEs) is often expensive, time consuming, and becomes increasingly complex, due to rising demands of hygiene. After beneficial results in reprocessing of rigid endoscopes using Impelux™ UV-C light technology, we tested the same method for reprocessing of FEs without working channel.
Materials And Methods: Testing was performed on FEs without working channel after routine clinical use (transnasal flexible endoscopy).
Background: Reprocessing of endoscopes becomes increasingly complex, due to rising demands of hygiene. Established methods are often expensive/time-consuming. Recent studies suggest beneficial aspects of disinfection by UV light.
View Article and Find Full Text PDFBackground: The role of Cytokeratin fraction 21-1 (CYFRA 21-1) as a tumour marker for head and neck cancer is still a matter of research. The aim of the present study was to evaluate the clinical impact of CYFRA 21-1 for patients with oropharyngeal squamous cell carcinoma (OSCC).
Patients And Methods: Data of 180 patients with an initial diagnosis of OSCC of any stage between 2003 and 2017 were retrospectively analysed regarding the association between pretherapeutic CYFRA 21-1 levels, clinical characteristics, overall and disease-free survival.
In the original publication of the article, first name and last names of all authors were swapped.
View Article and Find Full Text PDFPurpose: Early facial nerve palsy (eFNP) is the most frequent complication of the parotidectomy. Intraoperative neuromonitoring (IONM) in parotid surgery, which aims at reducing eFNP, has not evolved any further than the mere differentiation between the nerve and the surrounding tissue. Continuous IONM (cIONM), used in thyroid and posterior fossa surgery, has developed over the past years and has proved beneficial in reducing the rate of paresis in cases where a pattern of impending nerve injury is identified.
View Article and Find Full Text PDFPatients taking oral anticoagulants (OACs) currently represent one-third of all patients treated for epistaxis and an upward trend is expected. New direct oral anticoagulants (DOACs) have been on the market for approximately 10 years. DOACs are favoured over Vitamin K-Antagonists (VKAs) in the current guidelines.
View Article and Find Full Text PDFIntroduction: The retrograde approach (RP) to nerve identification is a method seldom used in parotid surgery. A systematic review comparing this method to the standard anterograde approach (AP) with respect to facial nerve palsy (FNP) does not currently exist.
Methods: In a meta-analysis according to the PRISMA statement, eight publications, including one randomized controlled trial, were selected.
Background: Posttonsillectomy hemorrhage (PTH) is the most feared complication. Dissection near the tonsillar capsule under microscopic view (TE) could be assumed to decrease PTH compared to traditional tonsillectomy (TE).
Methods: In this study, patients were evaluated with respect to the need for surgical control (R/N: return/no return to theater (RTT): the day of surgery [0] or thereafter [1]).
Postoperative haemorrhage following tonsillectomy occurs in 5.98% of all cases with up to 10 deaths reported annually in Germany. When comparing tonsillectomy (TE) and tonsillotomy (TT), the same long-term frequency of ENT infections is displayed in children and young adults.
View Article and Find Full Text PDFPurpose: In this retrospective study we analysed patients with advanced squamous cell carcinoma of the larynx and hypopharynx treated with primary total laryngectomy (PTL) between 1990 and 2007.
Methods: The patients were treated by classical PTL, radiotherapy 60-70 Gy, concomitant radio and chemotherapy (cisplatin and 5-fluorouracil) or salvage total laryngectomy (STL). They were followed up for 5 years and complications, survival, residual/recurrent disease and metastases were registered.
The number of aged patients with head and neck cancer is increasing. The aim of this study was to evaluate the outcome of elderly patients with head and neck cancer undergoing surgery. Retrospective analysis of a series of 1509 consecutive patients separated in two groups regarding their age: younger than 70 and older than 70 years, with head and neck tumors treated surgically was performed.
View Article and Find Full Text PDFChondromas are benign cartilaginous tumours that are uncommon in the head and neck region. Only few cases of chondroma have been reported in the trachea. We present a 70-year-old patient who presented clinically with severe dyspnoea requiring urgent tracheotomy.
View Article and Find Full Text PDFThe aim of this study was to define the existence of surface changes on auditory ossicles caused by rheumatoid arthritis. The study comprised of nine pairs of auditory ossicles (mallei and incudes) from autopsy of patients with rheumatoid arthritis, and five pairs of ossicles from persons without RA, taken during autopsies. The specimens were studied with JEOL JSM 5300 type scanning electron microscope.
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