Reconstruction for Salvage Laryngectomy With Limited Pharyngectomy.

Importance: Closure technique for optimization of postoperative and functional outcomes following salvage laryngectomy remains an area of debate among head and neck surgeons.

Objective: To investigate the association of salvage laryngectomy closure technique with early postoperative and functional outcomes.

Design, Setting, And Participants: This retrospective cohort study included patients from 17 academic, tertiary care centers who underwent total laryngectomy with no or limited pharyngectomy after completing a course of definitive radiotherapy or chemoradiotherapy with curative intent between January 2011 and December 2016.

Air pollution is associated with increased incidence-rate of head and neck cancers: A nationally representative ecological study.

Introduction: Early studies show conflicting findings regarding particulate matter ≤ 2.5 μm in diameter (PM) exposure and development of head and neck cancers (HNC). We analyzed the relationship between PM exposure and various types of HNC in a nationally representative ecological sample.

A Nationwide Analysis of Head and Neck Fibromatoses.

Background: Head and neck fibromatoses (HNFs) are a rare, diverse group of soft tissue tumors characterized by an abnormal proliferation of fibroblasts. Available literature on these tumors is limited to case reports and small single-institutional studies.

Objective: We aim to provide demographic, socioeconomic, tumor-related, and treatment characteristics of HNFs.

A Novel Immobilization Method for the Treatment of Head and Neck Cancer Using 3D Printing.

Proper immobilization is critical for the delivery of high-quality radiation therapy. In cases when traditional immobilization is not feasible, 3-dimensional (3D) printing may provide a better-tolerated custom immobilization that is comparably effective. We present the successful treatment of a patient with inoperable oropharyngeal squamous cell carcinoma who was unable to tolerate traditional immobilization.

A nationwide analysis of salvage surgery for laryngeal cancer in the elderly.

Background: We aim to describe outcomes of elderly patients undergoing salvage surgery for laryngeal cancer and to characterize the interplay of age with various other factors in this growing population.

Methods: Using the National Cancer Database, we identified cases of salvage laryngectomy in patients who failed chemoradiation. An age cutoff of 70 years was used to separate subjects into two groups.

Infratemporal Fossa Abscess Drainage via a Trans-Oral Image Guided Approach.

Deep neck space infections can cause antibiotic-resistant abscesses that can impinge on vital anatomical structures. Image-guided surgery systems using preoperative computed tomography (CT) imaging can be utilized to characterize pathology and assist surgeons in avoiding iatrogenic injury. This manuscript explores the presentation and unique CT-guided surgical management of an infratemporal fossa abscess in a 48-year-old male who presented with left-sided dental pain and facial swelling that had progressed despite antibiotics and dental extraction.

Impact of Routine Surveillance Imaging on Recurrence in Sinonasal Malignancies.

Background/aim: There is significant variation in post-treatment surveillance imaging for sinonasal malignancies. This study examined the utility of surveillance imaging in detecting recurrence in patients treated for sinonasal malignancies.

Patients And Methods: We performed a retrospective review on an IRB-approved dataset of patients with sinonasal malignancies treated at a single institution between 2005 to 2021.

Designing an evidence-based free-flap pathway in head and neck reconstruction.

Background: The use of autologous free-tissue transfer is an increasingly utilized tool in the ladder of reconstructive options to preserve and restore function in patients with head and neck cancer. This article focuses on the evidence surrounding perioperative care that optimizes surgical outcomes and describes one tertiary center's approach to standardized free-flap care.

Data Sources: This article examines English literature from PubMed and offers expert opinion on perioperative free-flap care for head and neck oncology.

Patient safety and quality improvements in parotid surgery.

Parotidectomy is the mainstay treatment for tumors of the parotid gland. In an effort to improve clinical outcomes, several modern surgical techniques and perioperative interventions have been evaluated and refined. This review discusses current and actively debated perioperative interventions aimed at improving patient safety and the quality of parotidectomy.

Association of HPV status with survival after surgical salvage of oropharyngeal cancers.

Objectives: This study used the National Cancer Database to determine the effect of human papillomavirus (HPV) on survival outcomes for recurrent oropharyngeal cancer treated with salvage surgery after initial treatment with radiation therapy or chemoradiation therapy.

Methods: Patients with recurrent oropharyngeal cancer receiving salvage surgery after initial treatment with adjuvant therapy were identified through the National Cancer Database. Demographics, tumor characteristics, and survival data were collected.

Effect of histopathological grade on treatment and survival in base of tongue adenocarcinoma.

Objectives: The purpose of this study was to investigate survival differences between low-grade and high-grade base of tongue (BOT) adenocarcinoma by examining demographics, tumor characteristics, and treatment modalities.

Methods: The National Cancer Database was queried for patients with BOT adenocarcinoma between 2004 and 2017. Univariate and multivariate analyses were performed for all cases of BOT adenocarcinoma.

Neck Dissection in Salvage Surgery for Larynx Cancer: National Cancer Database Review.

Objective: Salvage laryngeal surgery is the preferred treatment after failure of non-surgical treatment of larynx cancer. This study aims to identify the impact of ND in salvage surgery on survival and factors predictive of nodal metastasis.

Methods: The National Cancer Database was used to identify patients who received salvage laryngeal surgery.

Laryngeal Chondrosarcoma Characteristics and Survival Analysis in the National Cancer Database.

Objective: To highlight various patient, tumor, diagnostic, and treatment characteristics of laryngeal chondrosarcoma (LC) as well as elucidate factors that may independently affect overall survival (OS) for LCs.

Study Design: Retrospective cohort study.

Setting: National Cancer Database (NCDB).

Cytopathologic assessment of gloves and instruments after major head and neck surgery.

Purpose: To investigate the potential for cancer cells to be transferred between anatomic sites via instruments and other materials.

Materials And Methods: Pilot prospective study from April 2018-January 2019 at Rush University Medical Center. Glove and instrument washings were collected from 18 high-risk head and neck cancer resection cases (36 samples total).

Functional outcomes after extracapsular dissection with partial facial nerve dissection for small and large parotid neoplasms.

Purpose: Multiple surgical options exist for benign parotid tumors without agreement upon a single, best approach. We evaluated the short-term outcomes and rate of complications using the ECD-FND technique for small and large parotid neoplasms involving the superficial and deep lobes of the parotid gland using a categorical approach.

Material And Methods: A single surgeon retrospective cohort study with analysis of patient demographics, outcomes, and complication rates was conducted of patients undergoing the ECD-FND for benign parotid neoplasm.

Management of Cutaneously Exposed Carotid Stents in Recurrent and Unresectable Head and Neck Cancer.

 Carotid blowout syndrome (CBS) is a rare but potentially life-threatening complication of head and neck cancer (HNC) treatment. Patients with CBS are managed with covered stents, limited published information exists regarding the management of delayed complications, specifically cutaneous exposure of stents. Here, we present our experience managing cutaneously exposed carotid artery stents (CAS) in patients with recurrent and unresectable HNC.

Occult Lymph Node Metastasis in Early-Stage Glottic Cancer in the National Cancer Database.

Objectives: Early-stage glottic cancer (cT1-T2 cN0) may be treated by primary surgery or radiation. Elective treatment of the neck in clinically N0 disease is usually not performed due to low rates of regional lymph node metastasis. This study examines the role of elective neck dissection (END) and rate of occult nodal metastasis in cT1-T2 cN0 glottic cancer treated with primary surgery.

Enhanced recovery protocol for transoral robotic surgery demonstrates improved analgesia and narcotic use reduction.

Background: No study has evaluated the impact of the Enhanced Recovery After Surgery (ERAS) protocol on opioid usage among patients undergoing transoral robotic surgery (TORS).

Methods: In this retrospective study, patients undergoing TORS were enrolled in an ERAS protocol and compared to control patients. Primary outcome measures included postoperative mean morphine equivalent dose (MED), Defense and Veterans Pain Rating Scale (DVPRS) pain scores, and opioid prescriptions on discharge.

Targeted 595-gene genomic profiling demonstrates low tumor mutational burden in olfactory neuroblastoma.

Background: Olfactory neuroblastoma (ONB) is a rare skull-base malignancy associated with delayed local recurrence. Treatment options in recurrent disease are few and unreliable. We undertook analysis of the ONB exome and immune environment in order to identify potential future immunotherapy treatment options.

Implementation of Preoperative Screening Protocols in Otolaryngology During the COVID-19 Pandemic.

Objective: To highlight emerging preoperative screening protocols and document workflow challenges and successes during the early weeks of the COVID-19 pandemic.

Methods: This retrospective cohort study was conducted at a large urban tertiary care medical center. Thirty-two patients undergoing operative procedures during the COVID-19 pandemic were placed into 2 preoperative screening protocols.

Management of the Clinical and Academic Mission in an Urban Otolaryngology Department During the COVID-19 Global Crisis.

Objective: The objective of this study was to assess the strategic changes implemented in the departmental mission to continue safe delivery of otolaryngology care and to support the broader institutional mission during the COVID-19 pandemic response.

Study Design: Retrospective assessment was performed to the response and management strategy developed to transform the clinical and academic enterprise.

Setting: Large urban tertiary care referral center.

Prognostic Indicators in Base of Tongue Adenocarcinoma: A Population-Based Analysis.

Introduction: The objectives of this investigation are to characterize the epidemiology of base of tongue adenocarcinoma utilizing a population-based database and to identify prognostic factors that may affect survival.

Methods: A retrospective cohort study was conducted using the Surveillance, Epidemiology, and End Results database. Univariate Kaplan-Meier analysis and multivariate Cox-regression analysis were performed to evaluate the association of suspected prognostic factors with survival.