Optimising Patient Outcomes in Tongue Cancer: A Multidisciplinary Approach.

A multidisciplinary approach to the management of tongue cancer is vital for achieving optimal patient outcomes. Nursing and allied health professionals play essential roles within the team. We developed symposia comprising a series of online lectures offering a detailed perspective on the role each discipline and consumer perspective has in the management of patients with tongue cancer.

Genomic Signature of Oral Squamous Cell Carcinomas from Non-Smoking Non-Drinking Patients.

Molecular alterations in 176 patients with oral squamous cell carcinomas (OSCC) were evaluated to delineate differences in non-smoking non-drinking (NSND) patients. Somatic mutations and DNA copy number variations (CNVs) in a 68-gene panel and human papilloma virus (HPV) status were interrogated using targeted next-generation sequencing. In the entire cohort, (60%) and (24%) were most frequently mutated, and the most common CNVs were amplifications (9%) and deletions of (5%) and (4%).

Contralateral neck failure in oral tongue cancer: Outcomes from two centers using predefined treatment criteria.

Background: The objective was to determine the incidence of, and factors associated with contralateral neck failure (CNF) in oral tongue squamous cell carcinoma (OTSCC).

Methods: Consecutive patients with OTSCC between 2007 and 2016 were included. The predefined policy of the contralateral neck included neck dissection (ND) where the primary tumor extended/crossed midline or the contralateral neck was involved; and elective nodal irradiation (ENI) where the primary tumor was ≤1 cm from midline/2 cm from tip.

Impact of histological Oral Tongue Cancer margins on locoregional recurrence: A multi-centre retrospective analysis.

Objectives: To assess the effect of the histological margins (HM) upon locoregional failure (LRF) and overall survival (OS) for oral tongue squamous cell carcinoma (OTSCC).

Materials And Methods: We undertook a retrospective review of 258 patients, across two institutions, treated for OTSCC between 2007 and 2016. A Cox-proportional hazards model was used to compare the relative hazard ratio of HM to the accepted standard of 5 mm margins for LRF and OS.

Relationship between age, comorbidities and complications in head and neck cancer patients undergoing curative surgery.

Background: Both age and comorbidity are accepted as significant prognostic factors for adverse perioperative outcomes in major surgery. Elderly patients may be overlooked for radical treatment for fear of poor perioperative outcome. We aim to assess the relationship between age, comorbidities and post-operative outcomes in a tertiary head and neck unit.

Imaging characteristics of nodal metastases in paraganglioma, ameloblastoma and olfactory neuroblastoma: case reports and literature review.

Paraganglioma, ameloblastoma and olfactory neuroblastoma are uncommon primary head and neck tumours. When nodal metastases from these tumours occur, they may present later than and with different imaging characteristics compared with squamous cell carcinoma (SCC), demonstrating appearances similar to the primary tumour type rather than features typical of metastatic nodal SCC. We present three cases in which imaging characteristics of nodal metastases in paraganglioma, ameloblastoma and olfactory neuroblastoma mimicked the primary tumour and discuss their implications for clinicoradiological follow-up.

Survival Outcomes of Mucosal Melanoma in the Head and Neck: Case Series and Review of Current Treatment Guidelines.

Purpose: Malignant mucosal melanoma of the head and neck (MMHN) is an aggressive and rare neoplasm with poor long-term outcomes. The aim of this study is to evaluate the outcomes of patients treated by a single-institution head and neck multidisciplinary team.

Materials And Methods: In this retrospective case series, all MMHN cases treated at the Royal Melbourne Hospital from 1990-2015 were retrospectively reviewed.

Spontaneous Giant Pseudomeningocele in the Middle Cranial Fossa as a Cause of Pulsatile Proptosis.

The authors report a case of a 70-year-old man who presented with a long history of left pulsatile proptosis, irritation, and a pressure sensation behind the eye. Initial computed tomography brain demonstrated the presence of a suspected ethmoid sinus mucocele. Endoscopic sinus surgery was performed to drain the mucocele.

Saliva management options for difficult-to-wean people with tracheostomy following severe acquired brain injury (ABI): A review of the literature.

Primary Objective: To evaluate the evidence on saliva management options in those people who have a tracheostomy in situ following an acquired brain injury and to ascertain whether any of these treatments may facilitate tracheostomy decannulation.

Methods: The search was conducted on Medline, Embase, Cinahl and Central databases since 1990 and the evidence has been critiqued and summarized. Saliva management options were identified and analysed to see whether they had evidence or clinical support for the population.

Anatomic comparison of nasal versus lateral surgical access to the petrous apex.

To compare anatomic access to the petrous apex via the nasal and lateral approaches. Hundred consecutive fine-cut CT temporal bones at the Royal Melbourne Hospital from July 27, 2007 to October 30, 2010 were reviewed. Easy lateral access allowed use of a 4 mm burr past vital structures.

Outcomes of intubation in difficult airways due to head and neck pathology.

The purpose of this study was to examine the impact of surgical pathology, anesthesiologist experience, and airway technique on surgically relevant outcomes in patients identified by preoperative laryngoscopy to have a difficult airway due to head and neck pathology. We prospectively recorded a series of 152 difficult airway cases due to head and neck pathology out of 2,145 direct laryngoscopies undertaken between November 2005 and June 2008. One of two senior anesthesiologists specializing in head and neck procedures intubated 101 (66.

Prophylactic neck dissection in early oral tongue squamous cell carcinoma 2.1 to 4.0 mm depth.

Objective: Regional recurrence is common following surgery for T1/T2 oral tongue squamous cell carcinoma (SCC). Tumor depth >4.0 mm is commonly assigned as an indication for prophylactic neck dissection to improve regional control.

Functional outcomes of fibula and osteocutaneous forearm free flap reconstruction for segmental mandibular defects.

Objective/hypothesis: To demonstrate that the osteocutaneous radial forearm free flap provides equivalent functional outcomes and improved morbidity compared to the fibular free flap in mandibular reconstruction.

Study Design: Retrospective review.

Methods: There were 168 patients requiring free flap reconstruction of segmental mandibular defects between January 2001 and December 2008.

Outcomes of static and dynamic facial nerve repair in head and neck cancer.

Objectives/hypothesis: Determine outcomes associated with nerve grafting versus static repair following facial nerve resection.

Study Design: Retrospective chart review.

Methods: Charts from 105 patients who underwent facial nerve reconstruction between January 1999 and January 2009 were reviewed.

Outcomes of salvage surgery with free flap reconstruction for recurrent oral and oropharyngeal cancer.

Objectives/hypothesis: To evaluate outcomes of salvage surgery with free flap reconstruction for recurrent squamous cell carcinoma of the oropharynx and oral cavity with increased use of chemoradiotherapy.

Study Design: Retrospective patient review.

Methods: All patients undergoing salvage surgery with free flap reconstruction for oropharynx (n = 36) and oral cavity (n = 36) squamous cell carcinomas between January 2001 and January 2008 were obtained.

Postoperative reirradiation for mucosal head and neck squamous cell carcinomas.

Objectives: To compare toxic effects and functional outcomes of reirradiation with and without salvage surgery for nonnasopharyngeal mucosal head and neck squamous cell carcinoma.

Design: Retrospective review.

Setting: Academic tertiary referral hospital.

Endoscopic approach for pituitary surgery improves rhinologic outcomes.

Objectives: We hypothesized that the endoscopic approach to pituitary surgery improves rhinology-specific quality of life and has satisfactory tumor outcomes compared with the open approach.

Methods: Cases of pituitary surgery from the Department of Neurosurgery database included an inception cohort of all patients who had endoscopic procedures and consecutive patients who had open procedures between January 1998 and February 2008. The Sino-Nasal Outcome Test-22 was mailed.

Functional outcomes after transoral robotic surgery for head and neck cancer.

Objective: To evaluate functional outcomes following transoral robotic surgery for head and neck cancer.

Study Design: Case series with planned data collection.

Setting: Academic hospital.

Reconstruction of periauricular and temporal bone defects.

Large periauricular and temporal bone defects most commonly follow resection of advanced nonmelanoma skin cancers. Reconstruction aims to cover the cutaneous defect and adjacent vital structures with the ability to heal in an irradiated field and withstand further treatment. Preferred reconstructions are class I, cervicofacial rotation or radial forearm free flap; class II, anterolateral thigh; and class II, rectus abominis free flap.

Functional outcomes following secondary free flap reconstruction of the head and neck.

Objectives/hypothesis: To evaluate head and neck patients undergoing secondary (delayed) free flap reconstructions.

Study Design: Retrospective chart review.

Methods: Of the 523 free flaps between October 2004 and May 2008, 70 patients underwent 71 secondary free flaps.

Facial nerve sacrifice and radiotherapy in parotid adenoid cystic carcinoma.

Objectives: To evaluate the impact of facial nerve sacrifice and postoperative radiotherapy on the outcome of adenoid cystic carcinoma of the parotid gland.

Study Design: Inception cohort.

Methods: Retrospective review of Department of Pathology, SNOMED database, and Tumor Registry including health-related quality of life data for the subset enrolled in the longitudinal Outcomes Assessment Project.

Functional outcomes following total laryngopharyngectomy.

Background: Despite increasing use of laryngeal preserving protocols, laryngopharyngectomy remains the gold standard treatment for locally advanced hypopharyngeal and upper oesophageal tumours and for salvage following failed chemoradiotherapy. Nevertheless, improved perioperative medical care and experience in reconstruction have reduced mortality and improved functional outcomes.

Methods: All patients undergoing total laryngopharyngectomy between July 2001 and July 2006 were prospectively recorded in a head and neck database.