Prophylactic Swallowing Therapy During Head-and-Neck Cancer Radiotherapy: Effect of Service-Delivery Mode and Overall Adherence Level on Swallowing Function and Muscle Strength-the PRESTO Trial.

Prophylactic swallowing exercises (PSE) during head-and-neck cancer (HNC) (chemo)radiotherapy (CRT) have a positive effect on swallowing function and muscle strength. Adherence rates to PSE are, however, moderate to low, undermining these effects. PRESTO already showed that the service-delivery mode (SDM), the way the exercises are offered, can influence adherence.

Preoperative imaging for hyperparathyroidism often takes upper parathyroid adenomas for lower adenomas.

We retrospectively evaluated how accurately preoperative imaging localizes parathyroid adenoma in superior versus inferior parathyroids. Over 6 years, 104 patients with primary hyperparathyroidism underwent parathyroid surgery in a single centre. Of these, 103 underwent ultrasound, 97 [Tc]pertechnetate/MIBI SPECT/CT and 30 [F]fluorocholine (FCH) PET/CT.

Increasing Adherence to Prophylactic Swallowing Exercises During Head and Neck Radiotherapy: The Multicenter, Randomized Controlled PRESTO-Trial.

Background: Prophylactic swallowing exercises (PSE) during radiotherapy can significantly reduce dysphagia after radiotherapy in head and neck cancer (HNC). However, its positive effects are hampered by low adherence rates during the burdensome therapy period. Hence, the main goal of this multicenter randomized controlled trial (RCT) was to investigate the effect of 3 different service-delivery modes on actual patients' adherence.

Functional Outcomes and Complications After Salvage Total Laryngectomy for Residual, Recurrent, and Second Primary Squamous Cell Carcinoma of the Larynx and Hypopharynx: A Multicenter Retrospective Cohort Study.

We analyzed complications and functional outcomes and aimed at identifying prognostic factors for functional outcomes and complications in patients who underwent salvage total laryngectomy (STL) for residual, recurrent, and second primary squamous cell carcinoma (SCC) of the larynx and hypopharynx after initial (chemo)radiation. Retrospective cohort study of patients who underwent STL in four major Belgian reference hospitals between 2002 and 2018. Prognostic factors for functional outcomes and complications were identified with uni- and multivariable analysis.

Oncologic Outcomes After Salvage Laryngectomy for Squamous Cell Carcinoma of the Larynx and Hypopharynx: A Multicenter Retrospective Cohort Study.

Objective: We aimed to analyze oncologic outcomes and identify patterns of failure and negative prognostic factors in patients who underwent salvage total laryngectomy (STL) for residual, recurrent, and second primary squamous cell carcinoma (SCC) of the larynx and hypopharynx.

Methods: This was a retrospective cohort study of patients who underwent STL in four major Belgian reference hospitals between 2002 and 2018 for residual/recurrent/second primary SCC in the larynx or hypopharynx after initial (chemo)radiation. Prognostic factors for oncologic outcomes were identified using univariable and multivariable analysis.

Transoral Robotic Surgery for Obstructive Sleep Apnoea-Hypopnoea Syndrome.

Obstructive sleep apnoea-hypopnoea (OSAH) syndrome constitutes a major health care problem. Surgical modalities for the treatment of OSAH are regaining momentum in view of the increasing prevalence of OSAH and the low compliance rates associated with continuous positive airway pressure. There are several investigations to complement clinical examination in accurately determining the level of airway collapse to ensure correct patient selection and a targeted surgical approach.

Up-front and Salvage Transoral Robotic Surgery for Head and Neck Cancer: A Belgian Multicenter Retrospective Case Series.

Introduction/aim: We analyzed the functional and oncologic outcomes of primary and salvage transoral robotic surgery (TORS) procedures, performed in three Belgian institutions with a similar philosophy.

Patients And Methods: A total of 86 patients who underwent TORS between 24-12-2009 and 25-09-2015 were retrospectively reviewed. Descriptive statistics, overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS; Kaplan-Meier), and the variation of these outcomes according to whether patients had primary or salvage TORS were evaluated (univariate log-rank analysis).

Long-term results of a modified expansion sphincter pharyngoplasty for sleep-disordered breathing.

Our aim was to evaluate the long-term objective and subjective results of a modified expansion sphincter pharyngoplasty (ESP) technique in patients with sleep-disordered breathing. Single center prospective study of 35 patients underwent an ESP as a primary surgical treatment between June 2012 and September 2015 at the hospital AZ Sint-Jan Bruges-Ostend. Patients were divided into non-OSAS and OSAS (AHI >5).

Congenital laryngeal cyst: an unusual cause of stridor in the neonate.

Background: Congenital laryngeal cysts are a rare, but potentially fatal, cause of airway obstruction in infants and children. Most laryngeal cysts are acquired. Here, we describe a congenital laryngeal cyst, its treatment, and its presentation immediately after birth.

Transaxillary robotic thyroidectomy: Belgian team learning from the first 50 cases.

Background: In search for less invasive operative techniques, the da Vinci Robot System was introduced in thyroid surgery. Previous studies have reported on safety, effectiveness and improved cosmetics of transaxillary endoscopic thyroidectomy procedures in selected cases.

Methods: We report on the first 50 patients that have been treated with a gasless transaxillary robot-assisted thyroidectomy in a Belgian institution.

Transoral robotic surgery for parapharyngeal lesions: a case series of four benign tumours.

Objectives: The parapharyngeal space (PPS) is an anatomically complex space in the vicinity of vital structures. With the introduction of the daVinci robot in head and neck surgery, the surgical robotic system is now being used to gain direct access to the parapharyngeal space and to excise the tumors endoscopically. This study evaluates the outcomes of four patients with benign PPS tumors treated with a transoral robotic surgery approach in a single centre.

The importance of local eosinophilia in the surgical outcome of chronic rhinosinusitis: a 3-year prospective observational study.

Background: Patients with chronic rhinosinusitis with/without nasal polyps (CRSwNP/CRSsNP) benefit from endoscopic sinus surgery (ESS), with an estimated success rate of 80%. At present, the influence on clinical outcome after ESS of eosinophils, eosinophilic mucin (EM), and fungal hyphae (FH) in secretions remains unclear. By delineating CRS groups and subgroups based on the finding of eosinophils, EM, and FH, differences in recurrence after ESS were investigated.

Spectral, cepstral, and multivariate exploration of tracheoesophageal voice quality in continuous speech and sustained vowels.

Objectives/hypothesis: The quality of tracheoesophageal voice can vary substantially. Although previous research has identified acoustic differences between various types of voicing (i.e.

Prognostic index for patients with parotid carcinoma: international external validation in a Belgian-German database.

Background: Prognostic indices for recurrence-free interval in patients with parotid carcinoma were developed and validated in a nationwide database. International validation would increase generalizability.

Methods: In a Belgian-German database that contained 237 consecutive patients with parotid carcinoma, a pretreatment prognostic index (PS1) and a post-treatment prognostic index (PS2) were validated by calculating both indices for each patient, comparing coefficients, constructing survival curves, calculating the concordance measure C, and performing Wald tests for scale and weight optimization of included variables and for the possible inclusion of new variables.

Advances in the medical management of differentiated thyroid carcinoma and their impact on the surgical approach.

The introduction of recombinant human TSH and neck ultrasonography has refined the management of differentiated thyroid cancer, leading to the publication of new guidelines by the American Thyroid Association (ATA) and a consensus report by the European Thyroid Association (ETA) in 2006. In this paper, we give an overview of the current medical management of differentiated thyroid cancer (pre-surgical, post-surgical), of how the advances have been integrated into the recent 2006 ATA guidelines and ETA consensus and finally, of the impact on the surgical management (first surgery, treatment of cervical lymph nodes) of differentiated thyroid cancer.

Comparing the microdebrider and standard instruments in endoscopic sinus surgery: a double-blind randomised study.

Unlabelled: Comparing the microdebrider and standard instruments in endoscopic sinus surgery: a double-blind randomised study.

Objective: It is frequently stated that microdebriders provide better mucosal preservation in endoscopic sinus surgery (ESS), and therefore better and faster healing, when compared to the standard Blakesley instruments. However, evidence from comparative prospective studies is lacking.

Long term effects of cutting forceps in endoscopic sinus surgery.

Background: At present, some authors prefer cutting forceps to conventional non-cutting forceps in Endoscopic Sinus Surgery, based on the assumption of superior wound healing due to mucosal preservation, without any proof of better clinical outcome. The purpose of this study was to elaborate our previously reported short-term results, by evaluating the long-term outcome.

Methods: One hundred consecutive patients, who underwent a bilateral Endoscopic Sinus Surgery procedure, received follow-up in a prospective, double-blinded way.

Patterns of lymph node spread of cutaneous squamous cell carcinoma of the head and neck.

Background: Among patients with cutaneous squamous cell carcinoma (SCC) of the head and neck, recent studies have shown that those with involvement of the parotid gland also have a high incidence of neck node involvement. Treatment of the neck by either surgery or radiotherapy is therefore recommended among patients with parotid SCC, even if clinical examination is negative. The aim of this study was first to analyze patterns of metastatic spread in the parotid and cervical lymph nodes and then to correlate the pattern of involved nodes with the primary cutaneous site in order to guide the appropriate extent of surgery, should neck dissection be used to treat the neck in patients with parotid SCC.

Pneumosinus dilatans and orbital meningioma in neurofibromatosis type 2.

We report on a 9-year-old boy with neurofibromatosis type 2 and a progressive proptosis of the left eye. Imaging studies revealed a pneumosinus dilatans of the left ethmoidal and frontal sinuses and an adjacent left orbital mass. Incision biopsy of the orbital mass showed a meningiothelial meningioma.

Cutting forceps in functional endoscopic sinus surgery.

Twenty years of Functional Endoscopic Sinus Surgery have brought about a large amount of innovations and a variety of instruments, all claiming to result in better endoscopic procedures and/or better postoperative outcome. An example of such an innovation is the cutting forceps, which has been claimed to result in better wound healing. However, like several other instruments, it has never been proven to be superior to conventional non-cutting forceps techniques.