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External Carotid Artery Ligation Versus Selective Artery Ligation in Transoral Surgery for Oropharyngeal Cancer.
Otolaryngol Head Neck Surg
December 2024
ENT Specialty Care, Dallas, Texas, USA.
Objective: Prophylactic ligation of the external carotid artery (ECA) during oropharyngeal squamous cell carcinoma (OPSCC) resection is known to reduce severe postoperative oropharyngeal bleeding events, however, there is limited research on whether bleed rates vary between selective ligation of individual vessels or total ligation of the ECA. This study assesses outcomes related to total versus selective ligation of the ECA in patients who underwent transoral resection for OPSCC of the base of tongue or palatine tonsils.
Study Design: Retrospective review.
Pediatric glossopharyngeal neuralgia with incidental trigeminal compression treated using microvascular decompression: illustrative case.
J Neurosurg Case Lessons
December 2024
Division of Neurosurgery, Children's Hospital Los Angeles, Los Angeles, California.
Background: Glossopharyngeal neuralgia (GPN) is a rare condition typically manifesting as paroxysms of sharp, lancinating pain localized to the middle ear and auditory canal, base of the tongue, tonsillar fossa, and region just inferior to the angle of the mandible. Vascular compression is a common etiology, and microvascular decompression (MVD) has been established as a safe and efficacious treatment in adults. With the exception of one report of an adult patient undergoing the procedure for symptomatology that began in adolescence, there are no published cases of MVD for GPN in pediatric patients to the author's knowledge.
View Article and Find Full Text PDFInterrater reliability of different scoring systems for drug-induced sleep endoscopy.
Sleep Breath
November 2024
Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital Baselland, Liestal, Switzerland.
Purpose: To explore the interobserver reliability of drug-induced sleep endoscopy (DISE) for patients with obstructive sleep apnea syndrome (OSAS) of two classification systems.
Methods: DISE examinations were recorded digitally for all patients and were evaluated independently by five examiners blinded to all patient data. Areas of obstruction were rated using VOTE (velum, oropharynx lateral wall, tongue base, epiglottis) classification and PTLTbE (palate, tonsils, lateral pharyngeal wall, tongue base, epiglottis) classification.
Challenges and Considerations in Diagnosing and Managing p16+-Related Oropharyngeal Squamous Cell Carcinoma (OPSCC) with Neck Metastasis: Implications of p16 Positivity, Tobacco Exposure, and De-Escalation Strategies.
J Clin Med
November 2024
ENT Unit, Department of Mental, Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy.
Background: The incidence of patients showing neck metastasis and no obvious primary tumor at the initial diagnostic evaluation or neck cancer of unknown primary (NCUP) is rising. It is estimated that a relevant part of these tumors arises in the tonsillar crypts or base of the tongue and are p16+-related. However, today, the detection rate of the primary tumor is suboptimal.
View Article and Find Full Text PDFSurgical Puzzle: Concurrent Comprehensive Neck Dissection Strategies Unravelling the Mystery of Carcinoma Unknown Primary when Performed with TORS Radical Tonsillectomy and Mucosal Tongue Base Wedge Biopsy in Northern Indian Cohort.
Indian J Otolaryngol Head Neck Surg
December 2024
Department of Otorhinolaryngology and Head-Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India.
Article Synopsis
- The study focuses on patients with carcinoma of unknown primary who underwent specific surgical procedures, including transoral robotic surgery and neck dissection, to understand the patterns of cervical nodal metastasis.
- It reports a majority of patients presenting clinically as N2b, while histopathological results showed a higher prevalence of N3b disease, indicating some discrepancy between clinical evaluation and actual disease state.
- The most affected lymph node level was consistently found to be level II, with significant findings related to Lymph Node Yield (LNY) and emerging concepts like Lymph Node Ratio (LNR) and Lymph Node Density (LND) to better analyze the metastasis characteristics.
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