1
|
La Via L, Zanghì A, Cavallaro A, Di Vita M, Maniaci A, Cocuzza S, Cappellani A, Di Majo S. Vestibular approach for thyroid surgery: a comprehensive review. Front Surg 2024; 11:1423222. [PMID: 38948483 PMCID: PMC11211391 DOI: 10.3389/fsurg.2024.1423222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 05/29/2024] [Indexed: 07/02/2024] Open
Abstract
The transoral endoscopic thyroidectomy vestibular approach (TOETVA) is an innovative technique in thyroid surgery. This review compiles current research on TOETVA, covering its development, anatomical challenges, techniques, selection of suitable patients, results, complications, and future advancements. We performed a comprehensive literature review on PubMed, EMBASE, and Cochrane databases for articles published up to 15th March 2024. The search strategy included a combination of terms focused on "vestibular approach" and "thyroidectomy". The review underscores the necessity for preoperative planning and careful patient selection to reduce risks and enhance outcomes. It discusses the unique anatomical challenges of TOETVA, such as avoiding mental nerve damage and the complexities involved in creating a subplatysmal space. Outcomes of TOETVA, including surgical duration, complication rates, and recovery times, are compared favorably to traditional methods. The approach is particularly noted for high patient satisfaction and superior cosmetic results. Complications specific to TOETVA, like infection, bleeding, and potential harm to the recurrent laryngeal nerve, are recognized. Future research directions are discussed as well. In summary, TOETVA is a promising alternative for thyroidectomy with excellent cosmetic outcomes and patient satisfaction. Success relies on selective patient criteria, surgical expertise, and continuous research to refine the approach.
Collapse
Affiliation(s)
- Luigi La Via
- Department of Anesthesia and Intensive Care, University Hospital Policlinico “G.Rodolico-San Marco”, Catania, Italy
| | - Antonio Zanghì
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Catania, Italy
- Centro di Ricerca in Chirurgia Delle Sindromi Malformative Complesse Della Transizione e dell’Età Adulta, University of Catania, Catania, Italy
| | - Andrea Cavallaro
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Maria Di Vita
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Antonino Maniaci
- Faculty of Medicine and Surgery, University of Enna “Kore”, Enna, Italy
| | - Salvatore Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Catania, Italy
| | - Alessandro Cappellani
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Simone Di Majo
- Residency Program in General Surgery, University of Catania, Catania, Italy
| |
Collapse
|
2
|
Yu J, Pham TT, Wandrey N, Daly M, Karam SD. Multimodality Management of EBV-Associated Nasopharyngeal Carcinoma. Cancers (Basel) 2021; 13:6078. [PMID: 34885187 PMCID: PMC8657235 DOI: 10.3390/cancers13236078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/23/2021] [Accepted: 12/01/2021] [Indexed: 12/24/2022] Open
Abstract
Nasopharyngeal carcinoma (NPC) is a rare cancer of the nasopharyngeal mucosa with a specific geographic predisposition. NPC is often associated with Epstein-Barr Virus (EBV) infection and as a result contains many characteristic biomarkers. Treatment of locally-contained NPC is generally achieved through use of radiotherapy (RT), as part of a multimodality treatment regimen. Induction chemotherapy followed by concurrent RT and platinum-based chemotherapy regimen has emerged as the definitive treatment of choice for locoregionally-advanced NPC. Recently, immunotherapy is finding a role in the treatment of recurrent or metastatic NPC. Immune checkpoint blockade therapies targeted against the programmed death-1 (PD-1) receptor have demonstrated efficacy in early phase clinical trials, with ongoing phase III trials in effect. Biomarkers for treatment efficacy remain an ongoing area of investigation, with important prognostic implications on the horizon.
Collapse
Affiliation(s)
- Justin Yu
- Department of Otolaryngology, Head and Neck Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USA; (J.Y.); (T.T.P.)
| | - Tiffany T. Pham
- Department of Otolaryngology, Head and Neck Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USA; (J.Y.); (T.T.P.)
| | - Narine Wandrey
- Department of Radiation Oncology, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USA; (N.W.); (M.D.)
| | - Mackenzie Daly
- Department of Radiation Oncology, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USA; (N.W.); (M.D.)
| | - Sana D. Karam
- Department of Radiation Oncology, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USA; (N.W.); (M.D.)
| |
Collapse
|
3
|
Nethan S, Cherian M, Brain E, Ganguli A, Tullu F, Musolino N, Hariprasad R, Sullivan R, Mehrotra R. Cancer in the older Indian population: Understanding the current context in an emerging economy. J Geriatr Oncol 2021; 13:273-281. [PMID: 34776381 DOI: 10.1016/j.jgo.2021.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 08/30/2021] [Accepted: 10/25/2021] [Indexed: 10/19/2022]
Abstract
India is considered a demographically young country with over 65% of the population aged below 35 years. However, improvements in maternal and child health, and infectious diseases, have created a rapid epidemiological transition with an aging population (8.6% in 2011) with a projected increase (19% by 2050), equating to 104 million. In addition to the well-articulated issues surrounding the care of the older patients with cancer, the Indian context as an emerging economy provides additional social, political, economic and clinical challenges. This review addresses the key issues and possible solutions germane to both policymakers in India and other emerging economies. Extension of cancer prevention, equal, optimal treatment opportunities, and inclusion in clinical trials, akin to the younger population, must be encouraged. Various national health initiatives require effective implementation, to provide uniform, evidence-based, cancer care across India. Designated geriatric oncology departments, and required care at the primary healthcare level are essential.
Collapse
Affiliation(s)
- Suzanne Nethan
- Project ECHO (Extension for Community Healthcare Outcomes) - India, Building No 76 (2nd Floor), Okhla Phase III, Okhla Industrial Area, New Delhi 110020, India.
| | - Meena Cherian
- International Society of Geriatric Oncology (SIOG), International Environmental House 2, Chemin de Balexert 7-9, 1219 Chatelaine, Switzerland.
| | - Etienne Brain
- Department of Clinical Research & Medical Oncology, Institut Curie (Hôpital René Huguenin), 35 Rue Dailly, 92210 St Cloud, France.
| | - Atreyi Ganguli
- WHO India Country Office, 537, A Wing, Nirman Bhawan, Maulana Azad Road, New Delhi 110011, India.
| | - Fikru Tullu
- WHO India Country Office, 537, A Wing, Nirman Bhawan, Maulana Azad Road, New Delhi 110011, India.
| | - Najia Musolino
- International Society of Geriatric Oncology (SIOG), International Environmental House 2, Chemin de Balexert 7-9, 1219 Chatelaine, Switzerland.
| | - Roopa Hariprasad
- Division of Clinical Oncology, Indian Council of Medical Research (ICMR), National Institute of Cancer Prevention & Research (NICPR), I-7, Sector 39, Noida 201301, Uttar Pradesh, India.
| | | | - Ravi Mehrotra
- India Cancer Research Consortium (ICMR-DHR), Ministry of Health and Family Welfare, Department of Health Research, First Floor, Indian Red Cross Society (IRCS) Building, 1, Red Cross Road, New Delhi 110001, India; Centre for Health Innovation and Policy (CHIP) Foundation, 361, Sector 15A, Noida, Uttar Pradesh 201301, India.
| |
Collapse
|
4
|
Outcomes of Craniofacial Open Surgery in Octogenarians. J Neurol Surg B Skull Base 2018; 79:515-521. [PMID: 30456018 DOI: 10.1055/s-0038-1635077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 01/13/2018] [Indexed: 10/17/2022] Open
Abstract
Introduction The steady increase in average life expectancy has led to a rise in the number of referrals of elderly patients for major operations. It is not clear whether age itself is a risk factor for morbidity and mortality after skull base operations. We investigated a possible link among a cohort of patients older than 80 years of age who underwent those surgeries in our department. Methods We conducted a retrospective analysis of all patients who underwent skull base surgery at the TASMC (Tel Aviv Sourasky Medical Center) between 2000 and 2016. Results A total of 369 patients underwent open skull base surgeries in our institution, and 13 were patients older than 80 years. The median age of the octogenarians was 83.4 (range 80-89), and the male-to-female ratio was 7:6. Twelve patients had major systemic comorbidities. Four patients had major complications associated with surgery: three had early wound complications, and one each had early central nervous system complications, early and late systemic complications, and late orbital complications. This complication rate is comparable to that of our younger group of 356 patients. The overall survival rate was measured for 30 days, 1 year, and 3 years, and it was not significantly different between the octogenarians and that of the younger patients. Further comparison of the elderly group with 13 matched younger patients revealed no difference of morbidity and mortality between the two groups. Conclusions Despite their systemic comorbidities, the morbidity and mortality rates associated with skull base surgery in octogenarians appear to be comparable to that of younger patients undergoing the same procedures.
Collapse
|
5
|
Chougule A, Patil VM, Noronha V, Joshi A, Turkkar S, Chandrasekharan A, Pande N, Bagayatkar P, Prabhash K. Incidence and impact of Dihydropyrimidine dehydrogenase gene mutation on neoadjuvant chemotherapy in head and neck cancers. Oral Oncol 2017; 70:73-74. [DOI: 10.1016/j.oraloncology.2017.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 05/14/2017] [Indexed: 11/30/2022]
|