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Carsuzaa F, Verillaud B, Marcy PY, Herman P, Dufour X, Favier V, Thariat J. Interdisciplinary challenges and aims of flap or graft reconstruction surgery of sinonasal cancers: What radiologists and radiation oncologists need to know. Front Oncol 2022; 12:1013801. [PMID: 36203460 PMCID: PMC9530815 DOI: 10.3389/fonc.2022.1013801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
In sinonasal cancer surgery, a fundamental challenge is to understand the postoperative imaging changes after reconstruction. Misinterpretation of post-operative imaging may lead to a misdiagnosis of tumor recurrence. Because radiotherapy planning is based on imaging, there are many gaps in knowledge to be filled in the interpretation of postoperative imaging to properly define radiotherapy tumor volumes in the presence of flaps. On the other hand, radiotherapy may be responsible for tissue fibrosis or atrophy, the anatomy of the reconstructed region and the functional outcomes may change after radiotherapy compared to surgery alone. This narrative review illustrates the interdisciplinary aims and challenges of sinonasal reconstructive surgery using flaps or grafts. It is particularly relevant to radiologists and radiation oncologists, at a time when intensity modulated radiotherapy and proton therapy have the potential to further contribute to reduction of morbidity.
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Affiliation(s)
- Florent Carsuzaa
- Department of Oto-Rhino-Laryngology-Head and Neck Surgery, University Hospital of Poitiers, Poitiers, France
- Laboratoire Inflammation, Tissus Epithéliaux et Cytokines (LITEC), University of Poitiers, Poitiers, France
- *Correspondence: Florent Carsuzaa,
| | - Benjamin Verillaud
- Department of Oto-Rhino-Laryngology-Head and Neck Surgery, Hôpital Lariboisière, Paris, France
| | - Pierre-Yves Marcy
- Department of Radiology, Clinique du Cap d’Or, La Seyne-sur-mer, France
| | - Philippe Herman
- Department of Oto-Rhino-Laryngology-Head and Neck Surgery, Hôpital Lariboisière, Paris, France
| | - Xavier Dufour
- Department of Oto-Rhino-Laryngology-Head and Neck Surgery, University Hospital of Poitiers, Poitiers, France
- Laboratoire Inflammation, Tissus Epithéliaux et Cytokines (LITEC), University of Poitiers, Poitiers, France
| | - Valentin Favier
- Department of Oto-Rhino-Laryngology-Head and Neck Surgery, Hôpital Gui de Chauliac, University Hospital of Montpellier, Montpellier, France
| | - Juliette Thariat
- Department of Radiation Oncology, Centre François Baclesse, Caen, France
- Laboratoire de Physique Corpusculaire UMR6534 IN2P3 ENSICAEN CNRS, Normandy University, Caen, France
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Hans S, Baudouin R, Circiu MP, Couineau F, Lisan Q, Crevier-Buchman L, Lechien JR. Open Partial Laryngectomies: History of Laryngeal Cancer Surgery. J Clin Med 2022; 11:5352. [PMID: 36142999 PMCID: PMC9501694 DOI: 10.3390/jcm11185352] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
Historically, surgery was the first-choice therapy for early, intermediate and advanced laryngeal squamous cell carcinoma (LSCC). Partial laryngeal surgery has evolved in recent decades and was influenced by many historic events and the development of new technologies. Partial laryngectomies may be performed by open, endoscopic or transoral robotic approaches. In this historic paper, we describe the evolution of open partial laryngectomy techniques, indications and surgical outcomes. Since the first partial laryngectomy in 1788, many U.S., U.K. and European surgeons, including Henry Sands, Jacob da Silva Solis-Cohen and Theodor Billroth, performed this surgical procedure under local anesthesia for tuberculosis, cancer or syphilis. Partial laryngectomy gained reputation in the medical community in 1888 due to the laryngeal cancer and death of the prince of Prussia, Frederick III. Frederick III's death represented the turning point in the history of partial laryngectomies, calling attention to the importance of semiotics, biopsy and early diagnosis in laryngeal cancers. Hemi-laryngectomy was indicated/proposed for lateral laryngeal tumors, while thyrotomy was indicated for cancers of the middle part of the vocal fold. The second landmark in the history of partial laryngectomies was the discovery of cocaine, novocaine and adrenaline and the related development of local anesthetic techniques, which, together with the epidemiological and hygienic advances of the 19th century, allowed for better perioperative outcomes. General anesthesia was introduced in the second part of the 20th century and further improved the surgical outcomes. The diagnosis of laryngeal cancer was improved with the development of X-rays and direct laryngoscopies. The 20th century was characterized by the development and improvement of vertical partial laryngectomy procedures and the development of horizontal partial laryngectomies for both supraglottic and glottic regions. The history and the evolution of these techniques are discussed in the present historical paper.
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Affiliation(s)
- Stéphane Hans
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 92150 Suresnes, France
| | - Robin Baudouin
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 92150 Suresnes, France
| | - Marta P. Circiu
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 92150 Suresnes, France
| | - Florent Couineau
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 92150 Suresnes, France
| | - Quentin Lisan
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 92150 Suresnes, France
| | - Lise Crevier-Buchman
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 92150 Suresnes, France
| | - Jérôme R. Lechien
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 92150 Suresnes, France
- Division of Laryngology and Broncho-Esophagology, EpiCURA Hospital, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), 7000 Mons, Belgium
- Polyclinic of Poitiers—Elsan, 86000 Poitiers, France
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Thariat J, Leleu T, Micault E, Gery B, Bastit V, Jeanne C, Humbert M, Dugas A, Le Guevelou J, Florescu C, Patron V, Lasne-Cardon A, Babin E. Dix ans de progrès en chirurgie des tumeurs de la tête et du cou, quel impact sur la radiothérapie postopératoire ? Bull Cancer 2020; 107:823-829. [DOI: 10.1016/j.bulcan.2020.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 11/30/2022]
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Bozec A, Culié D, Poissonnet G, Dassonville O. Current role of primary surgical treatment in patients with head and neck squamous cell carcinoma. Curr Opin Oncol 2020; 31:138-145. [PMID: 30865132 DOI: 10.1097/cco.0000000000000531] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW The objective of this review article is to discuss the current role of surgery as the primary treatment modality in patients with head and neck squamous cell carcinoma (HNSCC). RECENT FINDINGS HNSCC represents one of the cancer locations where the primary treatment modality is the most under discussion. Indeed, the respective roles of primary surgical resection followed, as necessary, by adjuvant radiotherapy or definitive chemoradiotherapy remain controversial. The results of organ preservation trials and the drastic rise in the incidence of human papillomavirus-induced oropharyngeal tumors, which are known to be highly radiosensitive, have led to an increasing use of chemoradiation-based therapies in HNSCC patients. However, no chemoradiation-based protocol has shown better oncologic outcomes than radical primary surgery. Moreover, development of minimally invasive surgical techniques, such as transoral robotic surgery, and advances in head and neck microvascular reconstruction have considerably improved the clinical outcomes of the patients and have led to a reconsideration of the role of primary surgery in HNSCC patients. SUMMARY Surgery should be the primary treatment modality for most resectable oral cavity cancers and for T4a laryngeal/hypopharyngeal cancers. Primary surgery could also be the preferred modality of treatment for most early (T1-T2, N0) laryngeal and hypo/oropharyngeal carcinomas when this strategy offers an opportunity to reserve radiotherapy for a potential recurrence or second primary tumor. Primary surgery should also be considered in patients with locally advanced human papillomavirus-negative oropharyngeal carcinoma.
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Affiliation(s)
- Alexandre Bozec
- Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
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Breda E, Catarino R, Monteiro E. Transoral laser microsurgery as standard approach to hypopharyngeal cancer survival analysis in a hospital based population. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2018. [DOI: 10.1016/j.otoeng.2016.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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De Leeuw F, Breuskin I, Abbaci M, Casiraghi O, Mirghani H, Ben Lakhdar A, Laplace-Builhé C, Hartl D. Intraoperative Near-infrared Imaging for Parathyroid Gland Identification by Auto-fluorescence: A Feasibility Study. World J Surg 2017; 40:2131-8. [PMID: 27220510 DOI: 10.1007/s00268-016-3571-5] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Parathyroid glands (PGs) can be particularly hard to distinguish from surrounding tissue and thus can be damaged or removed during thyroidectomy. Postoperative hypoparathyroidism is the most common complication after thyroidectomy. Very recently, it has been found that the parathyroid tissue shows near-infrared (NIR) auto-fluorescence which could be used for intraoperative detection, without any use of contrast agents. The work described here presents a histological validation ex vivo of the NIR imaging procedure and evaluates intraoperative PG detection by NIR auto-fluorescence using for the first time to our knowledge a commercially available clinical NIR imaging device. METHODS Ex vivo study on resected operative specimens combined with a prospective in vivo study of consecutive patients who underwent total or partial thyroid, or parathyroid surgery at a comprehensive cancer center. During surgery, any tissue suspected to be a potential PG by the surgeon was imaged with the Fluobeam 800 (®) system. NIR imaging was compared to conventional histology (ex vivo) and/or visual identification by the surgeon (in vivo). RESULTS We have validated NIR auto-fluorescence with an ex vivo study including 28 specimens. Sensitivity and specificity were 94.1 and 80 %, respectively. Intraoperative NIR imaging was performed in 35 patients and 81 parathyroids were identified. In 80/81 cases, the fluorescence signal was subjectively obvious on real-time visualization. We determined that PG fluorescence is 2.93 ± 1.59 times greater than thyroid fluorescence in vivo. CONCLUSIONS Real-time NIR imaging based on parathyroid auto-fluorescence is fast, safe, and non-invasive and shows very encouraging results, for intraoperative parathyroid identification.
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Affiliation(s)
- Frederic De Leeuw
- Plateforme d'Imagerie et Cytométrie, UMS AMMICa, Gustave Roussy, Université Paris-Saclay, 114, rue Édouard-Vaillant, 94805, Villejuif, France.
- UMR CNRS 8081- IR4M, Université Paris-Sud, Université Paris-Saclay, 91401, Orsay, France.
| | - Ingrid Breuskin
- Département de Chirurgie ORL, Unité Thyroïde, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Muriel Abbaci
- Plateforme d'Imagerie et Cytométrie, UMS AMMICa, Gustave Roussy, Université Paris-Saclay, 114, rue Édouard-Vaillant, 94805, Villejuif, France
- UMR CNRS 8081- IR4M, Université Paris-Sud, Université Paris-Saclay, 91401, Orsay, France
| | - Odile Casiraghi
- Département de Pathologie, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Haïtham Mirghani
- Département de Chirurgie ORL, Unité Thyroïde, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Aïcha Ben Lakhdar
- Département de Pathologie, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Corinne Laplace-Builhé
- Plateforme d'Imagerie et Cytométrie, UMS AMMICa, Gustave Roussy, Université Paris-Saclay, 114, rue Édouard-Vaillant, 94805, Villejuif, France
- UMR CNRS 8081- IR4M, Université Paris-Sud, Université Paris-Saclay, 91401, Orsay, France
| | - Dana Hartl
- Département de Chirurgie ORL, Unité Thyroïde, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
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Breda E, Catarino R, Monteiro E. Transoral laser microsurgery as standard approach to hypopharyngeal cancer. Survival analysis in a hospital based population. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017; 69:1-7. [PMID: 28190450 DOI: 10.1016/j.otorri.2016.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 11/10/2016] [Accepted: 11/13/2016] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Cancer of the hypopharynx remains one of the most challenging chapters in head and neck oncology. The objective of this study is to ascertain the relevance of a transoral laser approach as a valid functional option for treatment of cancer of the hypopharynx in Portugal, and additionally, to confirm the reproducibility of survival and functional outcomes described in other reference centers. SUBJECTS AND METHODS The outcomes of 37 out of 60 patients presenting hypopharyngeal carcinoma primarily treated by TLM (transoral laser microsurgery) and neck dissection and or adjuvant treatment when needed, with curative intention in tertiary referral center, were retrospectively evaluated and compared with published results. RESULTS There were no patients in stage I. Three-year and five-year overall survival (Kaplan-Meier) were 83.5% and 63.5% for stage II (n=12), 57.1% (only 3-year overall survival evaluable for this stage) for stage III (n=7), and 53.1% and 39.8% for stage IVa (n=18), respectively. Five-year local control rates were 90% for stage II and 87.5% for stage IVa, respectively; only three-year local control rates were possible to evaluate for stage III, with a 100% control rate. Five-year total larynx preservation rate was 97.3%. CONCLUSIONS TLM, alone or with neck dissection and adjuvant therapy, is a valid procedure for treatment of hypopharyngeal cancer in different stages. Furthermore, this kind of approach can be replicated in different oncologic centers with similar oncologic and functional results.
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Affiliation(s)
- Eduardo Breda
- Department of Otolaryngology, Portuguese Institute of Oncology Dr Francisco Gentil, Porto, Portugal.
| | - Raquel Catarino
- Molecular Oncology GRP CI, Portuguese Institute of Oncology Dr Francisco Gentil, Porto, Portugal
| | - Eurico Monteiro
- Department of Otolaryngology, Portuguese Institute of Oncology Dr Francisco Gentil, Porto, Portugal
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Krishnan SGS, Umapathysivam K, Lockwood C, Hodge JC. Oncological and survival outcomes following transoral robotic surgery versus transoral laser microsurgery for the treatment of oropharyngeal squamous cell carcinoma: a systematic review protocol. ACTA ACUST UNITED AC 2016; 14:90-102. [PMID: 27635749 DOI: 10.11124/jbisrir-2016-003061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE/REVIEW QUESTIONS The objective of this systematic review is to synthesize the best available evidence regarding the oncological and survival outcomes (as measured by disease control, disease-free survival, disease-specific survival and overall survival) of transoral robotic surgery (TORS) versus transoral laser microsurgery (TLM) in the treatment of oropharyngeal squamous cell carcinoma in adults (aged 18 years or older). Specifically the review questions are:1 Is there a difference in oncological outcomes between a traditional "Halstedian" en bloc tumor resection technique used in TORS versus a modern segmental tumor dissection technique used in TLM?2 Does one surgical approach confer better oncological outcomes with respect to a particular patient subgroup, such as patients with a positive human papilloma virus status or patient's with different tumor T-stages?
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Affiliation(s)
- Sabapathy Giridhar Suren Krishnan
- 1The Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia 2Department of Otolaryngology, Head and Neck Surgery, The Royal Adelaide Hospital, Adelaide, Australia
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Gassner HG, Schwan F, Schebesch KM. Minimally invasive surgery of the anterior skull base: transorbital approaches. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2016; 14:Doc03. [PMID: 27453759 PMCID: PMC4940979 DOI: 10.3205/cto000118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Minimally invasive approaches are becoming increasingly popular to access the anterior skull base. With interdisciplinary cooperation, in particular endonasal endoscopic approaches have seen an impressive expansion of indications over the past decades. The more recently described transorbital approaches represent minimally invasive alternatives with a differing spectrum of access corridors. The purpose of the present paper is to discuss transorbital approaches to the anterior skull base in the light of the current literature. The transorbital approaches allow excellent exposure of areas that are difficult to reach like the anterior and posterior wall of the frontal sinus; working angles may be more favorable and the paranasal sinus system can be preserved while exposing the skull base. Because of their minimal morbidity and the cosmetically excellent results, the transorbital approaches represent an important addition to established endonasal endoscopic and open approaches to the anterior skull base. Their execution requires an interdisciplinary team approach.
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Affiliation(s)
- Holger G Gassner
- Department of Otolaryngology, Head & Neck Surgery, University Medicine of Regensburg, Germany
| | - Franziska Schwan
- Department of Otolaryngology, Head & Neck Surgery, University Medicine of Regensburg, Germany
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Kass JI, Giraldez L, Gooding W, Choby G, Kim S, Miles B, Teng M, Sikora AG, Johnson JT, Myers EN, Duvvuri U, Genden EM, Ferris RL. Oncologic outcomes of surgically treated early-stage oropharyngeal squamous cell carcinoma. Head Neck 2016; 38:1467-71. [PMID: 27080244 DOI: 10.1002/hed.24456] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to characterize oncologic outcomes in early (T1-T2, N0) and intermediate (T1-T2, N1) oropharyngeal squamous cell carcinoma (SCC) after surgery. METHODS Patients with oropharyngeal SCC treated with surgery were identified from 2 academic institutions. RESULTS Of 188 patients, 143 met the inclusion criteria. Eighty-six (60%) had T1 to T2 N0 and 57 (40%) had T1 to T2 N1 disease. Sixty-five patients (45%) underwent a robotic-assisted resection, whereas the remaining had transoral (n = 60; 42%), mandible-splitting (n = 11; 8%), or transhyoid approaches (n = 7; 5%). Human papillomavirus (HPV) status was known for 97 patients (68%), and 54 (55%) were HPV positive. Three-year recurrence-free survival (RFS) was 82% (95% confidence interval [CI] = 0.75-0.89). Since 2008, HPV infection was protective of recurrence (log-rank p = .0334). A single node did not increase the risk of recurrence (p = .467) or chance of a second primary (p = .175). CONCLUSION Complete surgical resection is effective therapy for early and intermediate oropharyngeal SCC. HPV-negative patients were at increased risk for locoregional recurrence or second primary disease. © 2016 Wiley Periodicals, Inc. Head Neck 38: First-1471, 2016.
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Affiliation(s)
- Jason I Kass
- Department of Otolaryngology, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania.,Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Laureano Giraldez
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - William Gooding
- Biostatistics Facility, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Garret Choby
- Department of Otolaryngology, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania
| | - Seungwon Kim
- Department of Otolaryngology, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania
| | - Brett Miles
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Marita Teng
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Andrew G Sikora
- Department of Otolaryngology, Baylor College of Medicine, Houston, Texas
| | - Jonas T Johnson
- Department of Otolaryngology, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania
| | - Eugene N Myers
- Department of Otolaryngology, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania
| | - Umamaheswar Duvvuri
- Department of Otolaryngology, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania.,Veterans Affairs Pittsburgh Health System, Pittsburgh, Pennsylvania
| | - Eric M Genden
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert L Ferris
- Department of Otolaryngology, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania.
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Endoscopic Endonasal Anterior Skull Base Surgery: A Systematic Review of Complications During the Past 65 Years. World Neurosurg 2016; 95:383-391. [PMID: 26960277 DOI: 10.1016/j.wneu.2015.12.105] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 12/19/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Endoscopic skull base surgery is becoming more popular as an approach to the anterior skull base for tumors and cerebrospinal fluid (CSF) fistulae. It offers the advantages of better cosmesis and improved quality of life after surgery. We reviewed the complication rates reported in the literature. METHODS A literature search was performed in the electronic database Ovid MEDLINE (1950 to August 25, 2015) with the search item "([Anterior] AND Skull base surgery) AND endoscopic." RESULTS We identified 82 relevant studies that included 7460 cases. An average overall complication rate of 17.1% (range 0%-68.0%) and a mortality rate of 0.4% (0%-10.0%) were demonstrated in a total of 82 studies that included 7460 cases. The average CSF leak rate for all studies was 8.9% (0%-40.0%) with meningiomas and clival lesions having the greatest CSF leak rates. The most frequent benign pathology encountered was pituitary adenomas (n = 3720, 49.8% of all cases) and the most frequent malignant tumor was esthesioneuroblastoma (n = 120, 1.6% of all cases). Studies that included only CSF fistula repairs had a lower average total complication rate (12.9%) but a greater rate of meningitis compared with studies that reported mixed pathology (2.4% vs. 1.3%). A trend towards a lower total complication rate with increasing study size was observed. CONCLUSIONS The endoscopic approach is an increasingly accepted technique for anterior skull base tumor surgery and is associated with acceptable complication rates. Increasing experience with this technique can decrease rates of complications.
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Tracheostomy and infection prolong length of stay in hospital after surgery for head and neck cancer: a population based study. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:22-28.e1. [DOI: 10.1016/j.oooo.2015.08.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 06/02/2015] [Accepted: 08/02/2015] [Indexed: 12/13/2022]
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Loos E, Meulemans J, Vranckx J, Poorten VV, Delaere P. Tracheal Autotransplantation for Functional Reconstruction of Extended Hemilaryngectomy Defects: A Single-Center Experience in 30 Patients. Ann Surg Oncol 2015; 23:1674-83. [DOI: 10.1245/s10434-015-5033-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Indexed: 11/18/2022]
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Morisod B, Simon C. Meta-analysis on survival of patients treated with transoral surgery versus radiotherapy for early-stage squamous cell carcinoma of the oropharynx. Head Neck 2015; 38 Suppl 1:E2143-50. [DOI: 10.1002/hed.23995] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2014] [Indexed: 11/07/2022] Open
Affiliation(s)
- Benoît Morisod
- Service d'Oto-Rhino-Laryngologie - Chirurgie Cervico-Faciale; Centre Hospitalier Universitaire Vaudois (CHUV), Université Lausanne (UNIL); Lausanne Switzerland
| | - Christian Simon
- Service d'Oto-Rhino-Laryngologie - Chirurgie Cervico-Faciale; Centre Hospitalier Universitaire Vaudois (CHUV), Université Lausanne (UNIL); Lausanne Switzerland
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Abstract
Cumulative findings from many research groups have identified new signaling mechanisms associated with head and neck cancers. We summarize these findings, including discussion of aberrant NOTCH, PI3K, STAT3, immune recognition, oxidative pathway, and regulation of cell cycle and cell death. The genomic landscape of head and neck cancers has been shown to differ depending on human papillomavirus (HPV) status. We discuss studies examining the integration of HPV into genomic regions, as well as the epigenetic alterations that occur in response to HPV infection, and how these may help reveal new biomarker and treatment predictors. The characterization of premalignant lesions is also highlighted, as is evidence indicating that the surgical removal of these lesions is associated with better clinical outcomes. Current surgical methods are also discussed, including several less aggressive approaches such as minimal invasive robotic surgery. While much remains to be done in the fight against head and neck cancer, continued integration of basic research with new treatment options will likely lead to more effective therapeutic strategies directed against this disease.
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Affiliation(s)
- Xaralabos Varelas
- Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts
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Machiels JP, Lambrecht M, Hanin FX, Duprez T, Gregoire V, Schmitz S, Hamoir M. Advances in the management of squamous cell carcinoma of the head and neck. F1000PRIME REPORTS 2014; 6:44. [PMID: 24991421 PMCID: PMC4047945 DOI: 10.12703/p6-44] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Squamous cell carcinoma of the head and neck (SCCHN) is the sixth most common cancer worldwide. The main risk factors for cancers of the oral cavity, larynx, oropharynx, and hypopharynx are alcohol and tobacco use. In addition, the human papillomavirus (HPV) is an established cause of oropharyngeal cancer. An experienced multidisciplinary team is necessary for adequate management and optimal outcome. The treatment of locally advanced disease generally requires various combinations of radiotherapy, surgery, and systemic therapy, but despite this aggressive multimodal treatment, 40% to 60% of the patients will relapse. In this report, we will discuss recent advances in the management of SCCHN, including new developments in molecular biology, imaging, and treatment.
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Affiliation(s)
- Jean-Pascal Machiels
- Clinique de cancérologie cervico-maxillo-faciale, Centre du cancer et d'hématologie, Cliniques universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (IREC), Université catholique de Louvain10 Avenue Hippocrate, 1200 BrusselsBelgium
| | - Maarten Lambrecht
- Clinique de cancérologie cervico-maxillo-faciale, Centre du cancer et d'hématologie, Cliniques universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (IREC), Université catholique de Louvain10 Avenue Hippocrate, 1200 BrusselsBelgium
| | - François-Xavier Hanin
- Clinique de cancérologie cervico-maxillo-faciale, Centre du cancer et d'hématologie, Cliniques universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (IREC), Université catholique de Louvain10 Avenue Hippocrate, 1200 BrusselsBelgium
| | - Thierry Duprez
- Clinique de cancérologie cervico-maxillo-faciale, Centre du cancer et d'hématologie, Cliniques universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (IREC), Université catholique de Louvain10 Avenue Hippocrate, 1200 BrusselsBelgium
| | - Vincent Gregoire
- Clinique de cancérologie cervico-maxillo-faciale, Centre du cancer et d'hématologie, Cliniques universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (IREC), Université catholique de Louvain10 Avenue Hippocrate, 1200 BrusselsBelgium
| | - Sandra Schmitz
- Clinique de cancérologie cervico-maxillo-faciale, Centre du cancer et d'hématologie, Cliniques universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (IREC), Université catholique de Louvain10 Avenue Hippocrate, 1200 BrusselsBelgium
| | - Marc Hamoir
- Clinique de cancérologie cervico-maxillo-faciale, Centre du cancer et d'hématologie, Cliniques universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (IREC), Université catholique de Louvain10 Avenue Hippocrate, 1200 BrusselsBelgium
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18
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Ferlito A, Takes RP, Silver CE, Strojan P, Haigentz M, Robbins KT, Genden EM, Hartl DM, Shaha AR, Rinaldo A, Suárez C, Olsen KD. The changing role of surgery in the current era of head and neck oncology. Eur Arch Otorhinolaryngol 2014; 270:1971-3. [PMID: 23371537 DOI: 10.1007/s00405-013-2353-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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19
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Blanco RG, Fakhry C, Ha PK, Ryniak K, Messing B, Califano JA, Saunders JR. Transoral Robotic Surgery Experience in 44 Cases. J Laparoendosc Adv Surg Tech A 2013; 23:900-7. [DOI: 10.1089/lap.2013.0261] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- Ray G.F. Blanco
- Johns Hopkins Head and Neck Surgery, Milton J. Dance, Jr. Head and Neck Center, Baltimore, Maryland
- Head and Neck Surgery, Department of Otolaryngology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Carole Fakhry
- Johns Hopkins Head and Neck Surgery, Milton J. Dance, Jr. Head and Neck Center, Baltimore, Maryland
- Head and Neck Surgery, Department of Otolaryngology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Patrick K. Ha
- Johns Hopkins Head and Neck Surgery, Milton J. Dance, Jr. Head and Neck Center, Baltimore, Maryland
- Head and Neck Surgery, Department of Otolaryngology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Keri Ryniak
- Johns Hopkins Head and Neck Surgery, Milton J. Dance, Jr. Head and Neck Center, Baltimore, Maryland
| | - Barbara Messing
- Johns Hopkins Head and Neck Surgery, Milton J. Dance, Jr. Head and Neck Center, Baltimore, Maryland
| | - Joseph A. Califano
- Johns Hopkins Head and Neck Surgery, Milton J. Dance, Jr. Head and Neck Center, Baltimore, Maryland
- Head and Neck Surgery, Department of Otolaryngology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - John R. Saunders
- Johns Hopkins Head and Neck Surgery, Milton J. Dance, Jr. Head and Neck Center, Baltimore, Maryland
- Head and Neck Surgery, Department of Otolaryngology, Johns Hopkins School of Medicine, Baltimore, Maryland
- Greater Baltimore Medical Center, Baltimore, Maryland
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