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Smeets M, Croonenborghs TM, Van Dessel J, Politis C, Jacobs R, Bila M. The Effectiveness of Surgical Methods for Trismus Release at Least 6 Months After Head and Neck Cancer Treatment: Systematic Review. FRONTIERS IN ORAL HEALTH 2022; 2:810288. [PMID: 35128526 PMCID: PMC8814314 DOI: 10.3389/froh.2021.810288] [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: 11/06/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background The objective of this systematic review was to identify the different surgical treatment modalities of severe trismus after head and neck squamous cell cancer treatment. Methods An electronic literature database search was conducted in Medline, Embase, Cochrane, Web of Science, and OpenGrey to determine articles published up to September 2021. Two observers independently assessed the identified papers for eligibility according to PRISMA guidelines. The inclusion criteria were trismus after head and neck squamous cell cancer with consecutive treatment, detailed description of the surgical procedure for trismus release, description of the initial treatment, at least 6 months between initial cancer treatment and trismus release surgery, a minimal follow-up (FU) of 6 months, and availability of full text. The quality was evaluated using the Newcastle-Ottawa scale. A subanalysis of the maximal mouth opening (MMO) was performed using a mixed-effect model. Results A total of 8,607 unique articles were screened for eligibility, 69 full texts were reviewed, and 3 studies, with a total of 46 cases, were selected based on the predetermined inclusion and exclusion criteria. Three treatment strategies were identified for trismus release (1) free flap reconstruction (FFR), (2) coronoidectomy (CN), and (3) myotomy (MT). There was a clear improvement for all treatment modalities. A quantitative analysis showed a beneficial effect of CN (mean 24.02 ± 15.02 mm) in comparison with FFR (mean 19.88 ± 13.97 mm) and MT (mean 18.38 ± 13.22 mm) (P < 0.01*). An increased gain in MMO after trismus release was found if no primary resection was performed (P = 0.014*). Two studies included in the analysis had an intermediate risk of bias and one had a low risk of bias. Conclusion Currently available reports suggest a low threshold for performing a CN compared with FFR and MT. There is a need for high-quality randomized controlled trials with carefully selected and standardized outcome measures.
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Affiliation(s)
- Maximiliaan Smeets
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- *Correspondence: Maximiliaan Smeets
| | - Tomas-Marijn Croonenborghs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Jeroen Van Dessel
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Michel Bila
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
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Schuch LF, Schmidt TR, de Oliveira Zigmundo G, Kirschnick LB, Silveira FM, Martins MAT, Carlos R, Dos Santos JN, Fonseca FP, Vargas PA, Wagner VP, Martins MD. Oral and Maxillofacial Neuroendocrine Carcinoma: A Systematic Review. Head Neck Pathol 2021; 16:525-537. [PMID: 34870796 PMCID: PMC9187797 DOI: 10.1007/s12105-021-01398-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/23/2021] [Indexed: 10/19/2022]
Abstract
The aim of the present study was to integrate the available data published in the literature on oral and maxillofacial neuroendocrine carcinomas concerning the demographic, clinical and histopathological features of this condition. An electronic search with no publication date restriction was undertaken in April 2021 in four databases. Eligibility criteria included reports published in English having enough data to confirm a definite diagnosis, always showing a neuroendocrine marker. Cases originating in the oropharynx, including base of the tongue and tonsils, were excluded. Outcomes were evaluated by the Kaplan-Meier method along with Cox regression. Twenty-five articles (29 cases) from nine different countries were detected. Mean patient age was 56.3 (± 17.5) years, with a slight male predilection. Symptomatology was present in 72.2% of informed cases. Regarding clinical presentation, a non-ulcerated nodule located in the gingiva with a mean size of 3.4 (± 2.0) cm was most frequently reported. Concomitant metastasis was identified in seven individuals. Histopathologically, most neoplasms were of the small cell type, and immunohistochemistry for both epithelial and neuroendocrine differentiation was used in 65.5% cases. Radical surgery was the treatment of choice in almost all cases, with or without adjuvant therapy. Mean follow-up was 20.5 (± 21.2) months, and only four patients developed recurrences. Eleven (44.0%) individuals died due to the disease. Ulcerated lesions were a prognostic factor. This study provides knowledge that can assist surgeons, oncologists, and oral and maxillofacial pathologists with the diagnosis and management of neuroendocrine carcinomas. Our findings demonstrated that the long-term prognosis of this lesion continues to be poor.
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Affiliation(s)
- Lauren Frenzel Schuch
- grid.411087.b0000 0001 0723 2494Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, São Paulo Brazil
| | - Tuany Rafaeli Schmidt
- grid.8532.c0000 0001 2200 7498Department of Oral Pathology, Faculdade de Odontologia, School of Dentistry, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos, 2492, room 503, Porto Alegre, Rio Grande do Sul CEP: 90035-003 Brazil
| | - Gisele de Oliveira Zigmundo
- grid.8532.c0000 0001 2200 7498Department of Oral Pathology, Faculdade de Odontologia, School of Dentistry, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos, 2492, room 503, Porto Alegre, Rio Grande do Sul CEP: 90035-003 Brazil
| | - Laura Borges Kirschnick
- grid.411087.b0000 0001 0723 2494Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, São Paulo Brazil
| | - Felipe Martins Silveira
- grid.11630.350000000121657640Molecular Pathology Area, School of Dentistry, Universidad de la República (UDELAR), Montevideo, Uruguay
| | - Marco Antonio Trevizani Martins
- grid.8532.c0000 0001 2200 7498Department of Oral Pathology, Faculdade de Odontologia, School of Dentistry, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos, 2492, room 503, Porto Alegre, Rio Grande do Sul CEP: 90035-003 Brazil ,grid.8532.c0000 0001 2200 7498Department of Oral Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul Brazil
| | - Roman Carlos
- Pathology Section, Centro Clínico de Cabeza y Cuello/Hospital Herrera Llerandi, Guatemala City, Guatemala
| | - Jean Nunes Dos Santos
- grid.8399.b0000 0004 0372 8259Department of Pathology, Postgraduate Program in Dentistry and Health, School of Dentistry, Universidade Federal da Bahia, Salvador, Bahia Brazil
| | - Felipe Paiva Fonseca
- grid.8430.f0000 0001 2181 4888Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - Pablo Agustin Vargas
- grid.411087.b0000 0001 0723 2494Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, São Paulo Brazil
| | - Vivian Petersen Wagner
- grid.11835.3e0000 0004 1936 9262Academic Unit of Oral and Maxillofacial Medicine and Pathology, Department of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Manoela Domingues Martins
- grid.8532.c0000 0001 2200 7498Department of Oral Pathology, Faculdade de Odontologia, School of Dentistry, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos, 2492, room 503, Porto Alegre, Rio Grande do Sul CEP: 90035-003 Brazil ,grid.411087.b0000 0001 0723 2494Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, São Paulo Brazil
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