Trend Analysis of Head and Neck Neoplasms between 2012-2018 in Patients Residing in Al-Madinah, Saudi Arabia: A Retrospective Study

Differential Expression Profile of Salivary oncomiRNAs among Smokeless Tobacco Users

OBJECTIVE

 The aim of this study was to evaluate the expression of selected salivary oncomiRNAs among smokeless tobacco users and nonsmokers.

MATERIALS AND METHODS

 Twenty-five subjects with chronic smokeless tobacco habit (> 1 year) and 25 nonsmokers were selected for this study. MicroRNA was extracted from saliva samples using the miRNeasy Kit (Qiagen, Hilden, Germany). The forward primers used in the reactions include hsa-miR-21-5p, hsa-miR-146a-3p, hsa-miR-155-3p, and hsa-miR-199a-3p. Relative expression of miRNAs was calculated using the 2-ΔΔCt method. Fold change is calculated by raising 2 to the power of the negative ΔΔCT value.

STATISTICAL ANALYSIS

 Statistical analysis was carried out using GraphPad Prism 5 software. A p-value less than 0.05 was considered statistically significant.

RESULTS

 The four tested miRNAs were found overexpressed in saliva of subjects with smokeless tobacco habit when compared with saliva from nontobacco users. miR-21 expression was 3.74 ± 2.26 folds higher among subjects with smokeless tobacco habit compared to nontobacco users (p < 0.01). The expression for miR-146a (5.56 ± 8.3 folds; p < 0.05), miR-155 (8.06 ± 23.4 folds; p < 0.0001) and miR-199a (14.39 ± 30.3 folds; p < 0.05) was significantly higher among subjects with smokeless tobacco habit.

CONCLUSION

 Smokeless tobacco leads to salivary overexpression of the miRs 21, 146a, 155, and 199a. Monitoring the levels of these four oncomiRs may provide insight about the future development of oral squamous cell carcinoma, especially in patients with smokeless tobacco habits.

Lipoma in Parotid Gland: A Rare Case Report

Lipoma is a benign, rare, mesenchymal tumor found in the head and neck region, especially in the parotid gland. It thus requires a careful and precise examination to establish a diagnosis. A surgical procedure of the parotid gland is challenging due to the associated risk factor of facial nerve injury. We report a rare case of head and neck region lipoma between the superficial and deep lobe of the parotid gland. A 44-year-old female patient was presented with the chief complaint of a painless lump on the left front ear to the left cheek for about 1 year. There were no complaints of tooth pain before the lump appeared, and there were no lumps in other regions. A fine-needle aspiration biopsy, ultrasonography, and magnetic resonance imaging were all performed to establish the preoperative diagnosis and to plan the correct surgical approach. Lipoma was the initial clinical diagnosis, and a surgical excision with superficial parotidectomy and facialis nerve preservation was performed. Follow-up examinations were conducted to assess any facial nerve injury complications. Conclusion Lipoma rarely grows in the parotid gland. Careful diagnosis should be performed to establish a precise surgery for parotid dissection and facial nerve preservation.

Oral and maxillofacial cancer: A 35-year retrospective analysis at a referral dental hospital in Saudi Arabia

Objectives

As rates of oral and maxillofacial cancer (OMFC) continue to rise, the role of dentists in early detection and prevention has become increasingly important. The present study examined the frequency and pattern of OMFC cases diagnosed at a referral dental hospital.

Methods

A retrospective analysis of all primary malignant neoplasms of the oral and maxillofacial area diagnosed at the Histopathology Laboratory of the Dental University Hospital, Medical City, King Saud University, Saudi Arabia from 1984 to 2020 was performed.

Results

A total of 242 patients had histologically diagnosed primary malignant neoplasms of the oral and maxillofacial area, accounting approximately 3.7% of the archives. The mean age of patients was 48.87 years, and the male-to-female ratio was 1.5:1. The most prevalent malignant neoplasm was squamous cell carcinoma (SCC) (58.3%), followed by mucoepidermoid carcinoma (11.6%). The tongue and gingiva were the most prevalent malignancy sites, accounting for 19.8% and 18.2% of the cases, respectively. The prevalence of SCC in patients over 50 years old (68.4%) was highly significantly greater than that in younger subjects (31.5%) (P < 0.0005). SCC was also more common in males (66.7%) than in females (33.3%) (P = 0.026).

Conclusion

OMFC primarily affecting the tongue and gingiva was the predominant in older male patients. SCC was the most frequent type of OMFC and was significantly associated with age older than 50 years. This study provides baseline data on the frequency of OMFC cases diagnosed for the first time by dental practitioners and warrants the need for increasing OMFC awareness among these clinicians.

Cyberknife Radiosurgery for the Treatment of Head and Neck Cancer: A Systematic Review

Cyberknife radiosurgery is a frameless stereotactic robotic radiosurgery which has shown to deliver better treatment outcomes in the treatment of advanced head and neck (H&N) carcinomas, especially in previously irradiated and recurrent cases. The aim of the study was to perform a systematic review of the available data on the outcomes of Cyberknife radiosurgery for treatment of head and neck cancer and to evaluate its collective outcomes. This systematic review was registered with the university with the registration no. FRP/2019/63 and was approved by the Institutional Review Board (RC/IRB/2019/132). Literature search was performed in the following: PubMed, Science direct, SciELO, MyScienceWork, Microsoft Academ EMBASE, Directory of Open Access Journals, and Cochrane databases with the keywords “Cyberknife,” “oral cancer,” “oropharyngeal cancer,” and “head and neck cancer” and data was extracted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The records identified were 147 manuscripts. Excluded articles included 5 duplicate articles, 33 abstracts, 101 full text articles due to being off-topic, case reports, review, non-English, 1 survey, and 2 other articles containing data extracted from a main study which was already included. A total of 5 articles were evaluated for qualitative synthesis. The mean dose of Cyberknife radiosurgery delivered for previously irradiated recurrent H&N carcinoma patients was 34.57 Gy, with a mean sample size of 5 studied during the period of 2000 to 2016. The available evidence from the systematic review indicates that Cyberknife can be an efficacious treatment option for recurrent previously irradiated H&N carcinoma, especially for nonresectable tumors. There is paucity of homogenous data and studies in this arena; hence, meta-analysis could not be performed. Further standardized studies are essential, especially where the treatment of H&N carcinoma is considered.