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Karekar HJ, Dafe T, Gandole SS. Post-surgery Physical Rehabilitation for Gingivobuccal Sulcus: A Case Report. Cureus 2024; 16:e72197. [PMID: 39583520 PMCID: PMC11584242 DOI: 10.7759/cureus.72197] [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: 08/28/2024] [Accepted: 10/22/2024] [Indexed: 11/26/2024] Open
Abstract
The gingivobuccal sulcus, an anatomical term, refers to the area where the gums (gingiva) meet the inside of the cheek (buccal mucosa). It is the groove or fold that forms between the upper or lower gums and the inner surface of the cheek. This area allows movement between the gums and cheeks while talking, eating, or moving the mouth. The gingivobuccal sulcus is a critical anatomical area within the oral cavity that can be affected by various conditions, including oral cancer, leading to significant functional impairment. Surgical intervention in this region, often necessary for tumor resection or trauma repair, can result in challenges related to speech, mastication, and oral hygiene. In order to recover these capabilities and enhance the patient's quality of life, post-surgical rehabilitation is essential. The 43-year-old patient whose main complaints in this article include pain, discomfort, swelling, and trouble chewing had a segmental mandibulectomy during the procedure. Following surgery, physical therapy's primary goals were to relieve pain and restore vital functions. A multidisciplinary strategy is used in this procedure, combining the knowledge of physiotherapists, rehabilitation specialists, and surgeons. The goal was to increase the movement of the jaw, the tongue, and the neck and the swallowing process. The physiotherapy regimens facilitated the patient's recuperation.
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Affiliation(s)
- Hrutuja J Karekar
- Department of Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Tejaswini Dafe
- Department of Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sakshi S Gandole
- Department of Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Bagadia RK, Thakur S, Lal R, Verma S, Subash A, Rao VUS. Role of Imaging in Predicting the Deep Surgical Margin in Gingivobuccal Complex Cancers: A Pilot Study. Indian J Otolaryngol Head Neck Surg 2024; 76:3319-3322. [PMID: 39130250 PMCID: PMC11306815 DOI: 10.1007/s12070-024-04680-1] [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: 11/22/2023] [Accepted: 04/01/2024] [Indexed: 08/13/2024] Open
Abstract
Cancers arising from the gingivobuccal complex are one of the most common types of cancer in the oral cavity and are associated with poor prognosis. Among the various prognostic factors, positive surgical margin is the most important one that can be controlled by the operating surgeon. The deep surgical margins for buccal mucosa cancers is normally assessed by palpating the skin for induration and skin pinchability. The present study evaluates the role of imaging in assessing the deep surgical margin and its efficacy for skin preservation in buccal mucosa/ gingivobuccal carcinomas. The patients of gingivobuccal complex squamous cell carcinomas after histopathological confirmation were selected for the study. In imaging, the distance between the base of the tumour and skin (epidermis) of the cheek was measured by a senior radiologist preoperatively. The frozen section findings were confirmed by histopathological examination and the depth of invasion of the tumour was measured and the clearance of the deep surgical margin was confirmed. The correlation between imaging, skin pinch test and histopathological examination of the specimen was assessed. The sensitivity and specificity of imaging to predict the skin preservation (deep surgical margin more than 5 mm) is 100% and 75% respectively compared to sensitivity and specificity of skin pinch test of 82.6% and 50% respectively. Imaging is an effective tool in predicting the skin preservation and skin excision compared to skin pinch test. Compared to the skin pinch test, imaging appears to be a useful tool for advising surgeons on skin preservation vs excision.
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Affiliation(s)
- Ritvi K. Bagadia
- Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu India
| | - Shalini Thakur
- Department of Head and Neck Oncology, Health Care Global Cancer Hospital, Bangalore, Karnataka 560002 India
| | - Radhika Lal
- Manipal Hospital, Bangalore, Karnataka India
| | - Shaurya Verma
- Department of Head and Neck Oncology, Health Care Global Cancer Hospital, Bangalore, Karnataka 560002 India
| | - Anand Subash
- Department of Head and Neck Oncology, Health Care Global Cancer Hospital, Bangalore, Karnataka 560002 India
| | - Vishal U. S. Rao
- Department of Head and Neck Oncology, Health Care Global Enterprises Ltd. Hospital, Bengaluru, Karnataka India
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3
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Asarkar AA, Chang BA, de Bree R, Kowalski LP, Guntinas-Lichius O, Bradley PJ, de Graaf P, Strojan P, Rao KN, Mäkitie AA, López F, Rinaldo A, Palme C, Genden EM, Sanabria A, Rodrigo JP, Ferlito A. Primary Management of Operable Locally Advanced Oral Cavity Squamous Cell Carcinoma: Current Concepts and Strategies. Adv Ther 2024; 41:2133-2150. [PMID: 38642199 DOI: 10.1007/s12325-024-02861-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 03/25/2024] [Indexed: 04/22/2024]
Abstract
INTRODUCTION Locally advanced oral cavity carcinoma (LAOCSCC) is primarily treated with surgery followed by radiotherapy with or without chemotherapy. METHODS A review of literature using PubMED was performed for studies reporting the management of LAOCSCC. Based on the reviewed literature and opinions of experts in the field, recommendations were made. RESULTS Studies have shown that outcomes following resection of T4a and infranotch (inferior to mandibular notch) T4b are comparable. We discuss the concept of compartmental resection of LAOCSCC and issues concerning the management of the neck. Further, patients who refuse or are unable to undergo surgery can be treated with chemoradiotherapy with uncertain outcomes. The role of neoadjuvant chemotherapy has shown promise for organ (mandibular) preservation in a select subset of patients. CONCLUSION The management strategy for LAOCSCC should be determined in a multidisciplinary setting with emphasis on tumor control, functional preservation, and quality of life of the patient.
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Affiliation(s)
- Ameya A Asarkar
- Department of Otolaryngology/Head and Neck Surgery, Louisiana Health Sciences Center, Shreveport, LA, 71103, USA.
| | - Brent A Chang
- Department of Otolaryngology/Head and Neck Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Luiz P Kowalski
- Head and Neck Surgery Department, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Department of Head and Neck Surgery and Otorhinolaryngology, A C Camargo Cancer Center, São Paulo, Brazil
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Institute of Phoniatry/Pedaudiology, Jena University Hospital, Jena, Germany
| | - Patrick J Bradley
- Department of ORLHNS, Queens Medical Centre Campus, Nottingham University Hospitals, Derby Road, Nottingham, NG7 2UH, UK
| | - Pim de Graaf
- Amsterdam UMC Location Vrije Universiteit, Radiology and Nuclear Medicine, de Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, 1000, Ljubljana, Slovenia
| | - Karthik N Rao
- Department of Head and Neck Oncology, Sri Shankara Cancer Hospital and Research Center, Bangalore, India
| | - Antti A Mäkitie
- Department of Otorhinolaryngology, Head and Neck Surgery, Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Fernando López
- ENT and Head and Neck Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Carsten Palme
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, NSW, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Eric M Genden
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY, 10029, USA
| | - Alvaro Sanabria
- Department of Surgery, School of Medicine, Centro de Excelencia en Cirugia de Cabeza y Cuello-CEXCA, Universidad de Antioquia, Medellin, Colombia
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, IUOPA, University of Oviedo, CIBERONC, 33011, Oviedo, Spain
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, 35030, Padua, Italy
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4
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A S, Mehta R, Nagarkar NM, Bodhey NK, Gupta RK, Satpute SS. Clinical, Radiological, and Pathological Correlation of Mandibular Invasion in Carcinoma Bucco-alveolar Complex. Indian J Surg Oncol 2024; 15:385-396. [PMID: 38741646 PMCID: PMC11088584 DOI: 10.1007/s13193-024-01903-3] [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: 10/23/2022] [Accepted: 02/15/2024] [Indexed: 05/16/2024] Open
Abstract
A prospective cross-sectional study was conducted to correlate clinically, radiologically, and pathologically the mandibular invasion in carcinoma bucco-alveolar complex. All biopsy-proven oral cavity cancer cases (64 patients) were assessed clinically and radiologically for involvement of the mandible. Preoperative clinicoradiological findings were compared with postoperative histopathological findings. In our study, oral cancer was 4 times more prevalent in males as compared to females and clinical evaluation was found to be highly sensitive in predicting mandibular invasion. Orthopantomogram showed sensitivity of 66.6% and specificity of 100%. CT scan showed sensitivity of 100% and specificity of 46% whereas MRI showed sensitivity of 54.5% and a specificity of 96%. MRI correlates well with final histopathology in predicting size of tumor. Prevalence of bony invasion in carcinoma oral cavity was 18%. We noted an inverse relation with tumor differentiation and mandibular invasion, and none of the verrucous carcinoma lesions showed mandibular invasion. Association of clinical T and N staging with postoperative histopathology was found to be statistically significant. Despite recent advances in molecular biology, radiological techniques, and newer modalities like visual surgical planning, exact measurement of bone invasion is still challenging. At present, CT scan and MRI along with clinical evaluation are widely used to evaluate mandibular invasion in carcinoma oral cavity, and all these are complementary to each other. The recent progress in tissue engineering technologies and stem cell biology has significantly promoted the development of regenerative reconstruction of jawbone defects.
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Affiliation(s)
- Subinsha A
- Department of Otorhinolaryngology-Head and Neck Surgery, AIIMS, Raipur, Chhattisgarh India
| | - Rupa Mehta
- Department of Otorhinolaryngology-Head and Neck Surgery, AIIMS, Raipur, Chhattisgarh India
| | - Nitin M. Nagarkar
- Department of Otorhinolaryngology-Head and Neck Surgery, AIIMS, Raipur, Chhattisgarh India
| | | | - Rakesh Kumar Gupta
- Department of Pathology and Laboratory Medicine, AIIMS, Raipur, Chhattisgarh India
| | - Satish S. Satpute
- Department of Otorhinolaryngology-Head and Neck Surgery, AIIMS, Raipur, Chhattisgarh India
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5
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Mahajan A, Agarwal U, PG N, Vaish R, Shukla S, Sahu A, Bhalla AS, Patil V, Ankathi SK, Laskar SG, Patil V, Noronha V, Menon N, Prabhash K, Shah D, Patil A, Ahuja A, Chaturvedi P, Pai PS, Dcruz AK. Imaging Recommendations for Diagnosis, Staging, and Management of Oral Cancer. Indian J Med Paediatr Oncol 2023; 44:150-158. [DOI: 10.1055/s-0042-1760314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
AbstractOral cavity cancers contribute to a majority of cancers in India. Clinical examination alone cannot determine the deeper extent of the disease; therefore, need for cross-sectional imaging including computed tomography and magnetic resonance imaging becomes indispensable for pre-treatment evaluation to decide optimal plan of management. Oral cavity squamous cell cancers (OSCC) can be treated with surgery alone, whereas deep muscle, neurovascular, osseous, or nodal involvement on imaging suggests advanced disease that requires a combination of surgery, radiation, and/or chemotherapy. Because of the complex anatomy of the oral cavity and its surrounding structures, imaging is crucial for locoregional staging and early detection of distant metastases. Imaging plays indispensable role not only in diagnosis but also in planning the management. An optimal guideline paper for developing countries like India is lacking that not only helps standardize the management but will also assist oncologists make reasonable decisions and reduce the unnecessary imaging. This imaging guideline paper will discuss the optimal imaging in diagnosis and management OSCC for Indian subcontinent.
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Affiliation(s)
- Abhishek Mahajan
- Department of Radiodiagnosis, The Clatterbridge Cancer Centre, Liverpool, United Kingdom
| | - Ujjwal Agarwal
- Department of Radiodiagnosis, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Nandakumar PG
- Department of Radiodiagnosis, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Richa Vaish
- Department of Head and Neck Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Shreya Shukla
- Department of Radiodiagnosis, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Arpita Sahu
- Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Ashu Seith Bhalla
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Vasundhara Patil
- Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Suman Kumar Ankathi
- Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Sarbani Ghosh Laskar
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Vijay Patil
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Nandini Menon
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Diva Shah
- Department of Radiodiagnosis, HCG Cancer Centre, Ahmedabad, Gujarat, India
| | - Asawari Patil
- Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Ankita Ahuja
- Department of Radiodiagnosis, Innovision Imaging, Mumbai, Maharashtra, India
| | - Pankaj Chaturvedi
- Department of Head and Neck Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Prathamesh S. Pai
- Department of Head and Neck Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - A K Dcruz
- Apollo Hospitals, Belapur, Mumbai, India
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6
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Chakraborty D, Ghosh D, Kumar S, Jenkins D, Chandrasekaran N, Mukherjee A. Nano-diagnostics as an emerging platform for oral cancer detection: Current and emerging trends. WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2023; 15:e1830. [PMID: 35811418 DOI: 10.1002/wnan.1830] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 06/05/2022] [Accepted: 06/15/2022] [Indexed: 01/31/2023]
Abstract
Globally, oral cancer kills an estimated 150,000 individuals per year, with 300,000 new cases being diagnosed annually. The high incidence rate of oral cancer among the South-Asian and American populations is majorly due to overuse of tobacco, alcohol, and poor dental hygiene. Additionally, socio-economic issues and lack of general awareness delay the primary screening of the disease. The availability of early screening techniques for oral cancer can help in carving out a niche for accurate disease prognosis and also its prevention. However, conventional diagnostic approaches and therapeutics are still far from optimal. Thus, enhancing the analytical performance of diagnostic platforms in terms of specificity and precision can help in understanding the disease progression paradigm. Fabrication of efficient nanoprobes that are sensitive, noninvasive, cost-effective, and less labor-intensive can reduce the global cancer burden. Recent advances in optical, electrochemical, and spectroscopy-based nano biosensors that employ noble and superparamagnetic nanoparticles, have been proven to be extremely efficient. Further, these sensitive nanoprobes can also be employed for predicting disease relapse after chemotherapy, when the majority of the biomarker load is eliminated. Herein, we provide the readers with a brief summary of conventional and new-age oral cancer detection techniques. A comprehensive understanding of the inherent challenges associated with conventional oral cancer detection techniques is discussed. We also elaborate on how nanoparticles have shown tremendous promise and effectiveness in radically transforming the approach toward oral cancer detection. This article is categorized under: Diagnostic Tools > Biosensing Diagnostic Tools > Diagnostic Nanodevices Diagnostic Tools > In Vitro Nanoparticle-Based Sensing.
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Affiliation(s)
- Debolina Chakraborty
- School of Advanced Sciences, Vellore Institute of Technology, Vellore, India
- Centre for Nanobiotechnology, Vellore Institute of Technology, Vellore, India
| | - Debayan Ghosh
- Centre for Nanobiotechnology, Vellore Institute of Technology, Vellore, India
| | - Sanjit Kumar
- Centre for Bioseparation Technology, Vellore Institute of Technology, Vellore, India
| | - David Jenkins
- Wolfson Nanomaterials & Devices Laboratory, School of Computing, Electronics and Mathematics, Faculty of Science & Engineering, University of Plymouth, Devon, UK
| | | | - Amitava Mukherjee
- Centre for Nanobiotechnology, Vellore Institute of Technology, Vellore, India
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7
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Sah A, S. TG, H. CS. Imaging of the Infratemporal Fossa: a Comprehensive Pictorial Essay. Indian J Surg Oncol 2022; 13:868-875. [PMID: 36687258 PMCID: PMC9845485 DOI: 10.1007/s13193-022-01591-x] [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: 05/19/2022] [Accepted: 07/12/2022] [Indexed: 01/25/2023] Open
Abstract
While radiologists are familiar with the masticator space, the surgeons are more familiar with the infratemporal fossa (ITF). Though often used interchangeably, there exists a subtle difference between them, which needs to be understood. The close anatomical relationship of the infratemporal fossa to critical structures makes timely diagnosis vital. In this pictorial review, we present a spectrum of various pathologies affecting ITF.
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Affiliation(s)
- Anjali Sah
- Department of Radio-Diagnosis, IRCH, Institute of Medical Sciences, All India New Delhi, 110029 India
| | | | - Chandrashekhara S. H.
- Department of Radio-Diagnosis, IRCH, Institute of Medical Sciences, All India New Delhi, 110029 India
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8
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Slieker FJB, Van Gemert JTM, Seydani MG, Farsai S, Breimer GE, Forouzanfar T, de Bree R, Rosenberg AJWP, Van Cann EM. Value of cone beam computed tomography for detecting bone invasion in squamous cell carcinoma of the maxilla. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:102-109. [PMID: 35318943 DOI: 10.1016/j.oooo.2022.01.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 01/13/2022] [Accepted: 01/28/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine the diagnostic value of cone beam computed tomography (CBCT) in detecting bone invasion in maxillary squamous cell carcinoma (MSCC). STUDY DESIGN In this retrospective cohort study, preoperative CBCT scans were independently assessed by a single surgeon in imaging assessment 1 (IA 1) and by 1 surgeon with 2 dentists in consensus (IA 2) for the presence of bone invasion in MSCC. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, area under the receiver operating characteristic curve (AUC), and Cohen's κ were calculated. Histopathologic results of resection specimens served as the reference standard. RESULTS Of 27 patients, 19 (70%) had proven bone invasion. IA 1 yielded 68.4% sensitivity, 75.0% specificity, 86.7% PPV, 50.0% NPV, 70.4% accuracy, and 0.717 AUC. All results of IA 2 were true-positive and true-negative, resulting in 100% sensitivity, specificity, PPV, NPV, accuracy, and AUC. The assessments differed in 6 cases. Interobserver κ was fair (0.38, 95% CI 0.04-0.72, P = .038). There was a significant association between CBCT detection of bone invasion and extent of surgical treatment (P = .006) CONCLUSIONS: The diagnostic accuracy of CBCT was high but observer-dependent. CBCT examination may be useful in surgical treatment planning.
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Affiliation(s)
- F J B Slieker
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J T M Van Gemert
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Ghafoori Seydani
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - S Farsai
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - G E Breimer
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - T Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - R de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A J W P Rosenberg
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E M Van Cann
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
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9
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Aldosimani M, Verdonschot RG, Iwamoto Y, Nakazawa M, Mallya SM, Kakimoto N, Toyosawa S, Kreiborg S, Murakami S. Prognostic factors for lymph node metastasis from upper gingival carcinomas. Oral Radiol 2021; 38:389-396. [PMID: 34559370 PMCID: PMC9200680 DOI: 10.1007/s11282-021-00568-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/13/2021] [Indexed: 12/02/2022]
Abstract
Objectives This study sought to identify tumor characteristics that associate with regional lymph node metastases in squamous cell carcinomas originating in the upper gingiva. Materials and methods Data from 113 patients from Osaka University Dental Hospital were included. We measured each primary tumor’s width, length, depth, and the extent of bone invasion. Additionally, tumor signal intensity for T1 and T2-weighted images as well as the center of the tumor’s location and T classification was assessed, and a histopathological analysis was performed. Results Tumor signal intensity was not found to be a significant prognostic factor. However, bucco-lingual width, histopathological classification as well as the tumor’s location were significantly different between metastatic and non-metastatic groups in both univariate and multivariate analysis. Superior–inferior depth and T classification were significant only in the univariate (and not the multivariate) analysis. Conclusions Bucco-lingual width, histopathological grading as well as the tumor’s location are likely to be important predictors for the occurrence of LN metastasis in upper gingival carcinoma patients and should be considered when managing care for these patients.
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Affiliation(s)
- Mazen Aldosimani
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
- Division of Radiology, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Rinus G Verdonschot
- Department of Oral and Maxillofacial Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands.
| | - Yuri Iwamoto
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Mitsuhiro Nakazawa
- Oral and Maxillofacial Surgery II, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - Sanjay M Mallya
- Section of Oral and Maxillofacial Radiology, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Satoru Toyosawa
- Department of Oral Pathology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Sven Kreiborg
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
- 3D Craniofacial Image Research Laboratory, University of Copenhagen, Copenhagen, Denmark
| | - Shumei Murakami
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
- Department of Oral Pathology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
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10
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Subramaniam N, Poptani H, Schache A, Bhat V, Iyer S, Sunil HV, Chandrasekhar N, Pillai V, Chaturvedi P, Krishna S, Krishnamurthy A, Kekatpure V, Kuriakose M, Iyer NG, Thakkar A, Kantharia R, Sonkar A, Shetty V, Rangappa V, Kolur T, Vidhyadharan S, Murthy S, Kudpaje A, Srinivasalu V, Mahajan A. Imaging advances in oral cavity cancer and perspectives from a population in need: Consensus from the UK-India oral cancer imaging group. JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS 2021. [DOI: 10.4103/jhnps.jhnps_10_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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11
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Shah D. Dynamic manoeuvres on MRI in oral cancers - A pictorial essay. Indian J Radiol Imaging 2020; 30:334-339. [PMID: 33273767 PMCID: PMC7694729 DOI: 10.4103/ijri.ijri_117_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/08/2020] [Accepted: 07/24/2020] [Indexed: 11/05/2022] Open
Abstract
Magnetic resonance imaging has been shown to be a useful tool in the evaluation of oral malignancies because of direct visualization of lesions due to high soft tissue contrast and multiplanar capability. However, small oral cavity tumours pose an imaging challenge due to apposed mucosal surfaces of oral cavity, metallic denture artefacts and submucosal fibrosis. The purpose of this pictorial essay is to show the benefits of pre and post contrast MRI sequences using various dynamic manoeuvres that serve as key sequences in the evaluation of various small oral (buccal mucosa and tongue as well as hard/soft palate) lesions for studying their extent as well as their true anatomic relationship.
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Affiliation(s)
- Diva Shah
- HCG Cancer Centre, Sola Science City Road, Ahmedabad, Gujarat, India
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Arya S. Letter to Editor in response to “Imaging in oral cancers: A comprehensive review. Oral Oncology 2020, 21;104:104658. Mahajan A, Ahuja A, Sable N, Stambuk HE”. Oral Oncol 2020; 109:104735. [DOI: 10.1016/j.oraloncology.2020.104735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/20/2020] [Indexed: 10/24/2022]
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Mahajan A, Ahuja A, Sable N, Stambuk HE. Imaging in oral cancers: A comprehensive review. Oral Oncol 2020; 104:104658. [PMID: 32208340 DOI: 10.1016/j.oraloncology.2020.104658] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 03/11/2020] [Accepted: 03/17/2020] [Indexed: 02/08/2023]
Abstract
This review aims at simplifying the relevant imaging anatomy, guiding the optimal imaging method and highlighting the key imaging findings that influence prognosis and management of oral cavity squamous cell carcinoma (OSCC). Early OSCC can be treated with either surgery alone while advanced cancers are treated with a combination of surgery, radiotherapy and/or chemotherapy. Considering the complex anatomy of the oral cavity and its surrounding structures, imaging plays an indispensable role not only in locoregional staging but also in the distant metastatic work-up and post treatment follow-up. Knowledge of the anatomy with understanding of common routes of spread of cancer, allows the radiologist to accurately determine disease extent and augment clinical findings to plan appropriate therapy. This review aims at simplifying the relevant imaging anatomy, guiding the optimal imaging method and highlighting the key imaging findings that influence prognosis and management.
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Affiliation(s)
- Abhishek Mahajan
- Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Mumbai 400012, India.
| | - Ankita Ahuja
- Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Mumbai 400012, India
| | - Nilesh Sable
- Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Mumbai 400012, India
| | - Hilda E Stambuk
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA
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Dhar H, Vaish R, D'Cruz AK. Management of locally advanced oral cancers. Oral Oncol 2020; 105:104662. [PMID: 32278110 DOI: 10.1016/j.oraloncology.2020.104662] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 12/11/2022]
Abstract
Despite easy access to clinical examination majority of oral cancer patients ironically present with locally advanced disease, which is a heterogeneous group that includes all stage III/IV tumours in absence of distant metastasis. The AJCC TNM classification has included all tumours with depth of invasion >1 cm into locally advanced group irrespective of their surface dimensions. Surgery followed by adjuvant therapy provides best results and should be offered to all patients when operable. There have been a slew of recent publications popularising the concept of compartmental excision in variance to traditional resection with adequate margins. The role of chemotherapy has been explored in this group of patients for both organ preservation as well as to aid bioselection of suitable patients with borderline operable tumours for surgery.
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Affiliation(s)
- Harsh Dhar
- Consultant Head Neck Surgeon, Dept. of Head Neck Surgery, Narayana Superspeciality Hospital, Howrah 711103, West Bengal, India
| | - Richa Vaish
- Dept. of Head Neck Surgery, Tata Memorial Hospital, Mumbai 400012, Maharashtra, India; Homi Bhabha National Institute (HBNI), Mumbai, India.
| | - Anil K D'Cruz
- Director Oncology - Apollo Hospitals, Apollo Hospital, Navi Mumbai 400614, India; Head Neck Services Tata Memorial Hospital Mumbai, Maharashtra, India
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Chatterjee A, Laskar SG, Chaukar D. Management of early oral cavity squamous cancers. Oral Oncol 2020; 104:104627. [PMID: 32169747 DOI: 10.1016/j.oraloncology.2020.104627] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 02/26/2020] [Accepted: 03/01/2020] [Indexed: 12/11/2022]
Abstract
Early oral cavity cancers comprise a favorable entity, amenable to clinical staging and single modality treatment. Surgery typically forms the mainstay of treatment and should ideally address both the primary and the neck in all cases. Careful attention must be paid to reconstruction and rehabilitation of such patients. Radical radiotherapy mainly in the form of brachytherapy can achieve excellent disease related and functional outcomes in a carefully chosen subset of patients. Increasingly, a subset of patients is being recognized, who harbor single or multiple adverse features on histopathology and may therefore benefit from escalation of adjuvant therapy. This review discusses the management of early oral cavity squamous carcinomas (Early OSCCs) in detail and highlights the dilemmas and controversies faced in the management of the same.
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Affiliation(s)
- Abhishek Chatterjee
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National University (HBNI), Mumbai, India
| | - Sarbani Ghosh Laskar
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National University (HBNI), Mumbai, India.
| | - Devendra Chaukar
- Department of Head & Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha National University (HBNI), Mumbai, India
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Panchbhai A, Bhowate R. MRI evaluation of involvement of parotid and submandibular glands by tongue squamous cell carcinoma. Oral Oncol 2019; 102:104557. [PMID: 31901631 DOI: 10.1016/j.oraloncology.2019.104557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/23/2019] [Accepted: 12/25/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The majority of cases of salivary gland involvement are diagnosed in its late stages as may be missed in the evaluation, the low detection rate of involvement of salivary gland by OSCC may have significant impact on spread and recurrence of the OSCC. The study aimed to evaluate involvement of parotid and submandibular salivary glands by tongue oral squamous cell carcinoma. MATERIAL AND METHOD The 144 histo-pathologically proven cases of tongue squamous cell carcinoma were evaluated for clinical staging, margins and extent of tumor and involvement of salivary gland on T1-T2 Weighted, STIR, diffusion-weighted and contrast-enhanced MRI sequences and data was subjected to analysis. RESULTS In tongue OSCC, total 9 (6.25%) patients showed salivary gland involvement, 2 of them involved parotid glands and 7 of them involved submandibular gland. The OSCC involving the salivary glands were in Stage 4 except for 2 cases with predilection for antero-lateral border and tendency towards midline crossing. Out of 9 cases that showed salivary gland involvement, the 5 cases showed direct involvement from the spreading lesion, the 3 cases showed the infiltration from adjacent lymph nodes and 2 cases showed infiltration from sublingual gland and medial pterygoid muscle. CONCLUSION The present study revealed the greater percentage of OSCC with salivary gland involvement as compared to previous studies; in contradiction present study demonstrated higher involvement of submandibular gland compared to parotid gland with additional imaging features in salivary glands (15.97%) suggesting the likely possibility of their involvement by OSCC in near future.
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Affiliation(s)
- Aarati Panchbhai
- Department of Oral Medicine and Radiology, S P Dental College & Hospital, DMIMSDU, Sawangi-M, Wardha, Maharastra, India; Department of Oral Medicine and Radiology, S P Dental College & Hospital, DMIMSDU, Sawangi-M, Wardha 442001, Maharastra, India.
| | - Rahul Bhowate
- Department of Oral Medicine and Radiology, S P Dental College & Hospital, DMIMSDU, Sawangi-M, Wardha, Maharastra, India; Department of Oral Medicine and Radiology, S P Dental College & Hospital, DMIMSDU, Sawangi-M, Wardha 442001, Maharastra, India
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A Study on Neck Nodes in Oral Cancers, with Special Reference to Skip Metastasis. Indian J Otolaryngol Head Neck Surg 2019; 71:474-481. [PMID: 31742006 DOI: 10.1007/s12070-018-1360-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 04/10/2018] [Indexed: 11/26/2022] Open
Abstract
To analyse the distribution of Neck metastases (NM) and to study frequency of skip metastases in oral squamous cell carcinoma (SCC) of oral cavity. From September 2012 to April 2013, 30 previously untreated patients with SCC of oral cavity underwent primary surgical treatment in our institution. From pathological report of Neck dissection specimen prevalence and distribution of NM were ascertained. All patients were classified according to American Joint Committee on Cancer 2005 TNM classification. Overall frequency of NM was 36.7%. Frequency of occult metastases was 33.3%. N+ metastases found in 37% cases. The overall frequency of NM in level IV and V was 9.5%. Isolated level III involvement was found in 3.3%. No isolated level IV and V involvement was found. Skip metastases to level III LN was 6.7%. We did not find any skip metastases to level IV in our study. Neck nodes at greater risk for metastases were level I and II (50 and 28.6%). Level III (11.9%), IV (7.14%), V (2.38%). The risk of skip metastases to level IV was nil in our study.
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Bron G, Scemama U, Villes V, Fakhry N, Salas S, Chagnaud C, Bendahan D, Varoquaux A. A new CT dynamic maneuver "Mouth Opened with Tongue Extended" can improve the clinical TNM staging of oral cavity and oropharynx squamous cell carcinomas. Oral Oncol 2019; 94:41-46. [PMID: 31178211 DOI: 10.1016/j.oraloncology.2019.04.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 04/12/2019] [Accepted: 04/27/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Cross sectional imaging is mandatory for oral cavity and oropharynx head and neck squamous cell carcinoma's (ooSCC) local extension and TNM staging. However a complex anatomy and frequent dental metallic artifacts make it difficult. This study assesses the clinical benefit of "Mouth Open with Tongue Extended" dynamic maneuver at CT (CTmote) as compared to the conventional CT (CTconv) and MRI. MATERIAL Retrospectively, 58 patients with histologically proven ooSCC (oral cavity: 34; oropharynx: 24) were included in the study. All had endoscopy with biopsies, MRI, CTconv and an CTmote acquisitions. Data were splitted in 3 datasets and 2 independent radiologists performed readings blindly. Gold standard was pTNM in 31% of cases; otherwise cTNM obtained at multidisciplinary team meeting with endoscopy and mapping biopsies were used. RESULTS CTmote was feasible for all patients including those already treated by surgery or radiotherapy. Exact TNM staging was obtained in 68%, 83%, 83% for CTconv, CTmote and MRI respectively. The best exam ratings at paired wise comparisons were 3%, 47%, 50% for CTconv, CTmote and MRI respectively. CTmote and MRI observer agreements, image quality and confidence ratings, were comparable and higher compared to CTconv (p < 0.001). CONCLUSIONS CTmote improves oral cavity and oropharynx tumour stage assessment compared to CTconv with performances close to those of MRI examination. In clinical practice, combining both CT with MOTE maneuver and MRI seems to be the optimal imaging strategy for local staging.
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Affiliation(s)
- Guillaume Bron
- Department of Medical Imaging, Conception University Hospital, Aix-Marseille University, Marseille, France.
| | - Ugo Scemama
- Department of Medical Imaging, Conception University Hospital, Aix-Marseille University, Marseille, France
| | - Virginie Villes
- Department of Public Healthcare EA 3279, Timone University Hospital, Aix-Marseille University, 264, Rue Saint-Pierre, 13385 Marseille, France.
| | - Nicolas Fakhry
- Department of Otorhinolaryngology-Head and Neck Surgery, Conception Hospital, Aix-Marseille University, Marseille, France.
| | - Sebastien Salas
- Department of Oncology, Timone University Hospital, Aix-Marseille University, 264, Rue Saint-Pierre, 13385 Marseille, France.
| | - Christophe Chagnaud
- Department of Medical Imaging, Conception University Hospital, Aix-Marseille University, Marseille, France; Biophysics and Nuclear Medicine, European Center for Research in Medical Imaging, UMR 7339, La Timone University Hospital, Aix-Marseille University, 264, Rue Saint-Pierre, 13385 Marseille, France.
| | - David Bendahan
- Biophysics and Nuclear Medicine, European Center for Research in Medical Imaging, UMR 7339, La Timone University Hospital, Aix-Marseille University, 264, Rue Saint-Pierre, 13385 Marseille, France.
| | - Arthur Varoquaux
- Department of Medical Imaging, Conception University Hospital, Aix-Marseille University, Marseille, France; Biophysics and Nuclear Medicine, European Center for Research in Medical Imaging, UMR 7339, La Timone University Hospital, Aix-Marseille University, 264, Rue Saint-Pierre, 13385 Marseille, France.
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20
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Nae A, O'Leary G, Feeley L, Fives C, Fitzgerald B, Chiriac E, Sheahan P. Utility of CT and MRI in assessment of mandibular involvement in oral cavity cancer. World J Otorhinolaryngol Head Neck Surg 2019; 5:71-75. [PMID: 31334484 PMCID: PMC6617213 DOI: 10.1016/j.wjorl.2019.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 02/09/2019] [Accepted: 02/12/2019] [Indexed: 01/08/2023] Open
Abstract
Objective Oral cavity squamous cell carcinoma (SCC) may present with early invasion of mandibular bone. Preoperative planning of surgery is essential considering patient's postoperative quality of life. Our purpose was to evaluate the efficacy of computer tomography scan (CT) and magnetic resonance imaging (MRI) in detecting mandibular bone involvement in oral SCC. Methods A retrospective study was conducted on 98 patients with SCC of floor of mouth, lower alveolus and retromolar trigone operated on with curative intent. Preoperative CT and MRI scans were re-reviewed by a consultant radiologist and original histology slides were re-reviewed by 3 pathologists. Results Forty-five patients were included in the final study. Combined CT and MRI had a sensitivity of 100% and a specificity of 72%. Conclusion The results suggest that combined CT and MRI have diagnostic utility in detecting mandibular invasion by oral cancer, but with a significant false positive rate.
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Affiliation(s)
- Andreea Nae
- ENT Department, South Infirmary-Victoria University Hospital, Cork, Ireland
- Corresponding author. ENT Department South Infirmary-Victoria University Hospital, Old Blackrock Road, Cork, T12X23H, Ireland.
| | - Gerard O'Leary
- ENT Department, South Infirmary-Victoria University Hospital, Cork, Ireland
| | - Linda Feeley
- Department of Pathology, Cork University Hospital, Cork, Ireland
| | - Cassie Fives
- Department of Pathology, Cork University Hospital, Cork, Ireland
| | | | - Elena Chiriac
- Radiology Department, South Infirmary-Victoria University Hospital, Cork, Ireland
| | - Patrick Sheahan
- ENT Department, South Infirmary-Victoria University Hospital, Cork, Ireland
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21
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Sarcomas of the Oral and Maxillofacial Region: Analysis of 26 Cases with Emphasis on Diagnostic Challenges. Pathol Oncol Res 2018; 25:593-601. [PMID: 30382526 DOI: 10.1007/s12253-018-0510-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 10/15/2018] [Indexed: 10/28/2022]
Abstract
Sarcomas of the Oral and Maxillofacial Region (SOMR) are rare lesions which pose diagnostic and management challenges. We analyzed 26 cases of SOMR with respect to clinical presentation, histopathological subtype, treatment modalities, recurrence, and treatment outcome. In our series, Osteosarcoma (OS) was the most common type of sarcoma (7 cases), followed by 5 cases of Ewing's Sarcoma (ES), 3 cases each of Chondrosarcoma (CS) and Leiomyosarcoma (LMS), 2 cases each of Malignant Peripheral Nerve Sheath Tumor (MPNST), Pleomorphic Undifferentiated Sarcoma (PUS), Myeloid Sarcoma (MS)and Rhabdomyosarcoma (RMS). Surgery was the primary treatment modality in most cases and was combined with adjuvant chemo/ radiotherapy in few cases. 24 of the 26 cases were followed up for an average period of 40.67 months. Adverse disease outcomes like recurrence were seen in 2 cases whereas death due to the disease was reported in 7 cases. In view of the diagnostic challenges faced in SOMRs, it appears practical to stress on the underlying genetic aspects of the disease process rather than histological subtyping to improve disease outcome.
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Jayasankaran SC, Chelakkot PG, Thankappan K, Iyer S, Moorthy S. Paralingual and sublingual space invasion in magnetic resonance imaging of squamous cell carcinoma of anterior two-thirds of tongue: Is there a prognostic significance? A prospective evaluation. Indian J Cancer 2018; 54:442-446. [PMID: 29469075 DOI: 10.4103/ijc.ijc_318_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) in tumors of anterior two-thirds of tongue has a significant role in assessing different tumor parameters, and in prognosticating. AIM This prospective study conducted in a tertiary cancer care center, focused on patients with squamous cell carcinoma of anterior two-thirds of tongue. The significance of invasion of paralingual and sublingual spaces in relation to the pathological grade of these tumors, and its predictive value in pathological nodal involvement were analyzed. MATERIALS AND METHODS All consecutive patients with the required inclusion criteria were accrued. Imaging was done with 3 Tesla MRI and invasion of sublingual and paralingual spaces were accurately assessed. Data elucidated were tabulated and analysed using IBM SPSS version 20.0. Chi-square test, nonparametric correlation using Spearman's Rho correlation, and two-independent sample test using Mann-Whitney's U-test were used to arrive at correlations between the imaging and histopathological parameters. RESULTS Sixty-three patients were analyzed. Mean age was 52.3 ± 11.45 years. 74.6% were males. MRI showed sublingual space invasion in 47.6%. 18/28 with and 11/33 without invasion had node positivity. Paralingual space involvement was observed in 31.7% of patients. Thirteen of these and 16/43 with no involvement had positive cervical nodes. No statistically significant correlation was observed. CONCLUSION This prospective study did not establish any statistically sound correlation, and robust data are lacking to support newer parameters such as sublingual space and paralingual space as probable predictors of cervical nodal involvement, and for prognostication.
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Affiliation(s)
- S C Jayasankaran
- Department of Radiology, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India
| | - P G Chelakkot
- Department of Radiation Oncology, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India
| | - K Thankappan
- Department of Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India
| | - S Iyer
- Department of Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India
| | - S Moorthy
- Department of Radiology, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India
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Juliano A, Moonis G. Computed Tomography Versus Magnetic Resonance in Head and Neck Cancer: When to Use What and Image Optimization Strategies. Magn Reson Imaging Clin N Am 2017; 26:63-84. [PMID: 29128007 DOI: 10.1016/j.mric.2017.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This article provides a practical overview of head and neck cancers, outlining an approach to evaluating these lesions and optimizing imaging strategies. Recognition of key anatomic landmarks as suggested by American Joint Committee on Cancer (AJCC) tumor, node, metastasis (TNM) criteria is emphasized. Further, the recently updated eighth edition of the AJCC staging manual has introduced some modifications that influence the TNM staging. These modifications are discussed throughout the article to provide an updated review on head and neck cancer.
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Affiliation(s)
- Amy Juliano
- Department of Radiology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA.
| | - Gul Moonis
- Department of Radiology, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, USA
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Singh A, Thukral CL, Gupta K, Sood AS, Singla H, Singh K. Role of MRI in Evaluation of Malignant Lesions of Tongue and Oral Cavity. Pol J Radiol 2017; 82:92-99. [PMID: 28289481 PMCID: PMC5325040 DOI: 10.12659/pjr.899352] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 06/13/2016] [Indexed: 02/01/2023] Open
Abstract
Background Aim of the present study was to evaluate the role of MRI in staging of malignant lesions of the oral cavity and to correlate MRI findings with clinical/surgical and anatomical-pathological findings, wherever possible. Material/Methods The study included 50 patients who presented with malignant lesions of the oral cavity and were referred to radiology departments for MRI. All patients included were subjected to a detailed physical examination following which MRI was carried out on Philips Gyroscan Achieva 1.5 Tesla unit. Results In the study, the highest number of patients were found to have tongue malignancy (82%) followed by buccal mucosa and gingivobuccal sulcus malignancy (18%). The highest number of patients was in the age group of 51–60 years (32%). The incidence was higher in males (96%). There was moderate agreement (k=0.537) for T stage between the clinical and MRI staging assessments. The agreement for N stage between clinical and MRI staging assessments was fair (k=0.328). The final diagnosis was made by histopathology in 22 patients. The agreement for T stage was good/substantial (k=0.790) and for N stage was moderate (k=0.458) between MRI and histopathology staging assessments. Conclusions MRI provides satisfactory accuracy for preoperative estimation of tumor thickness and predicting occult cervical nodal metastasis. MRI is the preferred modality in evaluation and staging of oral cavity malignancy which helps a clinician for planning of treatment.
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Affiliation(s)
- Amandeep Singh
- Department of Radiodiagnosis and Imaging, Sri Guru Ramdas Institute of Medical Sciences and Research, Vallah, Amritsar, Punjab, India
| | - Chuni Lal Thukral
- Department of Radiodiagnosis and Imaging, Sri Guru Ramdas Institute of Medical Sciences and Research, Vallah, Amritsar, Punjab, India
| | - Kamlesh Gupta
- Department of Radiodiagnosis and Imaging, Sri Guru Ramdas Institute of Medical Sciences and Research, Vallah, Amritsar, Punjab, India
| | - Arvinder Singh Sood
- Department of Otorhinolaryngology (ENT), Sri Guru Ramdas Institute of Medical Sciences and Research, Vallah, Amritsar, Punjab, India
| | - Hanish Singla
- Department of Radiodiagnosis, Sri Guru Ramdas Institute of Medical Sciences and Research, Vallah, Amritsar, Punjab, India
| | - Kunwarpal Singh
- Department of Radiodiagnosis, Sri Guru Ramdas Institute of Medical Sciences and Research, Vallah, Amritsar, Punjab, India
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Abstract
Oral cavity squamous cell carcinoma (OC-SCC) is the most common malignancy of the head and neck (excluding nonmelanoma skin cancer). Recent trends have shown a dramatic rise in the incidence of oropharyngeal squamous cell carcinoma (OP-SCC), with a marked increase in lesions related to human papillomavirus infection. This update presents the latest evidence regarding OC-SCC and OP-SCC. In particular, the authors compare and contrast tumors at these two sites with respect to epidemiology, etiopathogenesis, clinicopathologic presentation, clinical assessment, imaging, management, and prognosis. It is important for clinicians to be aware of differences between OC-SCC and OP-SCC so that appropriate patient education and multidisciplinary care can be provided to optimize outcomes.
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Affiliation(s)
- Angela C Chi
- Professor, Division of Oral Pathology, Medical University of South Carolina, Charleston, SC
| | - Terry A Day
- Professor, Wendy and Keith Wellin Endowed Chair for Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Brad W Neville
- Distinguished University Professor, Division of Oral Pathology, Medical University of South Carolina, Charleston, SC
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Evaluation of neuropathic pain occurring after high-dose-rate interstitial brachytherapy of oral tongue. J Contemp Brachytherapy 2015; 7:142-6. [PMID: 26034495 PMCID: PMC4444451 DOI: 10.5114/jcb.2015.50658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 12/10/2014] [Accepted: 01/03/2015] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To recognize neuropathic pain as a complication of high-dose-rate (HDR) interstitial brachytherapy of oral tongue and to evaluate the possible causes of neuropathy. MATERIAL AND METHODS Twenty one patients who underwent interstitial brachytherapy for early cancer of oral tongue were evaluated. The patients either underwent primary brachytherapy (42-48 Gy at 3-4 Gy/fraction) or a boost (18-24 Gy at 3 Gy/fraction) after external radiation to 40 Gy. Lingual nerve was the nerve concerned and the sublingual space (SLS) was contoured as its surrogate. Dosimetric parameters were correlated with onset of pain. RESULTS Ten patients out of 21 (47.61%) developed painful neuropathy. Five patients of six (5/6) who underwent primary brachytherapy developed neuropathy. Five out of 15 (5/15) patients who underwent brachytherapy as a boost developed neuropathy. The patients who underwent primary brachytherapy were ten times more likely to develop neuropathy. Among the patients receiving boost treatment, the equivalent dose at 2 Gy/fraction (EQD2) to 2 cc of SLS was higher (39.25 Gy) in the patients who developed pain compared to those without pain (10.29 Gy). CONCLUSIONS This is the first report to recognize neuropathic pain as a complication of HDR brachytherapy of oral tongue. Patients undergoing primary brachytherapy were more likely to develop pain. Among other factors like dose to SLS, number of catheters, size of the primary tumor, and the dose rate, only dose to 2 cc of the SLS correlated with onset of pain. The SLS (containing the lingual nerve) may be considered an organ at risk to prevent the occurrence of this complication.
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Xu SS, Li D, Zhou Y, Sheng B, Zeng C, Zhong SX. Pathways involved in the spread of buccal carcinoma on contrast-enhanced multislice CT. Dentomaxillofac Radiol 2014; 44:20140111. [PMID: 25315441 DOI: 10.1259/dmfr.20140111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To explore how buccal carcinoma spread, using contrast-enhanced multislice CT (CEMSCT). METHODS We retrospectively analysed the extent of lesions in 56 patients with primary buccal squamous cell carcinoma (SCCA). Abnormal manifestations on CEMSCT at oral subsites and involved adjacent structures were documented and evaluated, which were compared with the results of surgery and histopathology. RESULTS Infiltration and spread to oral subsites and/or adjacent structures was confirmed in 33 patients (58.9%). The opening of the Stensen duct was the most commonly invaded oral subsite (72.7%); other sites included the gingivobuccal sulcus (60.6%), pterygomandibular raphe (54.5%), gingiva (24.2%), retromolar trigone (24.2%), orbicularis oris (18.2%) and the floor of mouth (15.2%). Of the involved adjacent structures, the buccal space was the most common site of spread (69.7%), followed by the masticatory muscles and spaces (57.6%), bone (54.5%), skin and subcutaneous fat (39.4%), pharynx (30.3%), investing fascia (15.2%) and the base of the skull (6.1%). CEMSCT manifestations of the involvement in buccal SCCAs had correlations with pathological findings (p < 0.05). The sensitivities, specificities and accuracies of two radiologists' evaluation on buccal carcinoma involvement were 50.00%, 23.21% and 73.21%; and 51.79%, 32.14% and 83.93%, respectively. CONCLUSIONS Buccal SCCAs could superficially and deeply spread to multiple oral subsites and/or adjacent structures. CEMSCT could delineate their spread pathways and extents.
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Affiliation(s)
- S-S Xu
- 1 Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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