Factors favoring neck metastasis in patients underwent laryngectomy for laryngeal cancer

Background

One third of all head and neck cancers are caused by laryngeal cancer. However, the incidence and prevalence rates have decreased over the past 3 decades. Neck metastasis from cancer larynx is important to be addressed as its presence greatly reduces the probability of survival. However, quality of life should be taken into consideration. Hence, it was important to analyze factors related to neck metastasis from primary laryngeal cancer to detect any change of tumor behavior with time.

Results

One hundred thirty-eight patients underwent concomitant neck dissection with laryngectomy (total or partial). Supraglottic tumors had the greatest share in the neck metastasis with a count of 11 (of 26 neck metastasis), representing 42% and a total value of 11 (of 30 total supraglottic cancer) representing a tendency of spread in 37% of the total case number. Tumor midline crossing was present in 77% cases (20 of 26) with positive nodes, representing a P value 0.05.

Conclusion

This study investigated different factors related to lymph node metastasis from primary laryngeal tumor. The most important factors were the site of the tumor and its relation to the midline.

Impact of COVID-19 on Management of Laryngeal/Oropharyngeal Neoplasms

Study Design

A retrospective cohort study.

Objective

The world was unprecedentedly struck by the new coronavirus in December 2019. Consequently, lockdown measures were imposed by many governments. Health-care services were reserved for emergencies and malignancies. Nevertheless, many patients who urgently needed these services did not present. This study estimates the impact of COVID-19 and lockdown measures on the patients' flow in the outpatient clinic (OPC) and the operations for laryngeal and/or oropharyngeal neoplasms.

Methods

This study is a retrospective cohort study performed in otolaryngology department of a tertiary care hospital which is a major referral center. All patients who attended the OPC and all operations performed for laryngeal and/or oropharyngeal neoplasms were counted from February 1, 2020 to May 31, 2020 and compared with the previous year as a reference.

Results

In 2020, the number of patients attending the otolaryngology OPC and the laryngeal and/or oropharyngeal surgeries showed a major drop, especially after imposing the lockdown measures. The total number of these operations in April and May 2019 dropped by 79% for the same period in 2020.

Conclusion

An estimate of 79% of patients, who had been presenting for laryngeal and/or oropharyngeal neoplasms, did not show up due to indirect COVID-19 effect.

Objective Comparison Between Spreader Grafts and Flaps for Mid-Nasal Vault Reconstruction: A Randomized Controlled Trial

Objective

The goal of rhinoplasty is not exclusively aesthetic and the nasal function should always be considered. Several rhinoplasty techniques can participate in nasal valve dysfunction (eg, dorsal hump reductions). Therefore, mid-nasal vault reconstruction by spreader grafts or flaps is mandatory in these cases. To date, there is a literature gap in comparing both techniques objectively. This study shows an objective comparison between spreader grafts and flaps for mid-nasal vault reconstruction.

Material and Methods

This study was a double-blind randomized controlled trial including 40 patients who were randomly divided into 2 groups. Group 1 (20 patients) underwent spreader grafts insertion, whereas group 2 (20 patients) underwent spreader flap placement technique. Pre-operative active anterior rhinomanometry measurements were compared to 6-month post-operative measurements. Data were summarized as mean (standard deviation) for the quantitative variables. Comparisons between the 2 groups were done using unpaired t test.

Results

In both groups, a significant decrease in nasal resistance was noted in both the right and left sides 6 months post-operatively (P < .001). However, the comparison between the 2 both groups showed no statistical significance.

Conclusion

Both spreader grafts and flaps, which are used for the mid-nasal vault reconstruction, have comparable and effective results in reducing the nasal resistance as evidenced by active anterior rhinomanometry measurements.