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Thiagarajan S, Kantamani T, Sathe P, Shetty R, Deshmukh A, Chaukar D, Biswas S, Divatia JV, Srivastav S, Mathur P, Myatra SN. Impact of surgical site infection on unplanned hospital readmissions, initiation of adjuvant treatment following surgery, and disease-free survival on patients with upper aerodigestive tract squamous cell carcinoma. J Surg Oncol 2023; 128:692-700. [PMID: 37232552 DOI: 10.1002/jso.27356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 04/27/2023] [Accepted: 05/13/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Unplanned hospital readmission (UHR) is an important indicator of the quality of the healthcare system in place. It has various implications for the patients and the healthcare system at large. In this article, we have attempted to understand the various factors influencing UHR and the start of adjuvant treatment following cancer surgery. PATIENTS & METHODS In this study adult patients above 18 years of age with upper aerodigestive tract squamous cell carcinoma who underwent surgery at our center between July 2019 to December 2019 were included in the study. Various factors influencing UHR and delay in receiving adjuvant treatment were analyzed. RESULTS A total of 245 patients satisfied the inclusion criteria. Surgical site infection (SSI) was the factor that had the maximum influence on the UHR (p < 0.002, OR: 5.6, 95% CI: [1.911-16.4]) and delaying the start of adjuvant treatment (p = 0.008, OR: 3.786, 95% CI: [1.421-10.086]) on multivariate analysis. Surgery lasting for >4 h and patients who had received prior treatment tended to develop SSI postoperatively. The presence of SSI also seemed to have had a negative influence on disease-free survival (DFS) as well. CONCLUSIONS SSI is an important postoperative complication having major implications in terms of increased UHR and delays in starting adjuvant treatment which in turn is reflected as a poorer DFS among patients who develop SSI postoperatively.
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Affiliation(s)
- Shivakumar Thiagarajan
- Department of Head & Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Teja Kantamani
- Department of Head & Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Pranav Sathe
- Department of Head & Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Ratan Shetty
- Department of Head & Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Anuja Deshmukh
- Department of Head & Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Devendra Chaukar
- Department of Head & Neck Surgical Oncology, Max Nanavati Hospital, Mumbai, India
| | - Sanjay Biswas
- Department of Microbiology, Tata Memorial Hospital, Homi Bhabha ational Institute (HBNI), Mumbai, India
| | - Jigeeshu V Divatia
- Department of Anesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Sharad Srivastav
- Department of Laboratory Medicine, JPNA Trauma Center, AIIMS, New Delhi, India
| | - Purva Mathur
- Department of Laboratory Medicine, JPNA Trauma Center, AIIMS, New Delhi, India
| | - Sheila Nainan Myatra
- Department of Anesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
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Fritz C, Rajasekaran K. Delayed in diagnosis of upper aerodigestive tract cancers: A comprehensive review of medical malpractice cases. Head Neck 2023. [PMID: 37144329 DOI: 10.1002/hed.27390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/28/2023] [Accepted: 04/25/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Factors that prompt litigation and influence outcomes for malpractice cases involving cancers of the upper aerodigestive tract are incompletely described. METHODS Westlaw, a national legal database, was searched for medical malpractice claims related to upper aerodigestive tract cancer for all years available. RESULTS Of the 122 cases meeting inclusion criteria, 106 (86.9%) involved allegations of failure to diagnose or delay in diagnosis. Tongue, larynx, and nasopharynx cancers were more frequently litigated than would be expected based on their incidence (tongue, 38.7% of aerodigestive tract litigation vs. 26.9% of aerodigestive tract cancers; larynx, 33.0% vs. 22.3%; nasopharynx, 10.4% vs. 4.6%). Payouts were made in over half of diagnosis failure lawsuits (56.6%), which carried an average award of $2840690 [IQR 850219-2537509]. CONCLUSIONS An awareness of litigation on cancers of the upper aerodigestive tract holds the potential to improve patient care and help otolaryngologists avoid potential risks for litigation.
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Affiliation(s)
- Christian Fritz
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Karthik Rajasekaran
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Dhar L, Singh S, Passey JC. Association of human papillomavirus and Epstein-Barr virus with squamous cell carcinoma of upper aerodigestive tract. Natl J Maxillofac Surg 2022; 13:367-375. [PMID: 36683943 PMCID: PMC9851353 DOI: 10.4103/njms.njms_315_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/09/2021] [Accepted: 05/20/2021] [Indexed: 01/24/2023] Open
Abstract
Background Cancers of the upper aero-digestive tract (UADT) are fifth most common cancer in the world with around 10,55,000 new cases and 7,25,000 deaths worldwide. Tobacco and alcohol act synergistically and are the two most important etiological factors responsible for about 75% of SCC. Studies have reported changing trends in the incidence of SCC showing an increasing shift in epidemiology attributed to the infection by viruses. The most commonly implicated viruses are the Human Papillomavirus (HPV) and Epstein-Barr virus (EBV). Aim and Objective To study association of Human Papilloma virus (HPV) and Epstein Barr virus (EBV) with 100 newly diagnosed cases of squamous cell carcinoma (SCC) of upper aerodigestive tract (UADT) and correlate its association with clinical parameters, histomorphological grade and staging using immunohistochemical markers p16, LMP1, p53, p63. Materials and Methods The study was conducted in the department of Pathology, Maulana Azad medical college and associated hospitals, New Delhi from September 2018-April 2019. Specimens was routinely processed. Immunohistochemistry (IHC) was done using p16, LMP1, p53, p63 monoclonal antibodies. Statistical Analysis Used SPSS 20 software. The quantitative analysis was done using Pearson chi-square test. Probability values < 0.05 was be considered statistically significant. Results HPV was present in 29% cases while EBV in 38% cases. Oral cavity was the most common site involved by both HPV and EBV. Co-infectivity was found in 4% cases. There was significant male predominance in both. HPV was more prevalent in age >45 years while EBV was equally distributed in <45 years and >45 years. Moderately differentiated squamous cell carcinoma was the commonest grade involved by both the viruses. A significant correlation was found between EBV and alcohol. p53 positivity had an inverse relationship with HPV positivity. P63 expression was higher in HPV and EBV positive cases. Conclusion In resource constraint settings, p16 and Latent membrane protein 1 can be used as surrogacy markers for Human Papilloma virus and Epstein Barr virus along with p53 and p63 for its association with histomorphological grade and stage.
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Affiliation(s)
- Lity Dhar
- Department of Pathology, Otorhinolaryngology, Maulana Azad Medical College, New Delhi, India
| | - Sarika Singh
- Department of Pathology, Otorhinolaryngology, Maulana Azad Medical College, New Delhi, India
| | - J. C. Passey
- Department of Pathology, Otorhinolaryngology, Maulana Azad Medical College, New Delhi, India
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Nourbakhsh H, Adams A, Raverty S, Vogl AW, Haulena M, Skoretz SA. Microscopic Anatomy of the Upper Aerodigestive Tract in Harbour Seals (Phoca vitulina): Functional Adaptations to Swallowing. Anat Rec (Hoboken) 2022; 306:947-959. [PMID: 35719006 DOI: 10.1002/ar.25025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/05/2022] [Accepted: 05/31/2022] [Indexed: 11/07/2022]
Abstract
Abandoned harbour seal pups (Phoca vitulina) are frequently recovered by rehabilitation centres and often require intensive nursing, gavage feeding and swallowing rehabilitation prior to anticipated release. Seal upper aerodigestive tract (UAT) histology descriptions relevant to deglutition are limited, impacting advances in rehabilitation practice. Therefore, we examined the histological characteristics of the harbour seal UAT to understand species-specific functional anatomy and characterize adaptations. To this end, we conducted gross dissections, compiled measurements and reviewed histologic features of the UAT structures of 14 pre-weaned harbour seal pups that died due to natural causes or were humanely euthanized. Representative samples for histologic evaluation included the tongue, salivary glands, epiglottis, and varying levels of the trachea and esophagus. Histologically, there was a prominent muscularis in the tongue with fewer lingual papillae types compared to humans. Abundant submucosal glands were observed in lateral and pharyngeal parts of the tongue and rostral parts of the esophagus. When compared to other mammalian species, there was a disproportionate increase in the amount of striated muscle throughout the length of the esophageal muscularis externa. This may indicate a lesser degree of autonomic control over the esophageal phase of swallowing in harbour seals. Our study represents the first detailed UAT histological descriptions for neonatal harbour seals. Collectively, these findings support specific anatomic and biomechanic adaptations relevant to suckling, prehension and deglutition. This work will inform rehabilitation practices and guide future studies on swallowing physiology in harbour seals with potential applications to other pinniped and otariid species in rehabilitation settings. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Hirad Nourbakhsh
- School of Audiology & Speech Sciences, University of British Columbia, Vancouver, BC
| | - Arlo Adams
- Life Sciences Institute & Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC
| | - Stephen Raverty
- Animal Health Center, 1767 Angus Campbell Road, Abbotsford, BC
| | - A Wayne Vogl
- Life Sciences Institute & Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC
| | - Martin Haulena
- Vancouver Aquarium Marine Mammal Rescue Centre, Vancouver, BC
| | - Stacey A Skoretz
- School of Audiology & Speech Sciences, University of British Columbia, Vancouver, BC.,Department of Critical Care Medicine, University of Alberta, Edmonton, AB
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Giordano D, Botti C, Iotti V, Ghidini A. Foreign Body in the Cervical Oesophagus: A Case Report. Curr Med Imaging 2022; 18:1117-1119. [PMID: 35379156 DOI: 10.2174/1573405618666220404110751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/27/2022] [Accepted: 02/14/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Foreign bodies in the upper aerodigestive tract represent an uncommon cause of visits to emergency departments. In the majority of cases, foreign bodies do not go beyond the pharynx. They cause dyspnoea or pneumonia if they reach the tracheo-bronchial tree. If ingested, they will pass spontaneously through the gastrointestinal canal in the majority of cases. Nevertheless, especially in case of sharp-pointed or large objects, the foreign bodies can stop in the oesophagus. In case of dysphagia, stinging sensation and/or odynophagia occurring after eating a meal, a foreign body in the upper aerodigestive tract should be suspected. If not clinically visible, imaging is required. CASE PRESENTATION A 72-year-old woman presented to the Emergency Department with pharyngodynia, odynophagia, stinging, dysphagia, and sialorrhea for 12 hours. Her symptoms started after eating a meal with meat. The patient underwent a standard two-projection radiogram of the neck. The antero-posterior projection radiogram was unremarkable. The lateral projection radiogram showed 16 millimetres in maximum length radiopaque foreign body within the cervical oesophagus. The patient underwent transoral flexible oesophagoscopy under general anaesthesia, with successful removal of the foreign body (bony fragment). Her symptoms improved rapidly after the procedure, and the patient was discharged after 48 hours in good health. CONCLUSION A foreign body in the cervical oesophagus may lead to visceral perforation. Once suspected, every effort should be made to identify and remove the foreign body to avoid potentially catastrophic consequences. In some cases, imaging could be necessary to detect the foreign body.
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Affiliation(s)
- Davide Giordano
- Otolaryngology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Cecilia Botti
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Valentina Iotti
- Radiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Angelo Ghidini
- Otolaryngology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Chien HT, Yeh CC, Young CK, Chen TP, Liao CT, Wang HM, Cho KL, Huang SF. Polygenic Panels Predicting the Susceptibility of Multiple Upper Aerodigestive Tract Cancer in Oral Cancer Patients. J Pers Med 2021; 11:jpm11050425. [PMID: 34070222 PMCID: PMC8158753 DOI: 10.3390/jpm11050425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/08/2021] [Accepted: 05/14/2021] [Indexed: 11/16/2022] Open
Abstract
Head and neck cancer was closely related with habitual use of cigarette and alcohol. Those cancer patients are susceptible to develop multiple primary tumors (MPTs). In this study, we utilized the single nucleotide polymorphisms (SNPs) array (Affymetrix Axion Genome-Wide TWB 2.0 Array Plate) to investigate patients' risks of developing multiple primary cancers. We recruited 712 male head and neck cancer patients between Mar 1996 and Feb 2017. Two hundred and eighty-six patients (40.2%) had MPTs and 426 (59.8%) had single cancer. Four hundred and twelve normal controls were also recruited. A list of seventeen factors was extracted and ten factors were demonstrated to increase the risks of multiple primary cancers (alcohol drinking, rs118169127, rs149089400, rs76367287, rs61401220, rs141057871, rs7129229, older age, rs3760265, rs9554264; all were p value < 0.05). Polygenic scoring model was built and the area under curve to predict the risk developing MPTs is 0.906. Alcohol drinking, among the seventeen factors, was the most important risk factor to develop MPT in upper aerodigestive tract (OR: 7.071, 95% C.I.: 2.134-23.434). For those with high score in polygenic model, routine screening of upper digestive tract including laryngoscope and esophagoscope is suggested to detect new primaries early.
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Affiliation(s)
- Huei-Tzu Chien
- Department of Nutrition and Health Sciences, Chang Gung University of Science and Technology, Tao-Yuan 33302, Taiwan;
- Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Tao-Yuan 33302, Taiwan
| | - Chi-Chin Yeh
- Master Program in Applied Molecular Epidemiology, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan;
- Department of Public Health, College of Public Health, China Medical University, Taichung 40402, Taiwan
- Cancer Center, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Chi-Kuang Young
- Department of Otolaryngology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan;
| | - Tzu-Ping Chen
- Department of Thoracic Surgery, Chang Gung Memorial Hospital, Keelung 20401, Taiwan;
| | - Chun-Ta Liao
- Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou 33342, Taiwan; (C.-T.L.); (K.-L.C.)
- Medical College, Chang Gung University, Tao-Yuan 33302, Taiwan;
| | - Hung-Ming Wang
- Medical College, Chang Gung University, Tao-Yuan 33302, Taiwan;
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Tao-Yuan 33342, Taiwan
| | - Kai-Lun Cho
- Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou 33342, Taiwan; (C.-T.L.); (K.-L.C.)
| | - Shiang-Fu Huang
- Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou 33342, Taiwan; (C.-T.L.); (K.-L.C.)
- Medical College, Chang Gung University, Tao-Yuan 33302, Taiwan;
- Graduate Institute of Clinical Medical Science, Chang Gung University, Tao-Yuan 33302, Taiwan
- Correspondence: ; Tel.: +88-633-281-200 (ext. 3968); Fax: +88-633-979-361
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7
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Bugter O, van Iwaarden DLP, van Leeuwen N, Nieboer D, Dronkers EAC, Hardillo JAU, Baatenburg de Jong RJ. A cause-specific Cox model for second primary tumors in patients with head and neck cancer: A RONCDOC study. Head Neck 2021; 43:1881-1889. [PMID: 33655596 PMCID: PMC8247881 DOI: 10.1002/hed.26666] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/12/2021] [Accepted: 02/19/2021] [Indexed: 12/11/2022] Open
Abstract
Background The aim of this study was to identify risk factors for the development of second primary tumors (SPTs) in the head and neck region, lungs, and esophagus in patients with head and neck cancer. Methods We collected data from 1581 patients. A cause‐specific Cox model for the development of an SPT was fitted, accounting for the competing risks residual/recurrent tumor and mortality. Results Of all patients, 246 (15.6%) developed SPTs. Analysis showed that tobacco and alcohol use, comorbidity, and the oral cavity subsite were risk factors for SPTs. The C‐index, the discriminative accuracy, of the model for SPT was 0.65 (95% confidence interval, 0.61–0.68). Conclusions Our results show that there is potential to identify patients who have an increased risk to develop an SPT. This might increase their survival chances and quality of life. More research is needed to provide head and neck clinicians with definitive recommendations.
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Affiliation(s)
- Oisín Bugter
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Dirk L P van Iwaarden
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Nikki van Leeuwen
- Department of Public Health, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Center for Medical Decision Making, Rotterdam, The Netherlands
| | - Daan Nieboer
- Department of Public Health, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Center for Medical Decision Making, Rotterdam, The Netherlands
| | - Emilie A C Dronkers
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - José A U Hardillo
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Robert J Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Liu D, Qian T, Sun S, Jiang JJ. Laryngopharyngeal Reflux and Inflammatory Responses in Mucosal Barrier Dysfunction of the Upper Aerodigestive Tract. J Inflamm Res 2021; 13:1291-1304. [PMID: 33447069 PMCID: PMC7801919 DOI: 10.2147/jir.s282809] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/16/2020] [Indexed: 12/29/2022] Open
Abstract
The upper aerodigestive tract (UAT) is the first line of defense against environmental stresses such as antigens, microbes, inhalants, foods, etc., and mucins, intracellular junctions, epithelial cells, and immune cells are the major constituents of this defensive mucosal barrier. Laryngopharyngeal reflux (LPR) is recognized as an independent risk factor for UAT mucosal disorders, and in this review, we describe the components and functions of the mucosal barrier and the results of LPR-induced mucosal inflammation in the UAT. We discuss the interactions between the refluxate and the mucosal components and the mechanisms through which these damaging events disrupt and alter the mucosal barriers. In addition, we discuss the dynamic alterations in the mucosal barrier that might be potential therapeutic targets for LPR-induced disorders.
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Affiliation(s)
- Danling Liu
- Otorhinolaryngology Department, ENT Institute, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology, NHC Key Laboratory of Hearing Medicine Research, Fudan University, Shanghai 200032, People's Republic of China
| | - Tingting Qian
- Otorhinolaryngology Department, ENT Institute, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology, NHC Key Laboratory of Hearing Medicine Research, Fudan University, Shanghai 200032, People's Republic of China
| | - Shan Sun
- Otorhinolaryngology Department, ENT Institute, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology, NHC Key Laboratory of Hearing Medicine Research, Fudan University, Shanghai 200032, People's Republic of China
| | - Jack J Jiang
- Otorhinolaryngology Department, ENT Institute, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology, NHC Key Laboratory of Hearing Medicine Research, Fudan University, Shanghai 200032, People's Republic of China.,Department of Surgery, Division of Otolaryngology Head and Neck Surgery, University of Wisconsin Medical School, Madison, WI 53792-7375, USA
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9
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Akbar M, Clasen-Linde E, Specht L. Extranodal NK/T-cell lymphoma, nasal type, with extranasal presentation - a case report and a review of the literature. Acta Oncol 2020; 59:1480-1487. [PMID: 32689856 DOI: 10.1080/0284186x.2020.1795250] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Extranodal NK/T-cell lymphoma (ENKTCL), nasal type is a very rare and aggressive non-Hodgkin lymphoma. Most commonly it occurs in the upper aerodigestive tract. But, it can also manifest at locations such as the skin, soft tissue, gastrointestinal tract (GI), lungs, testis, etc. These locations are designated as extranasal ENKTCL. The patients with the latter have often more adverse clinical features and poorer survival rate compared with nasal sites. We present a case of an 83-year-old patient with a primary ENKTCL, nasal type, with extranasal presentation in the right upper eyelid. MATERIAL AND METHODS Materials for the literature review was obtained by a comprehensive search on PubMed, which yielded 82 eligible cases with extranasal ENKTCL. RESULTS Sixty-eight cases (83 %) were localized as primary ENKTCL in the lungs (17), central nervous system (CNS) (14), testis (11), GI-tract (7), skin (6), orbit and intraocular tissue (4), pancreas (2), adrenal gland (2), breast (1), etc. 14 cases (17 %) presented as extended or disseminated diseases involving exclusively organs outside the upper aerodigestive tract. There was no systematic pattern of organ involvement in the extended/disseminated ENKTCL. 63 % of the patient with localized extranasal ENKTCL and about 50% of patients with extended/disseminated disease were reported to have died of the disease. Treatment strategies varied with no preferred option. Among the used treatment options were chemotherapy, radiotherapy, surgery, stem cell transplantation alone or in different combinations. CONCLUSION ENKTCL is a highly aggressive disease which may present in extranasal areas. Although the tumors respond to both chemotherapy and radiotherapy, durable complete remissions are very rare.
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Affiliation(s)
- Momena Akbar
- Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark
| | - Erik Clasen-Linde
- Department of Pathology, Rigshospitalet, University of Copenhagen, Denmark
| | - Lena Specht
- Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark
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10
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Shaffer AD, Jacobs IN, Derkay CS, Goldstein NA, Giordano T, Ho S, Kim BJ, Park AH, Simons JP. Management and Outcomes of Button Batteries in the Aerodigestive Tract: A Multi-institutional Study. Laryngoscope 2020; 131:E298-E306. [PMID: 32068903 DOI: 10.1002/lary.28568] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/30/2019] [Accepted: 01/26/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS To describe the clinical presentation, management, and complications associated with button battery impaction in the aerodigestive tract in children. STUDY DESIGN Retrospective case series. METHODS This multi-institutional study, endorsed by the American Society of Pediatric Otolaryngology research consortium, is a retrospective medical record review, including all children at five tertiary-care institutions presenting with button batteries impacted in the aerodigestive tract between January 2002 and December 2014. Battery type/size, duration and location of impaction, presenting symptoms, treatment, complications, and outcomes were examined. RESULTS Eighty-one patients were included (64.2% male), with ingestion witnessed in 20 (24.7%). Median age at presentation was 3 years (range, 1 week-14 years). Median time from diagnosis to removal was 2.5 hours (range, 0.4-72 hours). Locations included the esophagus (n = 48), hypopharynx (n = 1), stomach (n = 6), nasal cavity (n = 22), and ear canal (n = 4). Most common symptoms for esophageal/hypopharyngeal impactions included dysphagia (26.5%), nausea/vomiting (26.5%), drooling (24.5%), cough (18.4%), and fever (18.4%). Most common symptoms for nasal impactions included epistaxis (54.6%), rhinorrhea (40.9%), nasal pain (27.3%), and fever (22.7%). Almost all esophageal impactions were from 3-V (89.5%), 20-mm (81.8%) lithium batteries. Severe esophageal complications included stricture (28.6%), perforation (24.5%), tracheoesophageal fistula formation (8.2%), pneumothorax (4.1%), and bilateral true vocal fold paresis (4.1%). Nasal complications included necrosis (59.1%), septal perforation (27.3%), and saddle nose deformity (4.5%). Duration of impaction correlated with an increased likelihood of persistent symptoms only for nasal batteries (P = .049). CONCLUSIONS Button batteries in the upper pediatric aerodigestive tract or ear canal should be considered a surgical emergency, requiring urgent removal and careful vigilance for complications. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E298-E306, 2021.
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Affiliation(s)
- Amber D Shaffer
- Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Ian N Jacobs
- Division of Pediatric Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Craig S Derkay
- Department of Otolaryngology, Children's Hospital of The King's Daughters, Norfolk, Virginia
| | - Nira A Goldstein
- Division of Pediatric Otolaryngology, State University of New York Downstate Medical Center, Brooklyn, New York
| | - Terri Giordano
- Division of Pediatric Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Sandra Ho
- Division of Pediatric Otolaryngology, State University of New York Downstate Medical Center, Brooklyn, New York
| | - Bong J Kim
- Division of Pediatric Otolaryngology, University of Utah School of Medicine, Salt Lake City, Utah, U.S.A
| | - Albert H Park
- Division of Pediatric Otolaryngology, University of Utah School of Medicine, Salt Lake City, Utah, U.S.A
| | - Jeffrey P Simons
- Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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11
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Chabrillac E, Morinière S, Jegoux F, Blanchard D, Choussy O, Hans S, Vergez S. Transoral robotic resection of benign tumors of the upper aerodigestive tract: Experience of the French group of GETTEC. Head Neck 2018; 40:2043-2049. [PMID: 29697873 DOI: 10.1002/hed.25197] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/13/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The purpose of this study was to assess the current use of transoral robotic surgery (TORS) in benign tumors of the upper aerodigestive tract through a case series and a literature review. METHODS This multicentric retrospective study was conducted in 6 French centers between November 2009 and July 2017. RESULTS Twenty-one patients had a TORS resection of a tumor at varied locations with differing histopathologic characteristics. The mean postoperative hospital stay was 6.1 days. Eight patients had nasogastric tubes, which were removed after a mean of 5.6 days. Two patients had a prophylactic tracheostomy for an average of 5.5 days. A third tracheostomy was performed secondarily for postoperative bleeding. No recurrences were observed during the 2-year follow-up. CONCLUSION This technique caused few complications and resulted in short hospitalization, with satisfactory functional and recurrence outcomes. However, the risk of bleeding and edema must be considered, and the need for a tracheostomy must be approached wisely.
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Affiliation(s)
- Emilien Chabrillac
- Department of Ear, Nose, and Throat - Head and Neck Surgery, Toulouse University Hospital, Hôpital Larrey, Toulouse, France
- Department of Surgery, University Cancer Institute Toulouse, Toulouse, France
| | - Sylvain Morinière
- Department of Ear, Nose, and Throat - Head and Neck Surgery, Tours University Hospital, Cedex, France
| | - Franck Jegoux
- Department of Ear, Nose, and Throat - Head and Neck Surgery, Rennes University Hospital, Rennes, France
| | - David Blanchard
- Department of Ear, Nose, and Throat - Head and Neck Surgery, Institut Curie Hospital, Paris, France
| | - Olivier Choussy
- Department of Ear, Nose, and Throat - Head and Neck Surgery, Rouen University Hospital, Rouen, France
| | - Stéphane Hans
- Department of Ear, Nose, and Throat - Head and Neck Surgery, Toulouse University Hospital, Hôpital Larrey, Toulouse, France
- Department of Surgery, University Cancer Institute Toulouse, Toulouse, France
| | - Sébastien Vergez
- Department of Ear, Nose, and Throat - Head and Neck Surgery, Georges Pompidou European Hospital, Paris, France
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12
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Hirata K, Yokoyama A, Nakamura R, Omori T, Kawakubo H, Mizukami T, Maruyama K, Kanai T, Yokoyama T. Soft palatal melanosis, a simple predictor for neoplasia in the upper aerodigestive tract in Japanese alcoholic men. Cancer Sci 2017; 108:1058-1064. [PMID: 28218985 PMCID: PMC5448598 DOI: 10.1111/cas.13207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 02/13/2017] [Accepted: 02/15/2017] [Indexed: 01/29/2023] Open
Abstract
Soft palatal melanosis can be detected by visual inspection during routine physical examination or even personally in a mirror. The aim of this study was to evaluate the association between squamous cell neoplasia in the upper aerodigestive tract (UAT) and soft palatal melanosis. We reviewed digitized records of high-quality endoscopic images of the soft palate of 1786 Japanese alcoholic men who underwent endoscopic screening. Soft palatal melanosis was observed in 381 (21.3%) of the subjects (distinct, 6.3%). Older age, an inactive heterozygous aldehyde dehydrogenase-2 genotype, smoking, and a high mean corpuscular volume were positively associated with the presence of soft palatal melanosis. The age-adjusted odds ratio (95% confidence interval) for UAT neoplasia was 1.92 (1.40-2.64) in the group with melanosis and 2.51 (1.55-4.06) in the group with distinct melanosis, compared with the melanosis-free group. A multivariate analysis showed that the presence of soft palatal melanosis was independently associated with a high risk of UAT neoplasia. We calculated the individual number of risk factors out of four easily identifiable and significant factors: age ≥55 years, current/former alcohol flushing, mean corpuscular volume ≥106 fL, and distinct soft palatal melanosis. Compared with the risk-factor-free condition, the odds ratio (95% confidence interval) values of UAT neoplasia for one, two, three, and four risk factors were 1.49 (0.97-2.30), 3.14 (2.02-4.88), 4.80 (2.71-8.51), and 7.80 (2.17-28.1), respectively. The presence of soft palatal melanosis provides a simple new strategy for identifying heavy drinkers with a high risk for UAT neoplasia.
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Affiliation(s)
- Kenro Hirata
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineKeio University School of MedicineTokyoJapan
| | - Akira Yokoyama
- National Hospital Organization Kurihama Medical and Addiction CenterYokosukaJapan
| | - Rieko Nakamura
- Department of SurgeryKeio University School of MedicineTokyoJapan
| | - Tai Omori
- Endoscopy CenterKawasaki Municipal Ida HospitalKawasakiJapan
| | | | - Takeshi Mizukami
- National Hospital Organization Kurihama Medical and Addiction CenterYokosukaJapan
| | - Katsuya Maruyama
- National Hospital Organization Kurihama Medical and Addiction CenterYokosukaJapan
| | - Takanori Kanai
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineKeio University School of MedicineTokyoJapan
| | - Tetsuji Yokoyama
- Department of Health PromotionNational Institute of Public HealthWakoJapan
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13
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Volgger V, Felicio A, Lohscheller J, Englhard AS, Al-Muzaini H, Betz CS, Schuster ME. Evaluation of the combined use of narrow band imaging and high-speed imaging to discriminate laryngeal lesions. Lasers Surg Med 2017; 49:609-618. [PMID: 28231400 DOI: 10.1002/lsm.22652] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Laryngeal lesions are usually investigated by microlaryngoscopy, biopsy, and histopathology. This study aimed to evaluate the combined use of Narrow Band Imaging (NBI) and High-Speed Imaging (HSI) in the differentiation of glottic lesions in awake patients. STUDY DESIGN Prospective diagnostic study. MATERIALS AND METHODS Thirty-six awake patients with 41 glottic lesions were investigated with both NBI and HSI, and the suspected diagnoses were compared to the histopathological results of tissue biopsies taken during subsequent microlaryngoscopies. Of the 41 lesions, 28 were primary lesions and 13 recurrent lesions after previous laryngeal pathologies. RESULTS Sensitivity, specificity, positive predictive value, and negative predictive value in the differentiation between benign/premalignant and malignant lesions with both NBI and HSI accounted to 100.0%, 79.4%, 50.0%, and 100.0%. Sensitivities and specificities were 100.0% and 85.7% for HSI alone, and 100.0% and 79.4% for NBI alone. Regarding only primary lesions the results were generally better with sensitivities and specificities of 100% and 81% for NBI, 100% and 84.2% for HSI and 100% and 85.7% for the combination of both methods, respectively. CONCLUSION NBI and HSI both seem to be promising adjunct tools in the differentiation of various laryngeal lesions in awake patients with high sensitivities. Specificities, however, were moderate but could be increased when using NBI and HSI in combination in a subgroup of patients with only primary lesions. Although both methods still have limitations they might ameliorate the evaluation of suspicious laryngeal lesions in the future and could possibly spare patients from repeated invasive tissue biopsies. Lasers Surg. Med. 49:609-618, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Veronika Volgger
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum der Universität München, 81377, Munich, Germany
| | - Axelle Felicio
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum der Universität München, 81377, Munich, Germany
| | - Jörg Lohscheller
- Department of Informatics, Trier University of Applied Sciences, Schneidershof, 54208, Trier, Germany
| | - Anna S Englhard
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum der Universität München, 81377, Munich, Germany
| | - Hanan Al-Muzaini
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum der Universität München, 81377, Munich, Germany
| | - Christian S Betz
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum der Universität München, 81377, Munich, Germany
| | - Maria E Schuster
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum der Universität München, 81377, Munich, Germany
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14
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Miller MC, Goldenberg D. AHNS Series: Do you know your guidelines? Principles of surgery for head and neck cancer: A review of the National Comprehensive Cancer Network guidelines. Head Neck 2016; 39:791-796. [PMID: 27987243 DOI: 10.1002/hed.24654] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2016] [Indexed: 02/05/2023] Open
Abstract
This article continues a series developed by the American Head and Neck Society's Education Committee entitled "Do you know your guidelines?" It is hoped that these features will increase awareness of and adherence to current best practices in head and neck cancer care. In this installment, the National Comprehensive Cancer Network (NCCN) guidelines for surgical therapy are reviewed. © 2016 Wiley Periodicals, Inc. Head Neck 39: 791-796, 2017.
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Affiliation(s)
- Matthew C Miller
- Department of Otolaryngology - Head and Neck Surgery, Strong Memorial Hospital, Rochester, New York
| | - David Goldenberg
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
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15
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Dubray-Vautrin A, Ballivet de Régloix S, Girod A, Jouffroy T, Rodriguez J. [Epidemiology, diagnosis and treatment of head and neck cancers]. Soins 2015:32-5. [PMID: 26369742 DOI: 10.1016/j.soin.2015.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Cancers of the upper aerodigestive tracts are the fourth most common cancer in France. The main risk factors are smoking and alcohol. They do not necessarily present specific signs, making their early diagnosis difficult. A change in the patient's general condition is a late sign leading to a poor prognosis of the disease.
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Affiliation(s)
- Antoine Dubray-Vautrin
- Service de chirurgie oncologique ORL et cervico-faciale, Institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | | | - Angélique Girod
- Service de chirurgie oncologique ORL et cervico-faciale, Institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - Thomas Jouffroy
- Service de chirurgie oncologique ORL et cervico-faciale, Institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - Joseph Rodriguez
- Service de chirurgie oncologique ORL et cervico-faciale, Institut Curie, 26, rue d'Ulm, 75005 Paris, France.
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16
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Ben Saad M, Spindler C, Tidière M, Wagner V, Wintz L. [Nursing care in reconstructive surgery in cases of head and neck cancer]. Soins 2015; 60:39-42. [PMID: 26369744 DOI: 10.1016/j.soin.2015.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The treatment of cancers of the upper aerodigestive tract favours an organ- and function- preserving surgical approach. The nursing care draws on multiple skills, on both a technical and educational level, in order to assure global patient management.
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Affiliation(s)
| | | | | | | | - Lydie Wintz
- Institut Curie, 26, rue d'Ulm, 75005 Paris, France.
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17
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Zhu SJ, Wang QY, Zhou SH, Bao YY, Wang SQ. Obstructive sleep apnea syndrome caused by uncommon tumors of the upper aerodigestive tract. Int J Clin Exp Pathol 2014; 7:6686-6693. [PMID: 25400748 PMCID: PMC4230070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 09/15/2014] [Indexed: 06/04/2023]
Abstract
Obstructive sleep apnea syndrome (OSAS) is always caused by anatomic abnormalities, including nasal cavity, pharynx, and neuromuscular dysfunctions, leading to airway narrowing. OSAS associated with a mass in the aerodigestive tract is rare. In the present study, we report OSAS caused by 9 cases of preoperative uncommon tumors in the aerodigestive tract. Two tumors in the parapharyngeal space were pleomorphic adenoma, one oropharyngeal tumor was mucoepidermoid carcinoma, one tumor in the right tonsil was schwannoma, and five tumors were non-Hodgkin's lymphoma (NHL). Of the five NHL cases, one in the nasopharynx was diffuse large B-cell lymphoma, two were mantle cell lymphoma, one was chronic lymphocytic leukemia/small lymphocytic lymphoma, and one was NHL. Tumors in the aerodigestive tract should be considered in the differential diagnosis of OSAS upon exacerbation of snoring or sudden gasping. Further examinations should be performed, including a routine workup (computed tomography (CT) and magnetic resonance imaging) and positron emission tomography/CT.
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Affiliation(s)
- Shao-Jun Zhu
- Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University310003, China
| | - Qin-Ying Wang
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University310003, China
| | - Shui-Hong Zhou
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University310003, China
| | - Yang-Yang Bao
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University310003, China
| | - Shen-Qing Wang
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University310003, China
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18
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Abstract
The concept of field cancerization has been ever changing since its first description by Slaughter et al in 1953. Field cancerization explains the mechanisms by which second primary tumors (SPTs) develop. SPTs are the tumors, which develop in the oral cavity in succession to the primary malignant tumors, which might vary in duration ranging from few months to years. Conceivably, a population of daughter cells with early genetic changes (without histopathology) remains in the organ, demonstrating the concept of field cancerization. This review explains the concept of field cancerization and various field theories along with molecular basis of field formation.
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Affiliation(s)
- Robin Sabharwal
- Department of Oral and Maxillofacial Pathology, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
| | - Ashish Mahendra
- Department of Oral Pathology, Chandra Dental College Barabanki, India
| | - Ninad J Moon
- Department of Periodontology, RKDF Dental College, Bhopal, India
| | - Parul Gupta
- Department of Orthodontics, Kalka Dental College, UP, India
| | - Ashish Jain
- Department of Conservative Dentistry, Krishna Dental College, UP, India
| | - Shivangi Gupta
- Department of Periodontology, Divya Jyoti College of Dental Sciences and Research, Ajit Mahal, Modinagar, Ghaziabad, Uttar Pradesh, India
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19
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Yang F, Liu T, Zhao H, Hu Z, Xiao L, Liu Y, Wang X, Li Z. Indolent T-lymphblastic proliferation: report of a case involving the upper aerodigestive tract. Int J Clin Exp Pathol 2014; 7:6350-6356. [PMID: 25337290 PMCID: PMC4203261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 08/23/2014] [Indexed: 06/04/2023]
Abstract
T-lymphoblastic lymphoma (T-LBP) is a high-grade malignant lymphoma, which possesses the characteristic of high metastasis and high mortality without treatment. We are presenting a special T-lymphoblastic proliferation involving in the oropharynx, nasopharynx, sinus and trachea in a patient with local involved about 15-years without systemic dissemination. The immunophenotype of this case was similar to T-LBP. The proliferous cells were positive for terminal deoxynucleotidyl transferase (TdT), CD3, and appeared co-expression CD4 and CD8. No clonal rearrangements of TCRγ and/or TCRβ gene were detected. Indolent T-lymphoblastic proliferations rarely occurred or unusually could not be diagnosed, combing with the relevant literature and clinically indolent manifestation, we interpreted this case as indolent T-lymphoblastic proliferation (iT-LBPs). So far, the mechanism of the T-lymphoblastic proliferations is still uncertain and requires further study.
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Affiliation(s)
- Fang Yang
- Department of Pathology, School of Basic Medical Sciences, Southern Medical UniversityGuangzhou, China
| | - Tengfei Liu
- Department of Pathology, School of Basic Medical Sciences, Southern Medical UniversityGuangzhou, China
| | - Haiyan Zhao
- Department of Pathology, The Central Hospital of LonggangShenzhen, China
| | - Zhiyan Hu
- Department of Pathology, School of Basic Medical Sciences, Southern Medical UniversityGuangzhou, China
| | - Liwei Xiao
- Department of Pathology, School of Basic Medical Sciences, Southern Medical UniversityGuangzhou, China
| | - Yanping Liu
- Department of Pathology, School of Basic Medical Sciences, Southern Medical UniversityGuangzhou, China
| | - Xiaoyan Wang
- Department of Pathology, School of Basic Medical Sciences, Southern Medical UniversityGuangzhou, China
| | - Zuguo Li
- Department of Pathology, Nanfang Hospital, Southern Medical UniversityGuangzhou, China
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20
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Hammoudi K, Pinlong E, Kim S, Bakhos D, Morinière S. Transoral robotic surgery versus conventional surgery in treatment for squamous cell carcinoma of the upper aerodigestive tract. Head Neck 2014; 37:1304-9. [PMID: 24816480 DOI: 10.1002/hed.23752] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 03/21/2014] [Accepted: 05/07/2014] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The purpose of our work was to compare a group of patients undergoing transoral robotic surgery (TORS group) for squamous cell carcinoma of the upper aerodigestive tract and a matched group of patients undergoing conventional surgery (conventional surgery group) for the same indication. METHODS In this retrospective single-center study, 26 patients were included in each group. RESULTS There were significantly fewer tracheotomies in the TORS group (p < .001). The mean durations of feeding by nasogastric tube and hospitalization were shorter for the TORS group (p = .001). There was no significant difference in disease-free survival at 3 years (p = .76). Mean treatment cost was $7124 lower for the TORS group (p = .03). CONCLUSION This comparative study shows that robotic technology can be used to treat selected squamous cell carcinomas of the upper aerodigestive tract, reducing morbidity and treatment costs while providing equivalent cancer control at 3 years.
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Affiliation(s)
- Karim Hammoudi
- ENT Department, University François Rabelais.,CHRU Bretonneau, Tours Hospital, France
| | | | - Soo Kim
- CHRU Bretonneau, Tours Hospital, France
| | - David Bakhos
- ENT Department, University François Rabelais.,CHRU Bretonneau, Tours Hospital, France
| | - Sylvain Morinière
- ENT Department, University François Rabelais.,CHRU Bretonneau, Tours Hospital, France
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21
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Gu X, Jiang R, Fowler MR. Acantholytic squamous cell carcinoma in upper aerodigestive tract: histopathology, immunohistochemical profile and epithelial mesenchymal transition phenotype change. Head Neck Pathol 2012; 6:438-44. [PMID: 22850983 DOI: 10.1007/s12105-012-0391-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 07/23/2012] [Indexed: 10/28/2022]
Abstract
Acantholytic squamous cell carcinoma is a rare variant of squamous cell carcinoma in the mucosa of upper aerodigestive tract. Histomorphologically, acantholytic squamous cell carcinoma may lose the typical features of conventional squamous cell carcinoma and mimic other epithelial or mesenchymal malignancies due to advanced acantholysis and dyskeratosis. Because of its rarity, information of prognosis, pathologic features and immunohistochemical profiles is limited. We have studied clinicopathologic features and immunohistochemical profiles of four acantholytic squamous cell carcinoma cases arising from upper aerodigestive tract. Clinical results indicate an aggressive biologic behavior. Morphologically, all tumors revealed significant acantholysis with separation of tumor cells and intratumoral spaces. The tumor cells were highly pleomorphic and growth patterns were variable. In immunohistochemical studies, all tumor cells revealed positive reactions for AE1/AE3 and p63 supporting a squamous epithelial origin. In contrast to conventional aerodigestive squamous cell carcinoma, acantholytic squamous cell carcinoma showed significant reductions of cytokeratin19, E-cadherin and concomitant up-regulation of vimentin expression. Both morphologic features and immunohistochemical profiles indicate that acantholytic squamous cell carcinoma has acquired an epithelial mesenchymal transition phenotype. However, in contrast to other solid malignant tumors, the epithelial mesenchymal transition phenotype change in acantholytic squamous cell carcinoma is not limited to the invasive front of the peripheral tumor but, rather, diffusely involves entire neoplastic lesion. In addition, because cytokeratin 19 staining is attenuated, this would be an insensitive marker for following up and/or in detecting disseminated tumor cells in cases of acantholytic squamous cell carcinoma in upper aerodigestive tract.
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22
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Mani S, Szymańska K, Cuenin C, Zaridze D, Balassiano K, Lima SCS, Matos E, Daudt A, Koifman S, Filho VW, Menezes AMB, Curado MP, Ferro G, Vaissière T, Sylla BS, Tommasino M, Pinto LFR, Boffetta P, Hainaut P, Brennan P, Herceg Z. DNA methylation changes associated with risk factors in tumors of the upper aerodigestive tract. Epigenetics 2012; 7:270-7. [PMID: 22430803 PMCID: PMC3335950 DOI: 10.4161/epi.7.3.19306] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 01/05/2012] [Accepted: 01/09/2012] [Indexed: 12/20/2022] Open
Abstract
Cancers of the upper aerodigestive tract (UADT) are common forms of malignancy associated with tobacco and alcohol exposures, although human papillomavirus and nutritional deficiency are also important risk factors. While somatically acquired DNA methylation changes have been associated with UADT cancers, what triggers these events and precise epigenetic targets are poorly understood. In this study, we applied quantitative profiling of DNA methylation states in a panel of cancer-associated genes to a case-control study of UADT cancers. Our analyses revealed a high frequency of aberrant hypermethylation of several genes, including MYOD1, CHRNA3 and MTHFR in UADT tumors, whereas CDKN2A was moderately hypermethylated. Among differentially methylated genes, we identified a new gene (the nicotinic acetycholine receptor gene) as target of aberrant hypermethylation in UADT cancers, suggesting that epigenetic deregulation of nicotinic acetycholine receptors in non-neuronal tissues may promote the development of UADT cancers. Importantly, we found that sex and age is strongly associated with the methylation states, whereas tobacco smoking and alcohol intake may also influence the methylation levels in specific genes. This study identifies aberrant DNA methylation patterns in UADT cancers and suggests a potential mechanism by which environmental factors may deregulate key cellular genes involved in tumor suppression and contribute to UADT cancers.
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Affiliation(s)
- Samson Mani
- International Agency for Research on Cancer (IARC); Lyon, France
| | | | - Cyrille Cuenin
- International Agency for Research on Cancer (IARC); Lyon, France
| | | | - Karen Balassiano
- International Agency for Research on Cancer (IARC); Lyon, France
| | - Sheila CS Lima
- International Agency for Research on Cancer (IARC); Lyon, France
- Divisão de Genética; Instituto Nacional de Câncer; Rio de Janeiro, Brazil
| | - Elena Matos
- Institut of Oncology Angel H. Roffo; University of Buenos Aires; Buenos Aires, Argentina
| | | | - Sergio Koifman
- Escola Nacional de Saude Publica; Rio de Janeiro, Brazil
| | | | | | | | - Gilles Ferro
- International Agency for Research on Cancer (IARC); Lyon, France
| | - Thomas Vaissière
- International Agency for Research on Cancer (IARC); Lyon, France
| | - Bakary S Sylla
- International Agency for Research on Cancer (IARC); Lyon, France
| | | | - Luis Felipe Ribeiro Pinto
- Divisão de Genética; Instituto Nacional de Câncer; Rio de Janeiro, Brazil
- Departamento de Bioquímica; Universidade do Estado do Rio de Janeiro; Instituto de Biologia Roberto Alcantara Gomes; Rio de Janeiro, Brazil
| | - Paolo Boffetta
- The International Prevention Research Institute; Lyon, France
| | - Pierre Hainaut
- International Agency for Research on Cancer (IARC); Lyon, France
| | - Paul Brennan
- International Agency for Research on Cancer (IARC); Lyon, France
| | - Zdenko Herceg
- International Agency for Research on Cancer (IARC); Lyon, France
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Kupferman ME, Acevedo J, Hutcheson KA, Lewin JS. Addressing an unmet need in oncology patients: rehabilitation of upper aerodigestive tract function. Ann Oncol 2011; 22:2299-303. [PMID: 21321090 PMCID: PMC3968308 DOI: 10.1093/annonc/mdq733] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Laryngeal dysfunction in the oncology population is common and may detract from quality of life (QoL) due to vocal restriction and aspiration. Therapies to address this complex issue have not been explored to date. We examined the outcomes among oncology patients treated with a minimally invasive office-based surgical approach for the rehabilitation of laryngeal dysfunction. PATIENTS AND METHODS A retrospective analysis was carried out of oncology patients referred for laryngeal dysfunction. Patients who underwent minimally invasive injection laryngoplasty (IL) were selected. Subjective outcome measures, objective voice analysis parameters, and swallowing studies were annotated. RESULTS Sixty-one patients underwent IL for the management of laryngeal dysfunction. Lung cancer was the most common cancer diagnosis (39.3%), and 52% of patients had thoracic malignancies. All patients had a self-reported improvement in vocal function with a single injection, and 55 patients (90%) reported lasting effects at 3 months. In patients with pre- and postoperative voice analysis, phonatory function increased from 5.0 to 10.5 s, more than twofold improvement compared with baseline functioning. Seventy-one percent of patients who aspirated before injection no longer required a modified diet. There were no major complications. CONCLUSIONS Interventions to improve the QoL in oncology patients continue to evolve. We report significant improvements in both subjective and objective measures of laryngeal function after IL for vocal fold dysfunction that are both immediate and sustained. We conclude that IL is a safe and efficacious procedure for the treatment of laryngeal dysfunction in oncology patients, resulting in palliation and improved QoL.
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Affiliation(s)
- M. E. Kupferman
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston,Correspondence to: Dr M. E. Kupferman, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit Number: 1445, Houston, TX 77030, USA. Tel: +1 713-794-1910; Fax: +1 713-794-4662; E-mail:
| | - J. Acevedo
- Department of Otolaryngology, Head and Neck Surgery, National Capitol Consortium, Washington
| | - K. A. Hutcheson
- Department of Speech Pathology, MD Anderson Cancer Center, Houston, USA
| | - J. S. Lewin
- Department of Otolaryngology, Head and Neck Surgery, National Capitol Consortium, Washington
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Rickert D. Polymeric implant materials for the reconstruction of tracheal and pharyngeal mucosal defects in head and neck surgery. GMS Curr Top Otorhinolaryngol Head Neck Surg 2011; 8:Doc06. [PMID: 22073099 PMCID: PMC3199816 DOI: 10.3205/cto000058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The existing therapeutical options for the tracheal and pharyngeal reconstruction by use of implant materials are described. Inspite of a multitude of options and the availability of very different materials none of these methods applied for tracheal reconstruction were successfully introduced into the clinical routine. Essential problems are insufficiencies of anastomoses, stenoses, lack of mucociliary clearance and vascularisation. The advances in Tissue Engineering (TE) offer new therapeutical options also in the field of the reconstructive surgery of the trachea. In pharyngeal reconstruction far reaching developments cannot be recognized at the moment which would allow to give a prognosis of their success in clinical application. A new polymeric implant material consisting of multiblock copolymers was applied in our own work which was regarded as a promising material for the reconstruction of the upper aerodigestive tract (ADT) due to its physicochemical characteristics. In order to test this material for applications in the ADT under extreme chemical, enzymatical, bacterial and mechanical conditions we applied it for the reconstruction of a complete defect of the gastric wall in an animal model. In none of the animals tested either gastrointestinal complications or negative systemic events occurred, however, there was a multilayered regeneration of the gastric wall implying a regular structured mucosa. In future the advanced stem cell technology will allow further progress in the reconstruction of different kind of tissues also in the field of head and neck surgery following the principles of Tissue Engineering.
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Affiliation(s)
- Dorothee Rickert
- University Hospital and Ambulance for Ear, Nose and Throat Diseases, Ulm, Germany
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Abstract
Epidemiologic, clinical, morphologic and molecular evidence show that high risk HPV, particularly type 16, is a prerequisite for some carcinomas of the upper aerodigestive tract (UADT), particularly tonsil and base of tongue. Sexual transmission is an important mode of infection while tobacco use and excessive drinking are not considered risk factors. HPV + tumors are distinct clinically and pathologically. They are more common in young patients (<40 years) with a male to female ratio of 4:1. They usually present as a small or occult primary tumor with advanced neck disease. Microscopically they are non-keratinizing squamous cell carcinomas with basaloid features, excessive mitosis and comedo type necrosis. The tumors have a distinct immunohistochemical profile characterized by strong and diffuse p16 reactivity, low or negative p53 staining and high Ki67 labeling scores. HPV + carcinomas are more radio-sensitive and have a better prognosis than the classical keratinizing SCC of the UADT. An anti-HPV vaccine has recently been made available for prevention of cervical cancer. The impact of the vaccine on the prevalence of HPV related carcinomas of the UADT is currently not known but likely beneficial.
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Chaukar DA, Prabhudesai SG, Bhambhani NL, Pathak KA, Sanghvi VD. Differentiated thyroid cancer invading the hypopharynx: A case report. Indian J Otolaryngol Head Neck Surg 2006; 58:92-4. [PMID: 23120251 PMCID: PMC3450624 DOI: 10.1007/bf02907755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Most thyroid cancers (90-95%) are well differentiated. Well differentiated cancers of the thyroid are usually confined to the thyroid capsule, making them amenable to isolated thyroid resection. Invasion of the upper aerodigestive tract by these cancers is infrequent and hypopharyngeal invasion is still rare. We report a 51 year old man with thyroid cancer invading the hypopharynx, who was successfully managed with complete resection along with a partial pharyngectomy. He is asymptomatic and disease free eighteen months after surgery. We advocate aggressive surgical extirpation of thyroid carcinoma invading the upper aerodigestive tract.
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Affiliation(s)
- D. A. Chaukar
- Department of Surgical Oncology, Head and Neck Services, Tata Memorial Hospital, Parel, 400 012 Mumbai, India
| | - S. G. Prabhudesai
- Department of Surgical Oncology, Head and Neck Services, Tata Memorial Hospital, Parel, 400 012 Mumbai, India
| | - N. L. Bhambhani
- Department of Surgical Oncology, Head and Neck Services, Tata Memorial Hospital, Parel, 400 012 Mumbai, India
| | - K. A. Pathak
- Department of Surgical Oncology, Head and Neck Services, Tata Memorial Hospital, Parel, 400 012 Mumbai, India
| | - V. D. Sanghvi
- Department of Surgical Oncology, Head and Neck Services, Tata Memorial Hospital, Parel, 400 012 Mumbai, India
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