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Microsurgical extirpation is one of the basic modalities of treatment for patients with vestibular schwannoma. Considering the significant decrease in mortality and morbidity of patients with vestibular schwannoma in the past decades, the quality of life has become the most important criterion of current treatment management. Despite the great scientific and technological progress in the surgical treatment of vestibular schwannoma, we can encounter a number of serious complications that can have a major impact on the quality of life. A number of questionnaire studies confirm that these are mainly postoperative facial nerve lesion, dizziness and long-term headache. In contrast, tinnitus or unilateral hearing loss may be a less serious handicap in terms of overall quality of life. [ABSTRACT FROM AUTHOR]

Copyright of Otorhinolaryngology & Phoniatrics / Otorinolaryngologie a Foniatrie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Otorhinolaryngology & Phoniatrics / Otorinolaryngologie a Foniatrie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: A facial nerve lesion causes serious health complications and leads to a general deterioration of the quality of life. A facial nerve lesion relatively often occurs as a complication of surgery of the parotid gland and skull base tumors. Non-surgical methods focus mainly on long-term rehabilitation of facial muscles and prevention of eye complications due to lagophthalmos. Surgical methods allow reconstruction of the facial nerve during its intracranial course, as well as after exiting the temporal bone. Methods: We retrospectively analyzed the results of facial nerve reconstruction techniques performed for a unilateral facial nerve lesion after 1 year and with an interval of at least 2 years after anastomosis. The etiology of paresis, interval between the onset of lesion and reconstructive surgery, length of follow-up and reconstruction technique were evaluated. Facial nerve function was assessed using the House-Brackmann classification. Results: The cohort contained a total of 73 patients; facial nerve function was assessed in 53 of them. Iatrogenic lesions due to vestibular schwannoma removal predominated. The primary reconstruction of the facial nerve prevailed over postponed operations. Direct anastomosis with an interposition of the autologous graft from the great auricular nerve followed by a sural nerve graft achieved the best functional results after 1 year. The best results with an interval of at least 2 years were achieved in direct end-to-end anastomoses without graft, in which the reconstruction did not fail in either case. In the case of an interposition of the autologous graft from the great auricular nerve, it has been shown that facial nerve function worsens with the length of the graft. This correlation was not observed in grafts from the sural nerve. No statistically significant difference was found between the resulting function of the facial nerve and the reconstruction technique, sex, age and interval between the onset of lasion and reconstruction. Conclusion: Reconstructive surgeries resulted in improved facial nerve function in 98 % of patients. 70% of patients with an interval of at least 2 years after the surgery achieved HB grade III. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnoea syndrome (OSA) is the most common sleep related breathing disorder. The basic examination for the diagnosis of OSA is an overnight sleep monitoring using limited polygraphy or polysomnography, which are costly and time consuming. OSA screening could contribute significantly to finding patients at risk. The article summarizes the most widely used screening methods (questionnaires, instrumental and physical) and compares their efficiency. [ABSTRACT FROM AUTHOR]

Copyright of Otorhinolaryngology & Phoniatrics / Otorinolaryngologie a Foniatrie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The EORTC 24971/TAX 323, a phase III study of 358 patients with unresectable locoregionally advanced squamous cell carcinoma of the head and neck, showed an improved progression-free and overall survival (OS) with less toxicity when docetaxel (T) was added to cisplatin and 5-fluorouracil (PF) for induction and given before radiotherapy (RT). The impact of the addition of docetaxel on patients' health-related quality of life (HRQOL) and symptoms was investigated.Methods: HRQOL was assessed at baseline, at end of cycle 2, and 4, 6, and 9 months after completion of RT using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30) and the EORTC QLQ Head and Neck Cancer-Specific Module (EORTC QLQ-H&N35). The primary HRQOL scale was global HRQOL per protocol.Results: Compliance to HRQOL assessments was 97% at baseline, but dropped to 54% by 6 months. Data were analysed up to 6 months. There was a trend towards improved global HRQOL during the treatment period. At 6 months after the end of RT, global HRQOL was higher in the TPF arm than in the PF arm, but the low compliance does not allow to draw definitive conclusions. Swallowing and coughing problems decreased more in the TPF arm than in the PF arm at the end of cycle 2, but to a limited extent.Conclusion: Induction chemotherapy with TPF before RT not only improves survival and reduces toxicity compared with PF but also seems to improve global HRQOL in a more sustainable manner. [ABSTRACT FROM AUTHOR]

Heterotopic calcification following radiotherapy is a very rare event. Here, we report a case of a patient who underwent surgical intervention including pectoralis major flap reconstruction for locally advanced pharyngolaryngeal squamous cell carcinoma with skin invasion. He was followed up post-operatively with adjuvant radiotherapy. 13 years after the treatment, suspect resistance in the myocutaneous flap region appeared and was diagnosed as a calcification. To date, the occurrence of subcutaneous calcification in the myocutaneous flap in the neck has not been described as a late complication of neck irradiation. [ABSTRACT FROM AUTHOR]

From 1997 to 2002, 55 patients with vestibular schwannomas (VS) were managed by radical removal in a one-stage procedure by a retromastoideal posterior fossa approach. Ninety percent of VS were of the 4th grade compressing the brainstem. The described group proves that a high standard of microsurgical technique and intraoperative neurophysiologic monitoring of cranial nerve function is essential. Small VS can be removed without any injury to the facial nerve and with subsequent serviceable hearing. Large VS can be removed with fairly good facial nerve function or with a temporary functional lesion. Less than 10% of operated VS necessitated a facial nerve reconstruction in a cerebellopontine angle (CPA). Cross anastomosis between nerves was never used. No serviceable hearing was maintained after surgery of large VS. Majority of VS in our group (90%) were not suitable for stereoradiosurgery (SRS) because of the size. Five patients operated on for a rapid growth after previous SRS proves that radiotherapy should not be a method of the first choice in VS. Our study supports an opinion that growing VS should be treated in the earliest possible stage. Total removal can be achieved with minimal morbidity and mortality. Auditory brainstem implant (ABI) brings a new chance of maintaining hearing in five patients with neurofibromatosis 2 (NF 2) and bilateral VS. [Copyright &y& Elsevier]

In this multi-ancestry genome-wide association study (GWAS) and fine mapping study of head and neck squamous cell carcinoma (HNSCC) subsites, we analysed 19,073 cases and 38,857 controls and identified 29 independent novel loci. We provide robust evidence that a 3' UTR variant in TP53 (rs78378222, T>G) confers a 40% reduction in odds of developing overall HNSCC. We further examine the gene-environment relationship of BRCA2 and ADH1B variants demonstrating their effects act through both smoking and alcohol use. Through analyses focused on the human leukocyte antigen (HLA) region, we highlight that although human papilloma virus (HPV)(+) oropharyngeal cancer (OPC), HPV(-) OPC and oral cavity cancer (OC) all show GWAS signal at 6p21, each subsite has distinct associations at the variant, amino acid, and 4-digit allele level. We also defined the specific amino acid changes underlying the well-known DRB1*13:01-DQA1*01:03-DQB1*06:03 protective haplotype for HPV(+) OPC. We show greater heritability of HPV(+) OPC compared to other subsites, likely to be explained by HLA effects. These findings advance our understanding of the genetic architecture of head and neck squamous cell carcinoma, providing important insights into the role of genetic variation across ancestries, tumor subsites, and gene-environment interactions.

Induction of autophagy represents an effective survival strategy for nutrient-deprived or stressed cancer cells. Autophagy contributes to the modulation of communication within the tumor microenvironment. Here, we conducted a study of the metabolic and signaling implications associated with autophagy induced by glutamine (Gln) and serum starvation and PI3K/mTOR inhibitor and autophagy inducer NVP-BEZ235 (BEZ) in the head and neck squamous cell carcinoma (HNSCC) cell line FaDu. We compared the effect of these different types of autophagy induction on ATP production, lipid peroxidation, mitophagy, RNA cargo of extracellular vesicles (EVs), and EVs-associated cytokine secretome of cancer cells. Both BEZ and starvation resulted in a decline in ATP production. Simultaneously, Gln starvation enhanced oxidative damage of cancer cells by lipid peroxidation. In starved cells, there was a discernible fragmentation of the mitochondrial network coupled with an increase in the presence of tumor susceptibility gene 101 (TSG101) on the mitochondrial membrane, indicative of the sorting of mitochondrial cargo into EVs. Consequently, the abundance of mitochondrial RNAs (mtRNAs) in EVs released by FaDu cells was enhanced. Notably, mtRNAs were also detectable in EVs isolated from the serum of both HNSCC patients and healthy controls. Starvation and BEZ reduced the production of EVs by cancer cells, yet the characteristic molecular profile of these EVs remained unchanged. We also found that alterations in the release of inflammatory cytokines constitute a principal response to autophagy induction. Importantly, the specific mechanism driving autophagy induction significantly influenced the composition of the EVs-associated cytokine secretome., (© 2024. The Author(s).)

Small extracellular vesicles (sEVs) secreted by various types of cells serve as crucial mediators of intercellular communication within the complex tumour microenvironment (TME). Tumour-derived small extracellular vesicles (TDEs) are massively produced and released by tumour cells, recapitulating the specificity of their cell of origin. TDEs encapsulate a variety of RNA species, especially messenger RNAs, microRNAs, long non-coding RNAs, and circular RNAs, which release to the TME plays multifaced roles in cancer progression through mediating cell proliferation, invasion, angiogenesis, and immune evasion. sEVs act as natural delivery vehicles of RNAs and can serve as useful targets for cancer therapy. This review article provides an overview of recent studies on TDEs and their RNA cargo, with emphasis on the role of these RNAs in carcinogenesis., (© 2024 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.)

Aim: To evaluate the most important factors of quality of life in patients after vestibular schwannoma surgery., Materials and Methods: Patients with unilateral sporadic occurrence of vestibular schwannoma who underwent surgery via suboccipital-retrosigmoid approach were included in the prospective study (2018-2021). Patients after previous Leksell gamma knife irradiation (or other methods of stereotactic radiosurgery) were excluded. Quality of life was assessed using 10 validated questionnaires that were distributed preoperatively, 3 months and 1 year after the surgery., Results: A total of 76 patients were included in the study, complete data were analysed in 43 of them (response rate 57%). Grade III and IV represented up to 70% of all tumors. Patients with larger tumors had a significantly higher risk of postoperative facial nerve paresis, liquorrhea and lower probability of hearing preservation. Patients with smaller tumors and those, who suffered from headaches before surgery had more frequent and severe headaches after surgery. Postoperative headaches were associated with higher incidence of anxiety and tinnitus. More frequent anxiety was also identified in patients with preoperative serviceable hearing who became deaf after surgery. Nevertheless, tinnitus and hearing impairment appeared to have less impact on overall quality of life compared to headaches and facial nerve function., Conclusion: According to our results, tumor size, postoperative function of the facial nerve and occurrence of postoperative headaches had the greatest influence on the overall postoperative quality of life in patients after vestibular schwannoma surgery., (© 2024. The Author(s).)