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Follow-up of laryngeal carcinoma patients is considered to be the important part of their care. The main purpose of follow-up is to early detect potential disease recurrence and second primary tumous, besides assessment of treatment effectiveness and rehabilitation. There is still no definitive guideline based on the data of survival rates, and our aim is to summarize current guidelines and recommendations based on current recommendations and our experience. A review of the literature regarding follow-up and rehabilitation of laryngeal cancer patients was made. Our considerations are based on critical appraisal of the current literature and clinical evidence. Staging is based on the current UICC (Union for International Cancer Control) laryngeal cancer TNM Classification. The parts of follow-up that we discussed in this review include the duration, frequency and setting of the visits, and imaging regarding the mode of treatment (surgery and/or chemoradiotherapy). One of the most important segments of follow-up is patient’s education about potential recurrence or second primary tumor signs and symptoms. Large prospective and retrospective studies remain to be undertaken for the current recommendations and practices to be properly evaluated for survival rates.

Introduction: The radial forearm free flap (FAFF) is ideal for head and neck reconstructive surgery due to its pliable tissue and long pedicle. In this study we analysed the role of perioperative factors on prolonged forearm healing and patient-reported aesthetic and functional outcomes. Materials and methods: The study was conducted at the Otorhinolaryngology and Head and Neck Surgery Department, Clinical Hospital Centre Zagreb, from 2018 to 2021. During this time, 31 FAFF were harvested, and 18 patients were available for analysis of aesthetic and functional outcome. Using the Visual Analogue Scale (VAS), each patient evaluated the aesthetic and functional state of their forearm. The Patient and Observer Scar Assessment Scale (POSAS) was used by patients and surgeons to evaluate scar quality from the harvested forearm flap, as well as from the harvested partial thickness skin graft used for reconstruction of the donor area. The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used to evaluate functional disability of the forearm. Numerical variables obtained from the questionnaires were translated into categories and compared to patient demographic and anamnestic data. Results: Smoking and increased body weight were negatively associated with radial forearm donor site reconstruction. Although 33.3% of the skin grafts healed properly, 72.2% of the patients experienced their donor site scar as good or even excellent. The scar on the proximal volar forearm area, were the partial thickness skin graft had been harvested, was evaluated as very bad in only 5.6% of the patients. None of the patients experienced their forearm as aesthetically bad 15 months after surgery. Conclusion: Skin graft failure in the donor area is associated with smoking intensity, and a higher body mass index. The preserved functionality of the hand directly depends on the preserved forearm sensation, and indirectly on the aesthetic outcome. Postponed healing and negative forearm aesthetics negatively affect everyday use of the operated extremity. This correlation diminishes six weeks after surgery, when the majority of forearms obtain their final appearance.

Lateral lymph node metastases occur in 30–80% of papillary thyroid carcinoma patients. It is generally accepted that they do not impact the overall survival but are identified as an independent risk factor for locoregional recurrence. However, their significance is still not clearly understood. The aim of this study is to analyse metastasizing to the lateral neck levels in a cohort of patients with papillary thyroid carcinoma and lateral neck metastases, and also to assess the recurrence rate through regular check-ups. Methods: We prospectively analysed the data of 135 patients who underwent total thyroidectomy with selective neck dissection (levels II–VI), from 2011 to 2020. We analysed demographics and clinical characteristics of patients and assessed their correlation. Patients were followed up until April 2021. The median follow-up period was 62 months. Patients were followed up through regular check-ups and hospital records. Results: The median age was 36.8 years, 28 percent were men. The most frequently affected neck levels were III, IV, II, and V, respectively. Primary tumours larger than one cm displayed a higher number of positive lymph nodes, while extracapsular spread was revealed to be an independent risk factor for a higher number of positive lymph nodes. During a median follow-up period of 62 months, 18 (13.3%) patients developed regional recurrence of the disease, while two patients (1.2%) developed distant metastases.The mean disease-free period was 16.7 months. Conclusion: Lateral neck metastases occur in predictable patterns. The most frequently affected neck level was III, followed by IV. In two-thirds of the patients, metastases were found in multiple lateral neck levels. Tumour size and extracapsular spread show association with a higher number of positive lymph nodes, and with the higher number of positive nodes in patients with extracapsular spreading. Considering the recurrence rate in the follow-up period, we can conclude that selective neck dissection of levels II–VI proved to be an optimal treatment modality for such patients.

Aim: The aim of this study was to show changes in the work of the Ear, Nose, Throat and Head and Neck Surgery Department, UHC Zagreb, during the COVID-19 pandemic. Methods: We retrospectively extracted and compared the data on the procedures and diagnoses of the Department during the period from January 1st to April 30th in 2019, 2020 and 2021. Results: The total number of cases was lower by 34.2% in 2020, and by 13.19% in 2021, compared to 2019 (p