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Myofibromatosis is a proliferative disorder characterized by the development of soft tissue neoplasms referred to as myofibromas that predominantly occur in infants and young children. These lesions have been described using varied terminologies since they were first reported in 1951. However, these neoplasms are histopathologically characterized by benign fibroblast and myofibroblast proliferation containing a biphasic presentation of spindle-shaped cells surrounding a central zone of less differentiated cells arranged in a hemangiopericytoma-like pattern in all cases. Usually, myofibromatosis occurs in children aged <2 years and is observed at birth in nearly 60% of cases. We report a rare case of myofibroma in an 8-year-old boy who presented with an approximately 6-month history of a left postauricular mass. Histopathological evaluation of the resected mass confirmed the diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Schwannomas are rare benign neurogenic tumours. About 25–45% of extracranial schwannomas are found in the head and neck region. In the head and neck, they can arise from various cranial, peripheral and autonomic nerves. Due to this, they have varied clinical presentations. Material and Methods: This retrospective cohort includes 97 patients diagnosed with extra cranial head and neck schwannoma, and operated in the Otolaryngology and Head & Neck Surgery department, from 2013 to 2022. The parameters observed were the age and gender distribution, location, nerve of origin, size, pressure symptoms, cranial palsies, post-operative symptoms, recurrence and complications. The data were collected from the institute's electronic records. Results: The median age of the study population was 36 years; among them, 51 were men and 46 were women. The most common tumour location was parapharynx. The patients had varied head and neck symptoms, of which 23.7% had nerve paresis at presentation. Transcervical surgical approaches was most used. New onset cranial nerve paresis immediately post-surgery was noted in 22.7%. Recurrence was noted in 2% of cases. Conclusions: Extra cranial schwannomas are uncommon neoplasms and have varied presentations. Comprehensive evaluation with appropriate imaging should be done in all cases. Though benign, patients can present with nerve paresis. Recurrence is uncommon after complete resection. [ABSTRACT FROM AUTHOR]

AbstractAngiosarcoma is a rare malignant tumor, even rarer particularly in the head and neck. It is considered a very aggressive neoplasm with high rates of local recurrence and a poor prognosis. We report a case of nasal angiosarcoma in which the patient underwent endoscopic surgery and postoperative chemoradiotherapy and is in good health 30 months after the treatment, without any recurrence. This result suggests that sinonasal angiosarcoma might have a better prognosis than angiosarcomas arising in other sites if it is treated appropriately. According to our review of the literature on sinonasal angiosarcomas, the 3-year overall survival rate for sinonasal angiosarcomas is 63.7%, which is better than the survival rate for angiosarcomas in other sites. Lymph node and distant metastases were rarely seen. In sinonasal angiosarcoma, appropriate resection and local control of the tumor with radiation therapy or chemoradiotherapy appear to result in a favorable outcome.

Background: Oral mucositis (OM) is an acute debilitating side effects of chemoradiotherapy (CRT) in head and neck cancer (HNC) patients. Salivary biomarkers are noninvasive and aid in early diagnosis and disease prevention. Objective: This study analyzed Bcl-2, Mcl-1, and Bax as potential biomarkers in CRT-induced OM in HNC patients. Methods: Forty-six HNC patients receiving CRT with OM were evaluated using WHO grading. Two time points were observed for saliva sample collection: Day 0 (prior to CRT) and Day 30 (CRT with OM) and from 46 healthy volunteers. Using an enzyme-linked immunosorbent assay (ELISA), levels of Bcl-2, Mcl-1, and Bax were measured. Oral mucositis progression was analyzed using Friedman’s test, and statistical significance between means of different salivary marker was determined using the ANOVA test. Results: From Day 0 to Day 30, grades of OM were statistically significant (P < 0.05). Apoptotic biomarkers showed statistically significant higher expression of proapoptotic regulator Bax and lower expressions of antiapoptotic markers Bcl-2 and Mcl-1 on Day 30 (severe OM) compared to Day 0 and healthy controls (P < 0.0001). Conclusion: Our research showcased Bax, Bcl-2, and Mcl-1 as early predictive indicators of OM, and targeted drugs should be developed against these to prevent onset and severity of oral mucositis that improves patients quality of life.

Introduction: Concomitant chemoradiation with cisplatin is standard treatment for non-metastatic head and neck cancers, but often limited by toxicities, especially deranged renal function and hearing complications. This leads to limited cycles of cisplatin due to challenges in administration and is not suitable for patients with poor renal function and hearing issues. Need of the study: Not enough data is available for patients who are not suitable for cisplatin administration along with radiation either due to sensitivity to cisplatin or the adverse effects mentioned earlier. Docetaxel has been recently observed to benefit such patients in overall response outcome including Disease Free Survival (DFS) and Overall Survival (OS) when administered concurrently with radiation. Improved clinical response with minimal toxicity to normal tissue is seen with docetaxel, as it is a phase-specific agent. Therefore, this would be a good alternative to Cisplatin in patients with deranged kidney function and sensorineural hearing loss. Aim: To estimate the adverse event profile and compliance of docetaxel with radiation. Methodology: This prospective observational study will be conducted in the department of Medical Oncology and Radiation Oncology at Sidharth Gupta Memorial Cancer Hospital, Datta Meghe Institute of Medical Sciences, Sawangi (M), Wardha, Maharashtra, India, starting from May 2024 to May 2025. Patients with pathologically confirmed non-metastatic Head and Neck Squamous Cell Carcinoma (HNSCC), who are planned for Concurrent Chemoradiation (CCRT) but not suitable for cisplatin, will receive concurrent weekly docetaxel at a dose of 15 mg/sqm. Radiotherapy (RT) will be delivered according to the institutional protocol, daily dose of 200 cGy for five days a week will be given. Continuous monitoring during treatment will include weekly clinical evaluations, regular blood tests (haemoglobin, blood counts, renal functions), and grading of adverse events (CTCAE v5 criteria). Treatment response will be assessed via clinical evaluation and CECT scans (RECIST v1.1). Statistical analysis will be performed using Statistical Package for Social Sciences (SPSS) version 26.0 and will involve analysis of categorical variables with Chi-square and Fisher-exact tests, and continuous variables with unpaired t-tests and Analysis of Variance (ANOVA). Time to event analysis will be done using the Kaplan-Meier method with p-value

Understanding the barriers and facilitators for prophylactic swallowing and trismus exercises for patients undergoing radiation to the head and neck may help exercise adherence. The analysis reviews all published reports of exercise adherence with a critical appraisal following PRISMA guidelines. A total of 137 potential papers were identified; 20 studies met the inclusion criteria. The most commonly reported facilitators for swallowing and trismus exercises were regular clinician contact and online resources to reinforce instructions, set goals, and manage radiation toxicities. Social support and perceived benefit from exercises were also reported to be of help. The most common barriers to exercise were radiation toxicities, anxiety, feeling overwhelmed with information, and not understanding the reason for the exercises. Understanding facilitators and barriers to adherence is critical when designing exercise interventions for patients undergoing radiation for head and neck cancer. [ABSTRACT FROM AUTHOR]

Study Design: Narrative review. Objective: To describe the advantages, challenges, and potential indications of the submental artery island flap as a local pedicled flap for head and neck reconstruction. Methods: We conducted a comprehensive review of the literature to describe the submental artery island flap's surgical technique, indications, and outcomes. Data sources included peer-reviewed articles, case reports, and clinical studies on using the submental flap in head and neck surgery reconstruction. Results: The submental artery island flap, while offering advantages such as minimal donor site morbidity, and good cosmetic outcomes, presents challenges related to the pedicle dissection and patient selection. This flap is particularly suitable for defects in the oral cavity, oropharynx, parotid bed, and midface or neck skin. Simultaneous neck dissection is feasible but should be approached with caution in patients with a history of prior neck surgery. Conclusions: The submental artery island flap is a valuable option for selected cases. When performed in the right patient with a correct technique, this flap can reconstruct defects in the oral cavity, oropharynx, parotid bed, and skin of the midface or neck with a minimally visible scar of the donor site. [ABSTRACT FROM AUTHOR]

Introduction Unplanned hospital returns are frequent and may be preventable. Objective To comprehend the reasons for unplanned hospital readmission and return to the Outpatient Department (OPD) and Emergency Department (ED) within 60 days after discharge following head and neck surgery (HNS) at a tertiary care center in Saudi Arabia. Methods In the present retrospective study, the medical records of all patients who underwent HNS for benign and malignant conditions between January 2015 and June 2022 were reviewed in terms of demographic data, comorbidities, and reasons for hospital return. Results Out of 1,030 cases, 119 (11.55%) returned to the hospital within 60 days after discharge, 19 of which (1.84%) were readmitted. In total, 90 (8.74%) patients returned to the OPD, and 29 (2.82%), to the ED. The common reasons for readmission included infections (26.32%) and neurological symptoms (21.05%). For OPD visits, the common causes were hematoma (20%) and neurological symptoms (14.44%). For ED returns, the frequent causes were neurological symptoms (20.69%) and equipment issues (17.24%). Compared with nonreadmitted patients, readmitted patients had a higher preoperative baseline health burden when examined using the American Society of Anesthesiologists (ASA) score (p = 0.004) and the Cumulative Illness Rating Scale (CIRS; p = 0.002). Conclusion The 60-day rates of unplanned hospital return to the OPD and ED were of 8.74% and 2.82% respectively, and 1.84% of the patients were readmitted. Hematoma, infections, and neurological symptoms were common causes. Addressing the common reasons may be beneficial to decrease postoperative hospital visits. [ABSTRACT FROM AUTHOR]

Introduction: Concomitant chemoradiation with cisplatin is standard treatment for non-metastatic head and neck cancers, but often limited by toxicities, especially deranged renal function and hearing complications. This leads to limited cycles of cisplatin due to challenges in administration and is not suitable for patients with poor renal function and hearing issues. Need of the study: Not enough data is available for patients who are not suitable for cisplatin administration along with radiation either due to sensitivity to cisplatin or the adverse effects mentioned earlier. Docetaxel has been recently observed to benefit such patients in overall response outcome including Disease Free Survival (DFS) and Overall Survival (OS) when administered concurrently with radiation. Improved clinical response with minimal toxicity to normal tissue is seen with docetaxel, as it is a phase-specific agent. Therefore, this would be a good alternative to Cisplatin in patients with deranged kidney function and sensorineural hearing loss. Aim: To estimate the adverse event profile and compliance of docetaxel with radiation. Methodology: This prospective observational study will be conducted in the department of Medical Oncology and Radiation Oncology at Sidharth Gupta Memorial Cancer Hospital, Datta Meghe Institute of Medical Sciences, Sawangi (M), Wardha, Maharashtra, India, starting from May 2024 to May 2025. Patients with pathologically confirmed non-metastatic Head and Neck Squamous Cell Carcinoma (HNSCC), who are planned for Concurrent Chemoradiation (CCRT) but not suitable for cisplatin, will receive concurrent weekly docetaxel at a dose of 15 mg/sqm. Radiotherapy (RT) will be delivered according to the institutional protocol, daily dose of 200 cGy for five days a week will be given. Continuous monitoring during treatment will include weekly clinical evaluations, regular blood tests (haemoglobin, blood counts, renal functions), and grading of adverse events (CTCAE v5 criteria). Treatment response will be assessed via clinical evaluation and CECT scans (RECIST v1.1). Statistical analysis will be performed using Statistical Package for Social Sciences (SPSS) version 26.0 and will involve analysis of categorical variables with Chi-square and Fisher-exact tests, and continuous variables with unpaired t-tests and Analysis of Variance (ANOVA). Time to event analysis will be done using the Kaplan-Meier method with p-value <0.05 considered significant. [ABSTRACT FROM AUTHOR]

Objectives: About 17% of patients with human papillomavirus (HPV)‐positive head and neck squamous cell carcinoma (HNSCC), which is mainly comprised of oropharyngeal SCC (OPSCC), will experience disease recurrence, which is often considered incurable when manifested at a metastatic and/or recurrent stage. We conducted a critical qualitative systematic review. Our objectives were to provide an overview of the molecular landscape of recurrent/metastatic HPV‐positive HNSCC as well as novel molecular biomarkers. Design: A literature review was conducted to identify studies reporting on the molecular characteristics of recurrent/metastatic HPV‐positive HNSCC, novel molecular biomarkers and treatment options. The reviews of abstracts, full articles, and revision of the included studies, followed by data extraction and quality assessment were performed by three independent assessors. All primary literature, such as retrospective, prospective, and clinical trials as well as basic research studies were considered, and the final search was conducted at the end of February 2023. The level of evidence was rated using the guidelines published by the Oxford Centre for Evidence‐based Medicine and quality was assessed using the Newcastle‐Ottawa Scale criteria. Results and Conclusions: The literature search resulted in the identification of 1991 articles. A total of 181 full articles were screened, and 66 articles were included in this analysis. Several studies reported that recurrent/metastatic HPV‐positive HNSCC had higher rates of TP53 mutation and were genomically similar to HPV‐negative HNSCC. The detection of circulating tumour tissue‐modified HPV DNA (ctHPVDNA) as a specific biomarker has shown promising results for monitoring treatment response and recurrence in the subset of HPV‐positive HNSCC. In addition, evidence for targeted therapy in recurrent/metastatic HPV‐positive HNSCC has emerged, including agents that inhibit overexpressed EGFR. Studies of combination immunotherapy are also underway. Our review outlines the latest evidence on the distinct molecular profiles of recurrent/metastatic HPV‐positive HNSCC as well as the clinical potential of ctHPVDNA testing in routine practice. More controlled and longitudinal studies are needed to identify additional molecular targets and to assess the performance and benefits of novel molecular biomarkers in clinical practice. [ABSTRACT FROM AUTHOR]

Introduction: Head and Neck Cancer (HNC) ranks sixth among the most common men’s tumours. The prevalence of HNC in children has increased in several countries, and the prevalence varies worldwide. In several regions in Brazil and the world, a lack of epidemiological data records on childhood HNC is observed, demonstrating little knowledge about the demographic profile of these patients. Aim: To determine the prevalence of HNC in paediatric patients over the years at a reference centre in the North region of Brazil. Materials and Methods: A cross-sectional study was conducted with the objective of quantitatively and qualitatively analysing the prevalence of HNC in a reference oncology hospital. The electronic medical records of patients aged 0 to 19 years were reviewed at a referral centre in Northern Brazil from October 2015 to February 2022. Demographic variables, topographic location of tumours, city of origin, patient outcome, and histopathological diagnosis were collected. Results: A total of 4,113 medical records were analysed, and 126 met the criteria for analysis. Males had a higher incidence n=75 (59.52%) of HNC than females n=51 (40.47%). The age group with the highest percentage of HNC was > 4 to 9-year-old n=40 (31.74%). The most common diagnosis were lymphoma 78 (61.90%), sarcoma 22 (17.46%); carcinoma 14 (11.11%), and histiocytosis 10 (7.93%). Conclusion: In Northern Brazil, the most common tumour was Hodgkin’s lymphoma, and the most prevalent group affected were males aged > 4-9-year-old.

Introduction: Head and Neck Cancer (HNC) ranks sixth among the most common men's tumours. The prevalence of HNC in children has increased in several countries, and the prevalence varies worldwide. In several regions in Brazil and the world, a lack of epidemiological data records on childhood HNC is observed, demonstrating little knowledge about the demographic profile of these patients. Aim: To determine the prevalence of HNC in paediatric patients over the years at a reference centre in the North region of Brazil. Materials and Methods: A cross-sectional study was conducted with the objective of quantitatively and qualitatively analysing the prevalence of HNC in a reference oncology hospital. The electronic medical records of patients aged 0 to 19 years were reviewed at a referral centre in Northern Brazil from October 2015 to February 2022. Demographic variables, topographic location of tumours, city of origin, patient outcome, and histopathological diagnosis were collected. Results: A total of 4,113 medical records were analysed, and 126 met the criteria for analysis. Males had a higher incidence n=75 (59.52%) of HNC than females n=51 (40.47%). The age group with the highest percentage of HNC was > 4 to 9-year-old n=40 (31.74%). The most common diagnosis were lymphoma 78 (61.90%), sarcoma 22 (17.46%); carcinoma 14 (11.11%), and histiocytosis 10 (7.93%). Conclusion: In Northern Brazil, the most common tumour was Hodgkin's lymphoma, and the most prevalent group affected were males aged > 4-9-year-old. [ABSTRACT FROM AUTHOR]

Thyroid cancer (TC) is the first malignant tumor in endocrine glands, and it is estimated that by 2030 it will be in the top five cancers worldwide. In Chile, TC was recently included as pathology No. 82 with Explicit Health Guarantees, which implies allocating significant public and private resources to the treatment of patients with a cancer that is on the rise. There are groups of young patients with small tumors that present a more aggressive clinical behavior, where decision-making could be advanced. Specifically, a group of patients under 55 years of age with tumors less than 2 cm in size but with regional metastases, that lack indication for radioiodine therapy and could require complementary treatment or present a worse evolution. Clinical and molecular tools to guide appropriate treatment in patients with lymph node metastases are limited and have not been updated. There are tumorigenicity and prognostic factors, such as EpithelialMesenchymal Transition (EMT) and Cancer Stem Cells (CSC) markers that have been incorporated into the study of other tumors and recently in thyroid cancer. Studies linking EMT and CSC with TC currently point to molecular and genetic description, with few reports clinically correlating these findings (particularly in subgroups with particular characteristics of aggressiveness) and proposing them as tumorigenicity and prognosis markers. The description of these biomarkers in the described population could facilitate decision-making regarding follow-up, surgical therapy, and radioiodine therapy. [ABSTRACT FROM AUTHOR]

Objective: To report our experience, and success rate for head and neck reconstruction in a Chilean oncologic center. Methods: Charts were reviewed retrospectively for all patients treated surgically for head and neck tumors that needed a free flap reconstruction from 2007 to 2020. The demographics and epidemiologic variables were described. Overall survival was calculated with the Kaplan-Meier method. Results: One hundred and eighty-six operations were performed on 173 patients; the median age was 59 years, and 55% were male. Twenty-nine percent of patients required a surgical rescue. The most frequently used free flaps were the anterolateral thigh, fibula osteocutaneous, and radial forearm. A second free flap was needed in 13 patients. Five-year overall survival for the whole cohort was 44.3% and varied according to histology: 28.2% for squamous cell carcinoma and 68.9% for salivary gland histology. Discussion: In analysis of our results in two seven-year periods (2007-2013 and 2014-2020), the percentage of flaps that failed decreased (10% earlier versus 2.6% later; p =.012); the length of hospital stay declined (median 23 days earlier vs 18 days later; p =.041), and the use of anterolateral thigh flaps increased 14% vs 29%, taking advantage of the versatility of the anterolateral thigh flap for the fabrication of multiple skin palettes, allowing for more complex reconstructions. Conclusion: In our institution, outcomes with free flap reconstruction for head and neck were satisfactory and improved with operator experience. [ABSTRACT FROM AUTHOR]

Background: Head and neck dermatofibrosarcoma protuberans (HNDFSP) is extremely rare and not entirely understood. Objective: To investigate the clinicopathological features of HNDFSP and identify the expression of its clinically relevant indicators, with the expectation of improving the existing treatment strategies. Methods: A long‐term follow‐up of patients with HNDFSP who received treatment between 2000 and 2021 at Shanghai Ninth People's Hospital was conducted. The clinical, histological, and immunohistochemical data of the patients were retrieved and analyzed. The endpoint of the study was the incidence of significant disease‐related clinical events (recurrences or metastasis). Results: A total of 49 patients with HNDFSP were included in the study, with males (92.7%) predominating than females (7.3%). Eighteen patients developed recurrent disease (36.8%) after surgery, and the median time of recurrence was 48 months (interquartile, 20–74 months). Metastasis occurred in two cases (4.1%). Two patients died during follow‐up, both with local recurrence, and one of them with intestinal metastasis. Post‐operation radiotherapy was administered to eight patients (16.3%) and the effect in local control was remarkable. Age, tumor size, and negative margins with sufficient safety width were the main independent factors affecting the disease‐free survival. Several potential targeted therapeutic indicators, including EZH2 (80.0%), EGFR (91.4%), PDGF (97.1%), PD‐L1 (77.1%), and VEGF (77.1%), were positively expressed in most tumor samples. Conclusion: HNDFSP is rare, significantly challenging to control locally, and has a worse prognosis with current treatment strategies. Wide local excision and long‐term follow‐up are needed. Radiotherapy could improve the prognosis of patients with HNDFSP. [ABSTRACT FROM AUTHOR]

Background: The evolution of radiotherapy over recent decades has reintroduced the hypofractionation for many tumour sites with similar outcomes to those of conventional fractionated radiotherapy. The use of hypofractionation in locally advanced head and neck cancer (LAHNC) has been already used, however, its use has been restricted to only a few countries. The aim of this trial was to evaluate the safety and feasibility of moderate hypofractionated radiotherapy (HYP-RT) with concomitant cisplatin (CDDP). Objectives: To evaluate the efficacy of hypofractionated radiotherapy in advanced unresectable head neck cancer, in terms of response rate and evaluate the local and systemic toxicities of hypofractionated regimen with symptomatic improvement of radiotherapy and treatment compliance. Methods: A total of 50 cases of locally advanced head and neck cancer (stage cT4b and/or N3) without any evidence of distant metastasis were included in this study. These 50 cases were randomly distributed into study and control group containing 25 each. Radiotherapy consists of a single fraction of 6 Gy Per week for a total of 6 weeks. If the patient received less than 6weeks of treatment, he/she was excluded from study. Total dose given was 36 Gy in 6 fractions. All the patients were treated by unilateral or bilateral portal till 24 Gy and then off cord planning was done. Patients with complete disease regression after initially planned 36 Gy (BED-57.6Gy, considering alpha/beta of 10 and corresponding EQD2-48Gy) were offered further dose escalation depending upon tumour regression status, tolerability and toxicity according to institutional guidelines. Partial responders are given no treatment up to end of treatment period. Results: Among the study and control group, incidence of carcinoma of tonsil was 12% and 20%, carcinoma of base of tongue was 24% and 16%, carcinoma larynx 16% and 24%, respectively and Hematological toxicities (reference to blood hemoglobin level), Renal (reference to blood urea) were assessed according to WHO toxicity criteria in all cases weekly up to six weeks Among the study and control group, 8% and 12% had no acute hematologic reactions (χ² = 0.22, p > 0.05), 56% and 48% had grade I hematologic reactions (χ² = 0.32 p > 0.05,), 28% and 36% had grade II hematologic reactions (χ² = 0.36, p > 0.05) and 8% and 4% had grade III hematologic reactions (χ² = 0.35, p > 0.05) respectively. No patient had had grade IV hematological toxicity. Among the study and control group, 80% and76% had no acute renal toxicity. (χ² = 0.11, p > 0.05), 20% and 24% had grade I hematologic reactions (χ²= 0.11 p > 0.05). No patients from either group develop grade II, III and IV renal toxicity. Conclusions: HYP-RT with concomitant CDDP was considered feasible for LAHNC, and the rate of acute toxicity was comparable to that of standard concomitant chemoradiation. A feeding tube was necessary for most patients during treatment. Further investigation of this strategy is warranted. [ABSTRACT FROM AUTHOR]

Introduction: Fine needle aspiration cytology is a simple, rapid, cost-effective method in diagnosis of head and neck swelling with minimal risk of complications. Head and neck swellings include a broad spectrum of diseases with different management for each. Fine needle aspiration cytology is a suitable and useful method for assessment of these swelling. This study was done with the objective to study the frequency and distribution of various head and neck lesions detected by fine needle aspiration cytology. Methods: A descriptive cross-sectional study was conducted at the Department of Pathology in a tertiary care center from February 1 to July 31, 2023 after obtaining ethical approval from Institutional Review Committee (Reference number: IRC-PA-191/2078-79). All the patients presenting with head and neck swelling during the study period were included in this study. Total sampling was done. Fine needle aspiration was done and cytological diagnosis was made. Descriptive analysis was done where frequency and percentage were calculated. Results: Out of 112 cases included in the study, 43 (38.40%) were of lymph nodes, 36 (32.14%) of thyroid, 22 (19.64%) of skin and soft tissue and 11 (9.82%) of salivary glands. Among the lymph nodes cases, there were 11 (25.57%) metastases. In thyroid lesions, beingn lesions were seen in 24 (66.68%). Conclusions: This study found that lymph nodes were the most common site for head and neck swellings, frequently involving metastatic lesions.

Introduction Unplanned hospital returns are frequent and may be preventable.

Patients with head and neck cancer (HNC) have ongoing pain but Stellate ganglion block which is a sympatholytic block may be a viable therapy for treating it. The data were retrospectively collected from five histopathologically confirmed HNC patients who had completed chemotherapy and radiation doses. Stellate ganglion block was given to these patients and was subsequently monitored for 3 months to assess pain alleviation and overall satisfaction. Over a 3-month period, there was a decrease in the pain levels with a better quality of life so the stellate ganglion block can be a promising modality for reducing the pain of HNC.

Respiratory epithelial adenomatoid hamartoma (REAH) in the head and neck is a rare benign lesion containing glandular tissue covered with ciliated respiratory epithelium. In the head and neck, REAH of the nasal cavity, paranasal sinuses, and nasopharynx have been reported in literature. Due to rareness of REAH and insufficient knowledge of its imaging features, the diagnosis can be challenging when we encounter a non-specific cystic mass at an uncommon site in the head or neck. Here, we report the case of a pathologically confirmed REAH showing a cystic mass centered at the buccal space (retromaxillary fat pad) with CT and MRI findings.

Patients with head and neck cancer (HNC) have ongoing pain but Stellate ganglion block which is a sympatholytic block may be a viable therapy for treating it. The data were retrospectively collected from five histopathologically confirmed HNC patients who had completed chemotherapy and radiation doses. Stellate ganglion block was given to these patients and was subsequently monitored for 3 months to assess pain alleviation and overall satisfaction. Over a 3-month period, there was a decrease in the pain levels with a better quality of life so the stellate ganglion block can be a promising modality for reducing the pain of HNC. [ABSTRACT FROM AUTHOR]

The enhanced recovery after surgery (ERAS) pathway is designed to facilitate recovery after surgery by packaging evidence-based protocols specific to each aspect of the perioperative period, including the preoperative, intraoperative, postoperative, and post-discharge periods. The ERAS pathway, which was originally developed for use with colonic resection, is now being expanded to include a variety of surgical procedures, and the ERAS Society has published a consensus review of the ERAS pathway for head and neck surgery with free tissue transfer reconstruction (HNS-FTTR). The ERAS pathway for HNS-FTTR consists of various important protocols, including early postoperative mobilization, early postoperative enteral nutrition, abolition of preoperative fasting, preoperative enteral fluid loading, multimodal pain management, and prevention of postoperative nausea and vomiting. In recent years, meta-analyses investigating the utility of the ERAS pathway in head and neck cancer surgery have also been presented, and all reports showed that the length of the postoperative hospital stay was reduced by the implementation of the ERAS pathway. The ERAS pathway is now gaining traction in the field of head and neck surgery; however, the details of its efficacy remain uncertain. We believe the future direction will require research focused on improving the quality of postoperative patient recovery and patient satisfaction. It will be important to use patient-reported outcomes to determine whether the ERAS pathway is actually beneficial. [ABSTRACT FROM AUTHOR]

Neoplasms of the maxilla have multiple different origins and histology, and often extend towards the infratemporal fossa, orbit, or skull base. Extensive resection may be required, often leading to poor esthetic and functional results. Usually, these lesions are removed via a transfacial approach. The aim of this study was to compare the outcomes of the transoral versus transfacial approach for maxillary tumors. A single-institution retrospective study was conducted on patients with maxillary-midface tumors, treated between January 2009 and December 2019. The patients were divided into two groups according to the surgical approach, transfacial or transoral, and the following outcomes were assessed: extent of the resection based on Brown's classification; postoperative pathology margin assessment; reconstruction technique; esthetic/functional results. A total of 178 patients were included. A satisfactory resection was obtained in both groups, with the transoral cohort achieving a higher rate of clear oncological margins (positive margins: transoral group 3.7% versus transfacial group 6.8%, P = 0.389) and a significantly higher University of Washington Quality of Life score (mean 72.2 versus 67.8, P < 0.001). Even large and invasive tumors can be treated successfully with the transoral approach, avoiding unesthetic facial scars while still providing complete resection of the tumor. [ABSTRACT FROM AUTHOR]

Sclerosing microcystic adenocarcinoma (SMA) is an uncommon neoplasm of the oral cavity, with only 14 reported cases documented in the literature. We present a case of SMA in a 65-year-old woman with a history of high-grade lymphoma who developed clear cell changes in the deep muscular layer of the tongue. Currently, the diagnosis of SMA relies on careful morphological evaluation and the exclusion of other potential differential diagnoses. [ABSTRACT FROM AUTHOR]

Malignant salivary glands tumors are uncommon and comprise a series of peculiar histological types, being mucoepidermoid carcinoma (MEC) the most frequent. Malignant salivary glands tumors have different prognostic factors and depend on particularly location, stage and histological type. Generally, the major glands are most affected, mainly parotid, however, MEC can occur in minor salivary glands of oral cavity being more common in palate and rare in other locations. The present report describes two cases of asymptomatic ulcerated nodules, occurring in retromolar region of a 45 and 70-year-old Caucasians women, users of inferior partial prosthesis. Incisional biopsies were performed and the diagnostic of low-grade MEC were established. Both patients were treated with surgery, and one patient received selective neck dissection and adjuvant radiotherapy. Although the clinical appearance of palate MEC is widely recognized, few reports illustrate the clinical aspect of MEC in the retromolar trigone and, therefore, the present report highlights two cases of MEC with a peculiar clinical presentation.

Head and Neck Lymphedema (HNL) is one of the complications of Head and Neck Carcinoma (HNC). It can be a consequence of the disease progression or can occur as a complication of HNC management. HNL patients not only have facial disfigurement but also have psychological effects and poor quality of life. Severe lymph edema can cause impairment in speaking, chewing, and hearing. The gold standard treatment for HNL is Complete Decongestive Therapy (CDT). We present a case of a 59-year-old male with metastatic squamous cell carcinoma of the tongue who came with complaints of painless and gradual swelling of the face, lips, eyelids, and neck leading to doubling of the head size. He had severe lymphedema of the head and neck which was refractory to treatment.

Introduction: Radiotherapy is one of the treatment modalities for the treatment of head and neck cancer (HNC). However, it leads to the development of chronic and acute side effects. These side effects impact negatively on the patient’s quality of life and oral functioning. This clinical review aims to provide basic information about HNC, understand the impact of radiotherapy on oral health, and explain the role of dental care providers for HNC patients during the pre-and post-radiotherapy time. Materials and Methods: Electronic databases (i.e., PubMed, Scopus, and Google Scholar) were searched using defined keywords. The main inclusion criteria were any studies describing “dental management of patients with head and neck cancer” and “dental management of patients treated with radiotherapy.” Results: Thematic analysis was used to summaries the findings of the included studies (n = 102) into main headings and subheadings. All studies were published between 1970 and 2023. Conclusion: The number of HNC patients is increasing. This necessitates the need for raising the awareness of dental care providers to the side-effects of HNC therapy which includes treatment with radiotherapy, chemotherapy, and/or surgery. Dental care providers should understand the common side-effects and their treatments besides their role in the pre- (i.e., dental extraction of teeth with poor prognosis and maintaining good oral hygiene) and post- (i.e., oral rehabilitation and post-HNC dental care) radiotherapy dental care.

Trismus secondary to head and neck neoplasm treatment impacts upon quality of life, nutrition, oral hygiene, and dentition. Current treatment options for trismus apply unquantified force to the jaw, and in many cases, the device costs are prohibitive. This study aimed to prospectively evaluate the impact of a novel trismus device. This single arm cohort study prospectively evaluated the impact of a novel trismus device on maximal incisal opening (MIO), trismus-related function and quality of life scores. Seventeen patients diagnosed with trismus were recruited to undergo a 10-week program using a novel device. The effect of the intervention was assessed by comparing pre- vs post-intervention validated measures. A significant improvement in MIO was observed post the 10-week intervention period (12.6 mm). This was associated with an improvement in patient reported trismus symptomology including quality of life, swallowing, speech, and jaw pain. This pilot study demonstrates the feasibility of a novel device in the treatment of trismus. Further evaluation of this device is warranted to assess efficacy, safety, and cost-effectiveness in a larger cohort with appropriate controls. [ABSTRACT FROM AUTHOR]

Objective: During the first wave of the COVID-19 pandemic in 2020, nonessential health services were suspended in Belgium, and the public was ordered to socially isolate. Underdiagnosis of cancer during this period was reported worldwide. Certain risk factors for head and neck cancer (HNC) overlap with those for COVID-19 incidence and mortality, making underdiagnosis and subsequent stage shift of this potentially rapidly progressing cancer a major concern. We aimed to analyze incidence, clinical stage at presentation, and survival of patients diagnosed with HNC in 2020 in Belgium, considering recent temporal trends. Methods: Using population-based data from the Belgian Cancer Registry (BCR), we extrapolated 2017-2019 trends in incidence, clinical stage, and 1-year relative survival (1yRS) of HNC to create an expected value for 2020 and compared this to the observed value. Results: There were 9.5% fewer HNCs diagnosed in 2020, compared to the predicted incidence. Underdiagnosis was larger for males (-11.8%), patients aged 50-64 (-11.2%) and 65-79 (-11.1%), and for oral cavity cancer (-17.6%). Shifts to more advanced stages were observed in larynx and oropharynx tumors and for (male) patients aged 80+. A 2.4 percentage point decline in 1yRS was observed, relative to the increasing trends in 1yRS (2017-2019). Conclusion: The COVID-19 pandemic led to underdiagnosis of HNC, resulting in shifts to more advanced stage at presentation in certain subgroups. A stage shift can be expected for the 9.5% of tumors not yet diagnosed at the end of 2020. HNC patients diagnosed in 2020 suffered higher than expected mortality. [ABSTRACT FROM AUTHOR]

Head and Neck Lymphedema (HNL) is one of the complications of Head and Neck Carcinoma (HNC). It can be a consequence of the disease progression or can occur as a complication of HNC management. HNL patients not only have facial disfigurement but also have psychological effects and poor quality of life. Severe lymph edema can cause impairment in speaking, chewing, and hearing. The gold standard treatment for HNL is Complete Decongestive Therapy (CDT). We present a case of a 59-year-old male with metastatic squamous cell carcinoma of the tongue who came with complaints of painless and gradual swelling of the face, lips, eyelids, and neck leading to doubling of the head size. He had severe lymphedema of the head and neck which was refractory to treatment. [ABSTRACT FROM AUTHOR]

Background: The squamous cell carcinoma (SCC) of the posterior pharyngeal wall (PPW) is associated with poor oncological outcomes based on current literature data. We reported the preliminary outcomes of a potential new treatment protocol based on neoadjuvant chemotherapy (NCT) and transoral robotic surgery (TORS). Methods: A retrospective single-center case series was performed including a total of 20 patients diagnosed with a SCC of the PPW between October 2010 and September 2021. All patients successfully completed TORS with neck dissection after NCT. Adjuvant treatment was performed in the presence of adverse pathologic features. Loco-regional control (LRC), overall survival (OS), and disease-specific survival (DSS) were defined as the time from surgery to tumor recurrence or death, as appropriate. Survival estimates were calculated by Kaplan–Meier analysis. Surgical data and post-operative functional outcomes were also reported. Results: Estimated 3-year LRC, OS, and DSS rates (95% Confidence interval) were 59.7% (39.7–89.6), 58.6% (38.7–88.8), and 69.4% (49.9–96.6). The median hospital stay was 21 days (IQR 17.0–23.5). Oral diet and decannulation were achieved after a median of 14 days (IQR 12.0–15.0). Feeding tube and tracheostomy dependence after 6 months was observed in 3 (15%) and 2 (10%) patients, respectively. Conclusions: The use of NCT followed by TORS for PPW SCC treatment appears to have good oncological and functional outcomes for both early and locally advanced cancers. Further randomized trials and site-specific guidelines are needed. [ABSTRACT FROM AUTHOR]

Objective: The outbreak of the COVID-19 pandemic had a considerable impact on the healthcare access, treatment, and follow-up of oncologic patients. The aim of this study was to evaluate how the COVID-19 pandemic has affected consultation and follow-up demand as well as treatment volume at Brazilian Head and Neck Surgery centers. Methods: An anonymous online questionnaire was used for collection of data across all Brazilian Head and Neck Surgery Centers across a 3-month period (April‒June 2021). This information included the characteristics of each center, and the perceived self-reported impact of the COVID-19 pandemic on academic activities, residency training, and the diagnosis, treatment, and follow-up of patients with Head and Neck diseases between 2019 and 2020. Results: The response rate across the 40 registered Brazilian Head and Neck Surgery Centers was 47.5% (n = 19). The data showed a significant reduction in the total number of consultations (24.8%) and number of attending patients (20.2%) between 2019 and 2020. The total number of diagnostic exams (31.6%) and surgical procedures (13.0%) conducted over this period also decreased significantly. Conclusions: The COVID-19 pandemic had a significant national impact on Brazilian Head and Neck Surgery Centers. Future studies should examine the long-term effects of the pandemic on cancer treatment. Level of evidence: Evidence from a single descriptive study.

Abstract Introduction The incidence of oral tongue squamous cell carcinoma (OTSCC) is increasing. OTSCC is comparatively higher in our region owing to the consumption of tobacco, beetle nut, alcohol, and poor oral hygiene. There is paucity of survival data for OTSCC from our high-burden region. Background There is paucity of survival data for OTSCC from our high-burden region, we aimed to determine 5-year overall and disease-free survival of patients with OTSCC. Methods A retrospective chart review was conducted for all the patients treated for oral tongue squamous cell carcinoma from January 2000 and December 2013. The data on overall survival and disease-free survival was collected via telephonic interviews up till 2018. Kaplan Meier curves were plotted to graphically represent survival. Results A total of 131 patients were included. The mean age of the patients was 49.4 ± 12.98 years, with most patients being male (65.9%). The most common tumor stage was T2 (55.1%) and the most common nodal stage was N0 (57.7%). Five-year disease-free survival was 59.2%, and overall survival was 60.7%. Overall survival dropped steeply from 84.4 to 7.5% in patients who developed recurrence in our cohort. Conclusion The most significant factor influencing the survival of patients with OTSCC is tumor recurrence. 5-year recurrence-free survival was 84.4% which is greater than reported in literature. This could be due to the low incidence of perineural and perivascular invasion in our population. Further research on factors leading to recurrence should be done.

ABSTRACT Objective: radiotherapy can lead to different adverse effects in the oral epithelial cells. This article aimed to address the main oral manifestations associated with radiotherapy of head and neck neoplasms, highlighting the importance of the dental practitioners’ participation within the skilled multidisciplinary personnel to treatment. Methods: Research was conducted in the PubMed, Lilacs, SciELO, and Google Scholar databases using the keywords “head and neck radiotherapy”, “oral manifestations’’, and “head and neck neoplasm”. Eighteen out of 533 articles published between 2015 and 2022 were selected after duplicates removal and eligibility criteria application. Results: xerostomia, hyposalivation, trismus, dysgeusia, dysphagia, dentin hypersensitivity, fungal and viral infections, radiation caries, osteoradionecrosis, mucositis, periodontal alterations, and tooth development abnormalities were the most frequently reported oral effects of radiotherapy. Conclusions: The participation of dentists in the multidisciplinary team that treats patients with head and neck cancers is fundamental since several oral complications of radiotherapy are observed. Dentists can prevent, reduce and treat some detrimental effects whether the patient is followed-up since the beginning of radiotherapy.

Objectives: Fatigue due to cancer is a challenging symptom that might be long‐lasting after cancer treatment. The aim of this study was to follow the development of fatigue among head and neck cancer (HNC) patients prospectively and longitudinally and to analyze predictors for acute and chronic fatigue. Methods: HNC patients treated with curative intent were included at diagnosis and completed the following questionnaires multiple times, up to 5 years after treatment: the EORTC QLQ‐FA12 for fatigue, EORTC QLQ‐C30, and HNC‐specific EORTC QLQ‐H&N35 together with an anxiety and depression questionnaire. Predictors of fatigue were evaluated at 3 months and 5 years after treatment. Results: Of the 311 study participants, 74% responded at the 5‐year follow‐up. Physical fatigue was significantly worse 3 months after treatment, while emotional and cognitive fatigue were the worst at diagnosis and at 3 months. All fatigue domains were significantly better after 1 year, and the fatigue scores remained stable from 1 until 5 years after treatment. Three months after chemoradiotherapy, physical fatigue was more significant, but no long‐term differences due to treatment modalities were found. Depression and anxiety were predictors for chronic emotional fatigue, and local HN pain and swallowing problems were predictors for chronic physical fatigue. Better global quality of life at diagnosis was associated with less physical and emotional fatigue. Conclusion: Fatigue was worst in the short term for HNC patients and improved after 1 year, and long‐term fatigue remained stable up to 5 years after treatment. A few predictors for chronic fatigue were found. Level of Evidence: 3 Laryngoscope, 133:2211–2221, 2023 [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the use of the head and neck cancer risk calculator version 2 in a primary care setting and to evaluate the impact of the risk calculator on the number of referrals stratified by urgency and cancer yield. Method: Referrals between April 2019 and August 2019, April 2020 and July 2020 (pre-risk calculator) and August 2020 and July 2021 (post-risk calculator) were analysed. Referral urgency, head and neck cancer risk calculator version 2 score, cancer diagnosis, cancer type and further investigations were recorded. Results: The 2023 patient encounters were analysed; there were 1110 (55 per cent) referrals before head and neck cancer risk calculator version 2 use and 913 (45 per cent) after head and neck cancer risk calculator version 2 use. A higher proportion of older (p < 0.001) and male (p < 0.013) patients were seen post-head and neck cancer risk calculator version 2 use. All cancer cases were seen on the urgent suspicion of cancer pathway post-head and neck cancer risk calculator version 2 use; however, a higher proportion of patients were seen as urgent suspicion of cancer (51.1 vs 83.5 per cent; p < 0.001). Overall, the cancer diagnosis rate increased from 2.7 to 4.1 per cent. Conclusion: The head and neck cancer risk calculator version 2 had high sensitivity in cancer diagnosis. More studies are required to optimise the predicted versus actual cancer probability gap. [ABSTRACT FROM AUTHOR]

Radiotherapy is one of the treatment modalities for the treatment of head and neck cancer (HNC). However, it leads to the development of chronic and acute side effects. These side effects impact negatively on the patient's quality of life and oral functioning. This clinical review aims to provide basic information about HNC, understand the impact of radiotherapy on oral health, and explain the role of dental care providers for HNC patients during the pre-and post-radiotherapy time. Electronic databases (i.e., PubMed, Scopus, and Google Scholar) were searched using defined keywords. The main inclusion criteria were any studies describing "dental management of patients with head and neck cancer" and "dental management of patients treated with radiotherapy." Thematic analysis was used to summaries the findings of the included studies (n = 102) into main headings and subheadings. All studies were published between 1970 and 2023. The number of HNC patients is increasing. This necessitates the need for raising the awareness of dental care providers to the side-effects of HNC therapy which includes treatment with radiotherapy, chemotherapy, and/or surgery. Dental care providers should understand the common side-effects and their treatments besides their role in the pre- (i.e., dental extraction of teeth with poor prognosis and maintaining good oral hygiene) and post- (i.e., oral rehabilitation and post-HNC dental care) radiotherapy dental care. [ABSTRACT FROM AUTHOR]

To define if positive and close surgical margins are associated to worse prognosis in patients who underwent transoral robotic surgery (TORS) after neoadjuvant chemotherapy (NCT). A retrospective cohort study was carried out at a tertiary referral center. The primary outcome was local-regional control (LRC), and the results were summarized with hazard ratios (HR) and 95% confidence intervals (CIs). A total of 308 patients (median age: 62.0, IQR: 55.0–68.2) were included. Univariable analysis showed a significant reduced LRC for patients with positive margins (HR = 1.82, 95% CI: 1.02–3.24). However, they were not associated with worse LRC after adjusting for adverse tumor variables (HR = 0.81, 95% CI: 0.40–1.65). ROC analysis was performed on 123 patients with negative margins (AUC: 0.54) measuring an optimal threshold of 1.25 mm (sensitivity = 60.0%; specificity = 50.5%). Univariable analysis showed non-significant differences between close and wide negative margins (HR = 1.44, 95% CI: 0.59–3.54). A positive surgical margin is not an independent predictor of tumor control and survival. A threshold of 1.25 mm was identified as the most appropriate to define close margins, but no difference was measured after distinguishing negative margins in close and wide margins. [ABSTRACT FROM AUTHOR]

Background: The American Joint Committee on Cancer (AJCC) system is the most acceptable staging method. In this study, an attempt has been made to evaluate the survival rate of laryngeal cancer based on the AJCC and T and N integer scores (TANIS). Methods: In this prospective cohort study, from March 2004 to March 2021, laryngeal cancer patients who were considered for nonsurgical treatment were included. Radiation alone was considered for T1-T2 lesions without nodal involvement. Sequential or concomitant chemoradiation (based on physician choice) was considered for locoregionally advanced patients (T3/T4 or node positive). The 2-year, 5-year and 10-year overall survival (OS) and progression-free survival (PFS) rates were estimated using Kaplan-Meier method. Cox -Regression method was used for covariates analysis. Results: The 2-year, 5-year and 10-year overall survival (OS) rates in all patients were estimated to be 82%, 70% and 41%, respectively. The 2-year, 5-year and 10-year progression-free survival (PFS) rates in all patients were estimated to be 78%, 59% and 41%, respectively. The 5-year OS rates for stages I, II, III, IVa, and IVb were 83, 84, 51, 12, and 19 percent, respectively. The 5-year OS rates for TANIS 1, 2, and 3 were 85, 62 and 53 percent, respectively. Based on multivariate analysis, the group stage (p=0.001), TANIS group (p=0.003) and tumour subsite. (p=0.006) were independently effective in survival rates. Conclusion: TANIS-3 can simply predict the prognosis of non-surgically treated laryngeal cancers. The separation of different prognostic groups by TANIS is better than the AJCC system. More extensive studies are necessary to confirm this. [ABSTRACT FROM AUTHOR]

Background: Replacement of missing teeth is not a straightforward task in head and neck cancer (HNC) patients post-radiotherapy. There is debate regarding the best way to care for these patients as it has been reported that using dentures by HNC patients after receiving treatment with radiotherapy might initiate the development of osteoradionecrosis. Aim: This rapid review aimed to collate and compare the national and international guidelines for the use of dentures following radiotherapy for HNC patients. Materials and methods: Three steps were included in data collection of this rapid review (first step; identification of dental and relevant non-dental associations/societies, second step, identification of national and international guidelines regarding the dental management of HNC patients, and third step; identification of recommendations about the replacement of missing teeth in HNC patients). Results: In the 193 countries recognized by the United Nations, there were 238 relevant societies found, from those 175 confirmed that they do not have clear guidelines. Only 32 associations/societies (all in either Europe and North America) recommend guidelines for their dentists (N = 12 guidelines) about the dental management of HNC patients and show their position regarding the use of dentures for HNC patients after receiving treatment with radiotherapy. Conclusions: There are very few guidelines and those that do exist differ, lack detail, and rarely go beyond routine advice. Accordingly, clear, detailed, and evidence-based guidelines are required to inform the management of patients with missing teeth following radiotherapy for HNC patients.

Purpose: Head and neck cancer (HNC) is one of the fastest increasing cancer-types, where both disease and oncologic treatment have severe impact on health-related quality of life (HRQL). This study aimed to report HRQL prospectively up to 5-years following radiotherapy-treatment in HNC and to, if possible, identify trends in HRQL over time. Methods: This prospective study followed 211 patients receiving curatively intended radiotherapy pre-diagnosis, 3-, 6-, 12- and 60-months post-radiotherapy completion. HRQL was measured using EORTC QLQ-C30 and EORTC QLQ-HN35. Results: A deterioration three months post-radiotherapy was reported in 14/15 domains of EORTC QLQ-C30. Eight out of 12 domains had recovered to baseline-values at 12 months post-radiotherapy and remained unchanged up to study endpoint. Corresponding figures for EORTC QLQ-HN35 were deteriorations in 15/16 domains at three months post-radiotherapy, with recovery of 5 domain at 12-months, whereas the other 11 domains remained significantly worse at 5-years post-RT compared to baseline. Conclusion: Following the deterioration in HRQL seen immediately following radiotherapy, the continued course of HRQL can be divided into three trends: short-term deterioration, long-term deterioration and long-term improvements. The combination of disease- and diagnosis-specific questionnaires is crucial when assessing HRQL in the HNC population. [ABSTRACT FROM AUTHOR]

Background: Previous studies have highlighted the unmet nutritional and supportive care needs of patients with head and neck cancer (HNC) and their carers from diagnosis and throughout the treatment and survivorship period. The aim of this study was to bring patients, carers and healthcare professionals together to co‐design a framework to improve access to nutrition information and support for patients and carers with HNC from diagnosis and throughout the treatment and survivorship period. Methods: Using experience‐based co‐design (EBCD), semistructured individual interviews were conducted with patients, carers and healthcare professionals to understand their experiences in accessing information and support outside of the hospital environment. Feedback events and co‐design workshops were held to prioritise areas for service improvement. Results: Participants (10 patients, 7 carers and 15 healthcare professionals) highlighted the importance of having consistent information and support recommendations from the multidisciplinary team. The two key areas for improvement identified through group and workshop events were linking reputable HNC resources to a HNC portal on the hospital website and the development of a series of short podcasts and video blogs with fact sheets attached presented by members of the multidisciplinary team, patients and carers at four time points spanning pretreatment and throughout the survivorship period. Conclusions: Using EBCD has enabled the co‐design of a framework for resource development with patients, carers and healthcare professionals to improve access to information and resources to support nutrition intake and supportive care needs for patients with HNC with their carers. Development and implementation of resources and evaluation of outcomes is ongoing. Key point: Using experience‐based co‐design has enabled the co‐design of a framework for resource development to improve access to nutrition care information and support for patients with head and neck cancer and their carers. [ABSTRACT FROM AUTHOR]

ObjectiveDuring the first wave of the COVID-19 pandemic in 2020, non-essential health services were suspended in Belgium, and the public was ordered to socially isolate. Underdiagnosis of cancer during this period was reported worldwide. Certain risk factors for head and neck cancer (HNC) overlap with those for COVID-19 incidence and mortality, making underdiagnosis and subsequent stage shift of this potentially rapidly progressing cancer a major concern. We aimed to analyze incidence, clinical stage at presentation, and survival of patients diagnosed with HNC in 2020 in Belgium, considering recent temporal trends.MethodsUsing population-based data from the Belgian Cancer Registry (BCR), we extrapolated 2017-2019 trends in incidence, clinical stage, and 1-year relative survival (1yRS) of HNC to create an expected value for 2020 and compared this to the observed value.ResultsThere were 9.5% fewer HNCs diagnosed in 2020, compared to the predicted incidence. Underdiagnosis was larger for males (-11.8%), patients aged 50-64 (-11.2%) and 65-79 (-11.1%), and for oral cavity cancer (-17.6%). Shifts to more advanced stages were observed in larynx and oropharynx tumors and for (male) patients aged 80+. A 2.4 percentage point decline in 1yRS was observed, relative to the increasing trends in 1yRS (2017-2019).ConclusionThe COVID-19 pandemic led to underdiagnosis of HNC, resulting in shifts to more advanced stage at presentation in certain subgroups. A stage shift can be expected for the 9.5% of tumors not yet diagnosed at the end of 2020. HNC patients diagnosed in 2020 suffered higher than expected mortality.

Disease Overview: Lymphomas, both Hodgkin’s and non-Hodgkin’s lymphomas, are one of the most common cancers in the head and neck area. The extra-nodal variant of lymphoma is rare, but it is the most common non-Hodgkin’s lymphoma (ENHL). Furthermore, it is difficult to diagnose due to its non-specific clinical and radiological features, which can mimic other benign or malignant clinical manifestations. The study: This retrospective study involved 72 patients affected by head and neck ENHL in the period between 2003 and 2017. All patients underwent a diagnostic-therapeutic procedure according to the guidelines, and a 5-year follow-up. Based on the location of the swelling at the time of diagnosis, patients were divided into two groups: oral and non-oral ENHLs. Statistical analysis was performed using Kaplan–Meier analysis with the log-rank test. In addition, Fisher’s exact test was applied to the two groups to evaluate and compare variances (the acceptable significance level was set at p < 0.05). Conclusion: ENHL with oral localization is much more aggressive than ENHL with non-oral localization, with a death rate of 40% (versus 4.76 for the non-oral one). In fact, between the two groups, there is a statistically significant difference in mortality, with a p-value of 0.0001 and 0.0002, respectively.

Background: Locally advanced head and neck cancer (LAHNC) can significantly impact the quality of life of patients in various ways. However, several factors can contribute to the decrease in quality of life. In Thailand, there is limited knowledge about the factors that affect the quality of life of patients with LAHNC before they receive treatment. Objective: This study aimed to examine the correlations between Palliative Performance Scale (PPS), family income, body mass index (BMI), age, comorbidity index, and the quality of life of patients with LAHNC before they undergo treatment. Methods: A correlational cross-sectional study was conducted, and data were collected from 94 pretreatment patients with LAHNC who were admitted to a cancer center in central Thailand using purposive sampling. The data collection instruments included a demographic data form, a medical record form, the Charlson Comorbidity Index (CCI), the Palliative Performance Scale (PPS), and the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) version 4. Descriptive statistics, Pearson’s correlation, and Spearman’s rank correlation were used to analyze the data. Results: All study participants completed the questionnaire. The results showed that the overall quality of life of the patients was moderate. PPS, family income, and body mass index were moderately positively correlated with quality of life (r = 0.494, p

Aims: To assess the association between length of dental arch and oral health‐related quality of life in head and neck cancer patients post‐radiotherapy. Methods: Thirty head and neck cancer participants reported their oral health‐related quality of life using the oral health impact profile‐14 instrument and their global self‐rating of general and oral health. All patients had received chemotherapy and radiotherapy. The length of dental arch was assessed in three tooth relational categories: canine‐to‐canine, shortened (premolars to premolars), and long (molars to molars) dental arches. Inclusion of participants for any of the three categories required verification of opposing teeth relationship with Shim Stock paper. Results: Out of 30 head and neck cancer patients, eight (27%) had a canine‐to‐canine dental arch, 14 (46%) had a shortened dental arch, and eight (27%) had a long dental arch. The median oral health impact profile‐14 scores for participants respectively with the canine‐to‐canine dental arch was six (IQR = 9.25), seven (IQR = 8) for participants with shortened dental arch, and 11 (IQR = 12.5) for participants with long dental arch. There were no significant differences in oral health impact profile‐14 scores between the three‐tooth relational groups (Kruskal‐Wallis H = 0.769, df = 2, P‐value =.681). Similarly, there were no significant differences between three‐tooth relational groups on the self rating of general (Chi‐squared = 1.714, df = 2, P‐value =.424) and oral health (Chi‐squared = 1.393, df = 2, P‐value =.498). Conclusion: Within the limitations of this study, no association was found between the length of dental arch and oral health‐related quality of life in head and neck cancer patients post‐radiotherapy. Other factors such as dry mouth, oral mucositis, loss of taste, and trismus should be considered as contributory factors to reduced oral health‐related quality of life in head and neck cancer patients post‐radiotherapy, particularly in relation to eating difficulties. [ABSTRACT FROM AUTHOR]