Journal of Head & Neck Physicians and Surgeons最新文献

{"title":"Oncological outcome following 3-drug neo-adjuvant chemotherapy initiated “Triple regimen” for selected subset of cT4b bucco-alveolar carcinoma with supra-notch infratemporal fossa extension","authors":"Parina Patel, D. Mandlik, K. Gupta, Purvi S. Patel, N. Sharma, A. Joshipura, A. Kaushal, K. Jani, Subhadha Kanhere, Diva S. Shah, D. Shah, G. Vishwakarma, Bijay Newpane, Kaustubh D. Patel","doi":"10.4103/jhnps.jhnps_19_23","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_19_23","url":null,"abstract":"Background: Locally advanced bucco-alveolar complex carcinoma (T4b) with supra-notch (supra-sigmoid notch) infratemporal fossa (ITF) extension is an oncological challenge with poor outcome. We analyzed oncological outcome in patients managed with 3-drug neo-adjuvant chemotherapy (NACT) followed with surgical compartmental resection and adjuvant radiotherapy/Chemotherapy-RT (RT/CTRT), i.e., “Triple regimen.” Materials and Methods: Thirty-three cases of T4b bucco-alveolar complex carcinoma with supra-notch ITF extension were included from June 2009 to January 2017. Patients received 3-Drug NACT for 2–3 cycles every 21 days. Response to NACT was assessed with clinical examination, improvement in symptoms (like improved mouth opening etc.,), and Response Evaluation Criteria in Solid Tumors (RECIST) criterion. Patients showing stable disease and responders on NACT underwent compartmental surgical resection with complete ITF clearance followed by adjuvant RT/CTRT. Data were analyzed using STATA 13 and Kaplan − Meir graphs for survival rates. Results: Thirty-one patients (93.9%) showed response on NACT and subsequently went ahead with surgery. Clinical response according to RECIST criterion and subjective clinical improvement of more than 50% was noted in 18 cases while it was <50% in 13 cases. Seventeen of the 31 patients were disease free at last follow-up. There were no recurrences in ITF. The 3-year disease-free survival and disease-specific survival were 69% and 73%, respectively. Conclusion: Three-drug NACT followed by surgical resection in selected cases who show response to NACT with adjuvant chemoradiation provides a realm of hope for these borderline resectable T4b supra-notch cases.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46263433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A longitudinal cohort study on assessing the impact of COVID-19 pandemic on the mental health of cancer care providers: Developing world scenario","authors":"A. Thaduri, A. Sehrawat, D. Poonia, Anindya Das, Rajesh Kumar, A. Varghese, L. Chadha, R. Seenivasagam, P. Garg, Deepak Sundryal, M. Gupta","doi":"10.4103/jhnps.jhnps_45_22","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_45_22","url":null,"abstract":"Background: COVID-19 is one of the most unfortunate events seen in the 21st century. Cancer care providers (CCPs) are under immense mental burden due to the unpredictable pandemic and compromised cancer care among patients. The pandemic has taken a toll on caregivers, be it physically, mentally, or psychosocially. Hence, a longitudinal study was planned to evaluate the temporal changes and the impact of COVID-19 on CCPs. Subjects and Methods: A prospective longitudinal study was conducted from May 2020 to October 2020 to assess the pandemic's impact on mental health among CCPs. Depression, Anxiety, and Stress Scale-21 and PCL5 instruments were used to identify the temporal change with pandemic evolution. An online survey was administered at 6-week intervals through e-mail. Quantitative data were presented as mean with standard deviation, and an independent t-test was used to compare the mean score between the three surveys. Categorical variables were presented in percentages, and the Chi-squared test was used to analyze the differences in categorical variables between different surveys. Results: The questionnaire was e-mailed to 240 CCP's; 115 responses were valid. The mean age is 29.9 ± 5.86, 62.6% were male and 27.4% were female, 41.7% were nursing staff, and 58.3% were doctors. Sixty-seven percentage had <5 years of medical experience. Respondents who stayed with family had significant depression levels in the first and third surveys (odds ratio [OR]: 0.37, confidence interval [CI]-0.15–0.91, P = 0.03) and (OR: 0.17, CI-0.026–1.1, P = 0.04). Stress levels were significantly high in the caregivers staying with family in the first survey (OR: 4.38, CI: 1.2–15.7, P = 0.02). On analyzing three surveys, 55 respondents in both the first and second survey and 21, 8, and 17 respondents persisted in having depression, stress, and anxiety. Conclusions: Pandemic has severely affected the mental well-being of CCPs, with more than one-third of them suffering from depression, anxiety, and stress. In any disaster or an unnatural event, time helps the human mind acclimate to new conditions; it is similar to our initial results that show improvement in depression, stress, and anxiety levels with the second survey. It is crucial to assess and address mental health-related problems to ensure health-care workers well-being and deliver quality health care to the patients.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48114163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating tumor cells in oral squamous cell carcinoma – Current status of its usefulness in clinical practice","authors":"Geetha Rajalakshmi, K. Pavithran, N. Smitha, S. Iyer","doi":"10.4103/jhnps.jhnps_83_22","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_83_22","url":null,"abstract":"Circulating tumor cells (CTCs) are considered metastatic intermediates that are being shed from the primary tumor which extravasate and circulate in the blood. CTCs are a hotspot of oncological research for the last few decades. It has immense potential in early diagnosis, detecting recurrence, determining chemotherapeutic efficiency as well as individuals' sensitivity toward drugs. CTCs are emerging as an invaluable detection tool in bridging the gap in the transition from a population-based to a personalized approach. These cells may be a future target in refining and personalizing cancer treatment. This review attempts to critically analyze the current understanding of CTCs in oral squamous cell carcinoma and the challenges to its clinical utility at present.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42648394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral health status of individuals affected with chronic kidney disease: A cross-sectional study","authors":"N. Krishnan, S. Kumar, A. Nair, R. Kavitha, M. Govind, M. Remya","doi":"10.4103/jhnps.jhnps_98_22","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_98_22","url":null,"abstract":"Introduction: Kidney diseases can lead to various oral manifestations as a result of systemic diseases which directly or indirectly affecting the kidney. Evidence suggests that in individuals with advanced chronic kidney disease (CKD), periodontal disease also tends to progress. Objective: The objective of this study was to assess the oral health status of individuals with CKD and also to correlate oral health diseases with different stages of CKD. Methods: Oral health status of the patients was obtained from hospital records. Decayed, missing, and filled teeth (DMFT) scores and periodontal status were assessed in these patients. Results: With increasing stages of CKD, loss of attachment also shows an increasing trend, and the correlation was found to be statistically significant (P = 0.015). Mean scores of the highest loss of attachment of stage 5 and stage 4 showed a significant difference in scores with those of stage 3 (P = 0.13 and P = 0.27, respectively). DMFT scores were not found to significantly vary according to CKD stages. Conclusion: In the present study, it was observed that individuals with advanced stages of CKD are more prone to develop periodontal lesions compared to those with mild CKD. Dental caries in individuals affected with CKD are not found to vary according to the severity of the kidney disease.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45163075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerating endoscopic diagnosis by videomics: The synergy of artificial intelligence and clinical endoscopy","authors":"C. Piazza, A. Paderno, Claudia Montenegro, Alessandra Sordi, Francesca Gennarini","doi":"10.4103/jhnps.jhnps_28_23","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_28_23","url":null,"abstract":"Videomics, an emerging interdisciplinary field, harnesses the power of artificial intelligence (AI) and machine learning (ML) for the analysis of videoendoscopic frames to improve diagnostic accuracy, therapeutic management, and patient follow-up in medical practice. This article reviews recent advancements and challenges in the application of AI and ML techniques, such as supervised learning, self-supervised learning, and few-shot learning, in videomics for otolaryngology-head-and-neck surgery. We discuss key concepts and tasks in videomics, including quality assessment of endoscopic images, classification of pathologic and nonpathologic frames, detection of lesions within frames, segmentation of pathologic lesions, and in-depth characterization of neoplastic lesions. Furthermore, the potential applications of videomics in surgical training, intraoperative decision-making, and workflow efficiency are highlighted. Challenges faced by researchers in this field, primarily the scarcity of annotated datasets and the need for standardized evaluation methods and datasets, are examined. The article concludes by emphasizing the importance of collaboration among the research community and sustained efforts in refining technology to ensure the successful integration of videomics into clinical practice. The ongoing advancements in videomics hold significant potential in revolutionizing medical diagnostics and treatment, ultimately leading to improved patient outcomes.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45175042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-grade sarcoma of the hyoid bone: An unusual case illustrating the challenges faced by the pathologist to arrive at a diagnosis","authors":"Alaknanda Gupta, S. Thiagarajan, M. Menon","doi":"10.4103/jhnps.jhnps_84_22","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_84_22","url":null,"abstract":"Our case was a suprahyoid mass in the neck with the probable epicenter in the hyoid bone. Cytopathology of suprahyoid neck masses, without imaging guidance, may lead to misdiagnoses. Imaging was suggestive of the hyoid bone as the probable epicenter. Based on the morphology and IHC findings of the core biopsy, a diagnosis of high-grade sarcoma most likely of myofibroblastic origin was made, which was also confirmed in the main surgical specimen. En bloc surgical excision of the mass was performed preserving the rest of the laryngeal framework and the thyroid gland followed by adjuvant radiotherapy. However, the patient developed distant metastasis within a few months of treatment completion highlighting the high-grade nature of the sarcoma.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41768985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biochemical and molecular characteristics of Porphyromonas gingivalis a key causative pathogen in periodontitis","authors":"Shivani Sachdeva, H. Saluja, A. Mani","doi":"10.4103/jhnps.jhnps_92_22","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_92_22","url":null,"abstract":"Periodontitis is an infection-driven inflammatory disease, which is characterized by gingival inflammation and bone loss. Periodontitis is associated with various systemic diseases, including cardiovascular, respiratory, musculoskeletal, and reproductive system-related abnormalities. The recent theory attributes the pathogenesis of periodontitis to oral microbial dysbiosis, in which Porphyromonas gingivalis acts as a critical agent by disrupting host immune homeostasis. Lipopolysaccharide, proteases, fimbriae, and some other virulence factors are among the strategies exploited by P. gingivalis to promote the bacterial colonization and facilitate the outgrowth of the surrounding microbial community. Virulence factors promote the coaggregation of P. gingivalis with other bacteria and the formation of dental biofilm. These virulence factors also modulate a variety of host immune components and subvert the immune response to evade bacterial clearance or induce an inflammatory environment. The antibody-based concept of P. gingivalis as a causative agent in human periodontitis is based on the humoral immune response; P. gingivalis is probably a causative agent in periodontal disease, and this humoral immune response is probably protective. P. gingivalis fimbriae promote monocytes and macrophage activation. Stimulation of memory T-cells derived from periodontitis patient with P. gingivalis has been shown to induce higher interleukin (IL)-4 production than in healthy controls. The induction of IL-4-producing memory T-cells in peripheral blood tended to coincide with that of autologous periodontitis lesion sites. The article focuses to discuss the virulence factors of periodontal pathogens, especially P. gingivalis, and their roles in regulating immune responses during periodontitis progression.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45069517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Locoregional radiotherapy in metastatic nasopharyngeal cancer – Review article of recent trials","authors":"G. Bora, G. Sarma","doi":"10.4103/jhnps.jhnps_94_22","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_94_22","url":null,"abstract":"Nasopharyngeal cancer (NPC) has a high prevalence in Southeast Asian regions and up to 80% of patients present with locally advanced disease. Almost 10% present with distant metastases, associated with unfavorable outcomes and poor prognosis. With the advent of newer radiotherapy techniques and systemic therapy, a good cure can be achieved in early and locally advanced diseases. However, the mainstay of treatment in metastatic NPC remains to be only palliative chemotherapy. Recently various studies have been conducted to validate the role of local radiotherapy in the locoregional site in a metastatic setting along with systemic therapy. Hence, here, we present a review of the literature supporting the addition of radiotherapy to the locoregional site in metastatic NPC.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49109443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological and demographic profile of salivary gland cancer patients from a tertiary care hospital: An institutional experience","authors":"Aashita, Rajiv Sharma, M. Manikandan, Vikas K Yadav, Abhidha Malik, Pragyat Thakur","doi":"10.4103/jhnps.jhnps_11_23","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_11_23","url":null,"abstract":"Background: Salivary gland cancer is a rare disease of the head-and-neck region. It can arise from either the three major salivary glands or minor salivary glands located throughout the aerodigestive tract. Materials and Methods: This retrospective analysis was performed in the Department of Radiation Oncology in a tertiary care hospital in north India. The records of 49 salivary gland cancer cases over the last 7 years were analyzed for demography and tumor characteristics. Results: In our department, the incidence of salivary gland cancer in the last 7 years was 0.51%. The mean age of presentation of patients with salivary gland cancer was 49.6 years. The male:Female ratio was 2.06:1. Patients presented after a mean symptom duration of 13.6 months in the locally advanced stage. The parotid gland was the most common site of involvement, followed by the submandibular gland. The most common histopathology observed was mucoepidermoid carcinoma and adenoid cystic carcinoma. Other histologies that were found were adenocarcinoma, acinic cell carcinoma, carcinoma ex pleomorphic adenoma, squamous cell carcinoma, mesenchymal tumor, muco-epidermoid carcinoma, salivary duct carcinoma, Hurthle cell carcinoma, malignant melanoma, atypical epitheliodermoid, undifferentiated neoplasm. Conclusion: Due to the heterogeneity of salivary gland tumors, diagnosis and management remains elusive. Multi-centric prospective studies are needed to better understand the disease.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46987544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dr. PA Shah Oration 2022","authors":"Joseph T. S. Wee","doi":"10.4103/jhnps.jhnps_7_23","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_7_23","url":null,"abstract":"","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49056418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}