Pub Date : 2020-07-01DOI: 10.4103/jhnps.jhnps_53_20
S. Rajan, Karthik C. Babu, Pulak Tosh
Introduction: Major head-and-neck surgeries involving wide excision of the tumor usually necessitate reconstruction with free flaps for tissue cover. Even with meticulous fluid management with crystalloids, colloids, albumin, blood, and blood products, many patients become hemodynamically unstable and require the use of vasopressors perioperatively. Objectives: The purpose of this analysis was to assess the safety, role, and present-day trends of the use of vasopressor agents in free flap surgeries and to find any relation of graft rejection or failure of flap surgeries or postoperative complications with perioperative use of such agents. Methods: Reviewing the literature regarding the usage of vasopressors in head-and-neck free flap surgeries, percentage of flap survival, thrombosis of the artery, venous edema, and need for revision surgery were analyzed. Most of the published data had shown that optimizing hemodynamic stability with vasopressors had a more beneficial effect on overall flap perfusion and minimized the complications of iatrogenic fluid overload. The common conclusion was that perioperative vasopressor administration was not detrimental to free flap survival. Conclusion: Based on available data, it is concluded that perioperative use of vasopressors does not adversely affect free flap outcome in patients undergoing head-and-neck reconstructive surgeries and could even be beneficial considering the avoidance of complications of liberal intravenous fluid administration.
{"title":"Effect of intraoperative vasopressor use on free flap outcome following major head-and-neck reconstructive surgeries","authors":"S. Rajan, Karthik C. Babu, Pulak Tosh","doi":"10.4103/jhnps.jhnps_53_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_53_20","url":null,"abstract":"Introduction: Major head-and-neck surgeries involving wide excision of the tumor usually necessitate reconstruction with free flaps for tissue cover. Even with meticulous fluid management with crystalloids, colloids, albumin, blood, and blood products, many patients become hemodynamically unstable and require the use of vasopressors perioperatively. Objectives: The purpose of this analysis was to assess the safety, role, and present-day trends of the use of vasopressor agents in free flap surgeries and to find any relation of graft rejection or failure of flap surgeries or postoperative complications with perioperative use of such agents. Methods: Reviewing the literature regarding the usage of vasopressors in head-and-neck free flap surgeries, percentage of flap survival, thrombosis of the artery, venous edema, and need for revision surgery were analyzed. Most of the published data had shown that optimizing hemodynamic stability with vasopressors had a more beneficial effect on overall flap perfusion and minimized the complications of iatrogenic fluid overload. The common conclusion was that perioperative vasopressor administration was not detrimental to free flap survival. Conclusion: Based on available data, it is concluded that perioperative use of vasopressors does not adversely affect free flap outcome in patients undergoing head-and-neck reconstructive surgeries and could even be beneficial considering the avoidance of complications of liberal intravenous fluid administration.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45375069","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}
Pub Date : 2020-07-01DOI: 10.4103/jhnps.jhnps_54_20
M. Kathar, P. Jain, K. Manikantan, R. Sharan, A. Pattatheyil
Objective: Unlike most head and neck cancers, the presence of distant metastasis (DM) does not preclude curative intent treatment and surgical interventions are common in metastatic disease. This research attempts to study the demographics, patterns of metastasis, and surgical interventions in patients of differentiated thyroid cancer (DTC) with DM. Materials and Methods: The retrospective cohort study of thirty-two patients of DTC with radiologically or histopathologically/cytopathologically confirmed DM who underwent surgery at a tertiary care center from August 2011 to December 2018. Results: The study population comprised of 59% of women and had a median age of 55 (19–79) years. Thorax was the most common site of metastasis, documented in 56% patients, while 53% of patients had bone metastases. Multiple DM were noted in 8 patients. Surgery for metastatic sites was possible in 14 patients (44%), with debulking and spine fixation being the most common surgical intervention for metastasis. The median dose of radioactive iodine (RAI) received by patients was 400 (25–749) mCi in one to four sessions (median-2 sessions). Three patients received conventional chemotherapy, while four received Sorafenib. Conclusion: Metastasectomy in DTC with DM is feasible in selected patients, and surgical interventions are most commonly performed on the spine to prevent neurological complications. RAI ablation is universally administered in this subset of patients and in very high doses, often distributed in multiple sessions. The role of chemotherapy and tyrosine kinase inhibitor is still restricted to palliative settings and cost constraints remain a detriment to more widespread use.
{"title":"Characteristics and patterns of surgical interventions in differentiated thyroid cancer with distant metastasis","authors":"M. Kathar, P. Jain, K. Manikantan, R. Sharan, A. Pattatheyil","doi":"10.4103/jhnps.jhnps_54_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_54_20","url":null,"abstract":"Objective: Unlike most head and neck cancers, the presence of distant metastasis (DM) does not preclude curative intent treatment and surgical interventions are common in metastatic disease. This research attempts to study the demographics, patterns of metastasis, and surgical interventions in patients of differentiated thyroid cancer (DTC) with DM. Materials and Methods: The retrospective cohort study of thirty-two patients of DTC with radiologically or histopathologically/cytopathologically confirmed DM who underwent surgery at a tertiary care center from August 2011 to December 2018. Results: The study population comprised of 59% of women and had a median age of 55 (19–79) years. Thorax was the most common site of metastasis, documented in 56% patients, while 53% of patients had bone metastases. Multiple DM were noted in 8 patients. Surgery for metastatic sites was possible in 14 patients (44%), with debulking and spine fixation being the most common surgical intervention for metastasis. The median dose of radioactive iodine (RAI) received by patients was 400 (25–749) mCi in one to four sessions (median-2 sessions). Three patients received conventional chemotherapy, while four received Sorafenib. Conclusion: Metastasectomy in DTC with DM is feasible in selected patients, and surgical interventions are most commonly performed on the spine to prevent neurological complications. RAI ablation is universally administered in this subset of patients and in very high doses, often distributed in multiple sessions. The role of chemotherapy and tyrosine kinase inhibitor is still restricted to palliative settings and cost constraints remain a detriment to more widespread use.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41309654","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}
Pub Date : 2020-07-01DOI: 10.4103/jhnps.jhnps_59_20
K. Bhattacharya, S. Kulkarni, A. Janu, Anand Jadhav, S. Nair, A. Joshi, N. Khattry, Sudeep Gupta, N. Shetty
Introduction: The coronavirus disease 2019 pandemic has posed numerous challenges to health care across the globe. Time is of the essence in cancer care to prevent disease progression. Materials and Methods: TrueConf ®, a local area network-based software, has been used for holding joint clinic meetings which are an essential part of cancer management at our hospital. Results: A total of 12 meetings were held over a period of 12 weeks where 42 patients were examined and their clinicoradiological evaluation was done. Further treatment decisions were made based on these joint clinics. Conclusion: TrueConf ® is an economical platform and easily implementable system, easing decision-making for critical cases, avoiding crowding in outpatient departments.
{"title":"Conducting interdepartmental tele-joint clinic during the coronavirus disease 2019 pandemic in a tertiary cancer care center","authors":"K. Bhattacharya, S. Kulkarni, A. Janu, Anand Jadhav, S. Nair, A. Joshi, N. Khattry, Sudeep Gupta, N. Shetty","doi":"10.4103/jhnps.jhnps_59_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_59_20","url":null,"abstract":"Introduction: The coronavirus disease 2019 pandemic has posed numerous challenges to health care across the globe. Time is of the essence in cancer care to prevent disease progression. Materials and Methods: TrueConf ®, a local area network-based software, has been used for holding joint clinic meetings which are an essential part of cancer management at our hospital. Results: A total of 12 meetings were held over a period of 12 weeks where 42 patients were examined and their clinicoradiological evaluation was done. Further treatment decisions were made based on these joint clinics. Conclusion: TrueConf ® is an economical platform and easily implementable system, easing decision-making for critical cases, avoiding crowding in outpatient departments.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44246715","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}
Pub Date : 2020-07-01DOI: 10.4103/jhnps.jhnps_57_20
N. Gupta, Shripal Jani, Priya Dubey, Zainab Fidvi, M. Kapre
Introduction: Physiological, functional, and psychological implications of head-and-neck cancer treatment are significant. Improving outcomes in cancer care must include due diligence to quality of life (QOL) along with disease control. This study assesses QOL of head-and-neck cancer patients before and after treatment and explores predictive factors. Materials and Methods: Prospective observational study of consecutive head-and-neck cancer patients. QOL assessments were made at baseline, and different stages of their treatment and prognostic factors such as age, gender, socioeconomic strata, comorbidities, tumor stage, requirement of reconstruction, adjuvant treatment, were examined. EORTC QOL questionnaire-H and N0 35 were employed, and prognostic factor correlation was studied by logistic regression analysis. Results: Ninety-eight patients at least 12 months post-treatment scored worst for dryness of the mouth (33.4), followed by sticky saliva (23.4). Although results steadily improved over time, this did not reach statistical significance (P = 0.235). Stage of the primary tumor, requirement of reconstruction, and adjuvant treatment were statistically significant prognostic factors (P < 0.05). Conclusion: Understanding of QOL parameters would improve treatment planning, counseling of head-and-neck cancer patients and care-givers and enable physical, functional, and social rehabilitation.
{"title":"Prognosticators for quality of life in surgically treated head-and-neck cancer patients","authors":"N. Gupta, Shripal Jani, Priya Dubey, Zainab Fidvi, M. Kapre","doi":"10.4103/jhnps.jhnps_57_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_57_20","url":null,"abstract":"Introduction: Physiological, functional, and psychological implications of head-and-neck cancer treatment are significant. Improving outcomes in cancer care must include due diligence to quality of life (QOL) along with disease control. This study assesses QOL of head-and-neck cancer patients before and after treatment and explores predictive factors. Materials and Methods: Prospective observational study of consecutive head-and-neck cancer patients. QOL assessments were made at baseline, and different stages of their treatment and prognostic factors such as age, gender, socioeconomic strata, comorbidities, tumor stage, requirement of reconstruction, adjuvant treatment, were examined. EORTC QOL questionnaire-H and N0 35 were employed, and prognostic factor correlation was studied by logistic regression analysis. Results: Ninety-eight patients at least 12 months post-treatment scored worst for dryness of the mouth (33.4), followed by sticky saliva (23.4). Although results steadily improved over time, this did not reach statistical significance (P = 0.235). Stage of the primary tumor, requirement of reconstruction, and adjuvant treatment were statistically significant prognostic factors (P < 0.05). Conclusion: Understanding of QOL parameters would improve treatment planning, counseling of head-and-neck cancer patients and care-givers and enable physical, functional, and social rehabilitation.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47702532","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}
Pub Date : 2020-07-01DOI: 10.4103/jhnps.jhnps_28_20
M. Anoop, R. Avtar, W. Akhtar, Y. Yadav
Background: Branchial cleft anomalies are of five types. Among these, second branchial cleft anomalies are the most common developmental disorders. The aim of the study was to evaluate the clinical data in various subsets among the patients who had been diagnosed and treated for second branchial anomalies in the past 2 years. Materials and Methods: The present study was a retrospective study conducted from January 2018 to January 2020 in our institute. We collected the clinical data from patient’s medical records, radiological reports, surgical files, and histopathological reports. Results: A total of 22 patients presented with second branchial cleft anomalies. Among these, 18 (81.8%) were branchial cysts and 4 (18.2%) were branchial sinuses. There was no branchial fistula. The highest number of cases belonged to the second decade (72.7%). The mean age was found to be 16.8 years. The male-to-female ratio was 1.75:1. The rural-to-urban ratio was 3.4:1. There was no proclivity to any one side of the neck. All 22 patients underwent surgical excision as the treatment. There was no recurrence. Conclusion: We concluded that branchial cysts are the main type among second branchial cleft anomalies. Most patients belonged to the second decade of life. Early detection and reaching correct diagnosis are the major factors influencing treatment outcome. Preferably, surgical excision has to be performed in noninfected neck. Meticulous dissection helps in avoiding recurrence. Genetic disorders such as branchio-oto-renal syndrome have to be kept in mind in the evaluation of any branchial cleft anomalies.
{"title":"A Clinical Study of Second Branchial Cleft Anomalies: Our Experience in a Teaching Hospital in Northern India","authors":"M. Anoop, R. Avtar, W. Akhtar, Y. Yadav","doi":"10.4103/jhnps.jhnps_28_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_28_20","url":null,"abstract":"Background: Branchial cleft anomalies are of five types. Among these, second branchial cleft anomalies are the most common developmental disorders. The aim of the study was to evaluate the clinical data in various subsets among the patients who had been diagnosed and treated for second branchial anomalies in the past 2 years. Materials and Methods: The present study was a retrospective study conducted from January 2018 to January 2020 in our institute. We collected the clinical data from patient’s medical records, radiological reports, surgical files, and histopathological reports. Results: A total of 22 patients presented with second branchial cleft anomalies. Among these, 18 (81.8%) were branchial cysts and 4 (18.2%) were branchial sinuses. There was no branchial fistula. The highest number of cases belonged to the second decade (72.7%). The mean age was found to be 16.8 years. The male-to-female ratio was 1.75:1. The rural-to-urban ratio was 3.4:1. There was no proclivity to any one side of the neck. All 22 patients underwent surgical excision as the treatment. There was no recurrence. Conclusion: We concluded that branchial cysts are the main type among second branchial cleft anomalies. Most patients belonged to the second decade of life. Early detection and reaching correct diagnosis are the major factors influencing treatment outcome. Preferably, surgical excision has to be performed in noninfected neck. Meticulous dissection helps in avoiding recurrence. Genetic disorders such as branchio-oto-renal syndrome have to be kept in mind in the evaluation of any branchial cleft anomalies.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45746121","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}
Pub Date : 2020-07-01DOI: 10.4103/jhnps.jhnps_8_20
M. Al-Mendalawi
{"title":"Response to \"Ocular Melanoma: A Rare Entity\"","authors":"M. Al-Mendalawi","doi":"10.4103/jhnps.jhnps_8_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_8_20","url":null,"abstract":"","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44628487","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}
Pub Date : 2020-07-01DOI: 10.4103/jhnps.jhnps_26_20
Shivani Sachdeva, H. Saluja, Amit Mani, Tanupriya Sonkar
Key modulators of inflammation are interleukins (ILs). There is a complex network of interactions in acute and chronic inflammation which is modulated by ILs. Mechanistic explanations for positive and negative interactions between individual ILs will also depend on new insights into the signal transduction pathways for each IL. ILs are the cytokines that act specifically as mediators between leukocytes. Approximately more than 35 ILs have been described, each having unique biological activity and role in periodontal health or disease. It seems quite likely that the lymphocyte may behave in a manner similar as a neuron that receives information from several other neurons and integrates the positive and negative signals and then corresponds accordingly by initiating or refraining from initiating action potential. Like a neuron, the response of the lymphocyte will depend both on the positive and negative signals and also on the nature of their individual signal transduction pathways.
{"title":"Interleukins in Periodontics","authors":"Shivani Sachdeva, H. Saluja, Amit Mani, Tanupriya Sonkar","doi":"10.4103/jhnps.jhnps_26_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_26_20","url":null,"abstract":"Key modulators of inflammation are interleukins (ILs). There is a complex network of interactions in acute and chronic inflammation which is modulated by ILs. Mechanistic explanations for positive and negative interactions between individual ILs will also depend on new insights into the signal transduction pathways for each IL. ILs are the cytokines that act specifically as mediators between leukocytes. Approximately more than 35 ILs have been described, each having unique biological activity and role in periodontal health or disease. It seems quite likely that the lymphocyte may behave in a manner similar as a neuron that receives information from several other neurons and integrates the positive and negative signals and then corresponds accordingly by initiating or refraining from initiating action potential. Like a neuron, the response of the lymphocyte will depend both on the positive and negative signals and also on the nature of their individual signal transduction pathways.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47415985","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}
Pub Date : 2020-07-01DOI: 10.4103/jhnps.jhnps_46_20
D. Mandlik, S. Chopra, D. Balasubramanian, V. Kekatpure, S. Iyer, J. Dabholkar, Kaustubh D. Patel
{"title":"Developing the South Asian region's first head-and-neck surgical oncology multi-institutional program: Journey, milestones, challenges, and future","authors":"D. Mandlik, S. Chopra, D. Balasubramanian, V. Kekatpure, S. Iyer, J. Dabholkar, Kaustubh D. Patel","doi":"10.4103/jhnps.jhnps_46_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_46_20","url":null,"abstract":"","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41872031","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}
Pub Date : 2020-07-01DOI: 10.4103/jhnps.jhnps_21_20
V. Mungutwar, Manya Thakur, Harbans Singh, Sushma Singh, D. Hota
Background: Head-and-neck malignancies are uncommon in childhood unlike in adults, also it contributes to low proportion of overall cancer incidence among children. The number in India has been increasing in the recent past. Hence, we conducted a study to know the pattern of head-and-neck cancers in hospitalized patients of 0–18 years’ age group. Aim: The aim was to study the pattern of different types of head-and-neck malignancies in the pediatric age group (<18 years) in a referral hospital. Subject and Methods: We have conducted an observational study of pediatric head-and-neck malignancies in our tertiary care center. All children in the age group of 0–18 years were included in the study. A total of 72 cases were taken retrospectively and prospectively from various departments of hospital which deal with pediatric patients. Results: Our study comprises total 72 cases, maximum cases were of acute lymphocytic leukemia with secondaries in neck n = 21, followed by 9 cases were of acute myeloid leukemia with secondaries in the neck. Carcinomas of the nasopharynx and parotid both were 8 in number; 15 cases were of Hodgkin/non-Hodgkin lymphoma with involvement of neck nodes. The least number of cases was of carcinoma mandible, Burkitt lymphoma, and chronic myeloid leukemia with secondary neck nodes. Most cases presented with right-sided neck mass or lymphadenopathy. Male-to-female ratio was 1.78:1 in all cases. Most of the cases were diagnosed either by bone marrow aspiration biopsy, fine-needle aspiration cytology, or excisional biopsy. Conclusion: Malignancy is one of the differentials of pediatric neck masses. Hematological malignancies and lymphomas are still two major contributors of head-and-neck cancers in the pediatric age group.
{"title":"Pattern of Head-and-Neck Malignancies in the Pediatric Population","authors":"V. Mungutwar, Manya Thakur, Harbans Singh, Sushma Singh, D. Hota","doi":"10.4103/jhnps.jhnps_21_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_21_20","url":null,"abstract":"Background: Head-and-neck malignancies are uncommon in childhood unlike in adults, also it contributes to low proportion of overall cancer incidence among children. The number in India has been increasing in the recent past. Hence, we conducted a study to know the pattern of head-and-neck cancers in hospitalized patients of 0–18 years’ age group. Aim: The aim was to study the pattern of different types of head-and-neck malignancies in the pediatric age group (<18 years) in a referral hospital. Subject and Methods: We have conducted an observational study of pediatric head-and-neck malignancies in our tertiary care center. All children in the age group of 0–18 years were included in the study. A total of 72 cases were taken retrospectively and prospectively from various departments of hospital which deal with pediatric patients. Results: Our study comprises total 72 cases, maximum cases were of acute lymphocytic leukemia with secondaries in neck n = 21, followed by 9 cases were of acute myeloid leukemia with secondaries in the neck. Carcinomas of the nasopharynx and parotid both were 8 in number; 15 cases were of Hodgkin/non-Hodgkin lymphoma with involvement of neck nodes. The least number of cases was of carcinoma mandible, Burkitt lymphoma, and chronic myeloid leukemia with secondary neck nodes. Most cases presented with right-sided neck mass or lymphadenopathy. Male-to-female ratio was 1.78:1 in all cases. Most of the cases were diagnosed either by bone marrow aspiration biopsy, fine-needle aspiration cytology, or excisional biopsy. Conclusion: Malignancy is one of the differentials of pediatric neck masses. Hematological malignancies and lymphomas are still two major contributors of head-and-neck cancers in the pediatric age group.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45489760","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}
Pub Date : 2020-07-01DOI: 10.4103/jhnps.jhnps_56_20
Nageswara R. Noothanapati, Krishnakumar Thankappan, N. Akali, T. Patel, D. Balasubramanian, S. Iyer
Facial artery is a branch of the external carotid system extending from the upper neck to the nasion. Various flaps are described in the literature based on the facial artery and vein in the neck and face to reconstruct the head-and-neck cancer defects, either superiorly based or inferiorly based. This article summarizes the flaps and their variations based on the facial arteriovenous system. The flap harvest techniques, the indications, advantages and the limitations of the nasolabial flap, facial artery myomucosal flap, and submental flap are described, with appropriate case demonstrations. Variations of the flaps are also discussed.
{"title":"Flaps based on facial arteriovenous system for the reconstruction of head-and-neck cancer defects","authors":"Nageswara R. Noothanapati, Krishnakumar Thankappan, N. Akali, T. Patel, D. Balasubramanian, S. Iyer","doi":"10.4103/jhnps.jhnps_56_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_56_20","url":null,"abstract":"Facial artery is a branch of the external carotid system extending from the upper neck to the nasion. Various flaps are described in the literature based on the facial artery and vein in the neck and face to reconstruct the head-and-neck cancer defects, either superiorly based or inferiorly based. This article summarizes the flaps and their variations based on the facial arteriovenous system. The flap harvest techniques, the indications, advantages and the limitations of the nasolabial flap, facial artery myomucosal flap, and submental flap are described, with appropriate case demonstrations. Variations of the flaps are also discussed.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41768869","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：