Head and Neck-Journal for the Sciences and Specialties of the Head and Neck最新文献

Aim: Antiresorptive therapy (ART) is commonly used in osteoporotic patients to prevent bone loss. This retrospective cohort study aimed to identify the risk factors associated with medication-related osteonecrosis of the jaw (MRONJ) in osteoporotic patients receiving dental extraction during ART.

Materials and methods: Data were collected from 937 patients with 1067 dental extractions conducted between January 2003 and May 2022, including 519 patients on oral alendronate, 276 on denosumab, and 172 on zoledronate. Multivariate logistic regression analysis was employed to assess potential risk factors.

Results: Regression model analysis revealed older age (AOR 1.09 per year; 95% CI, 1.06-1.12) and drug treatment exceeding 24 months (AOR 2.07; 95% CI, 1.29-3.30) as significant risk factors. A drug interruption of 3 or more months prior to tooth extraction lowered MRONJ risk (AOR 0.11; 95% CI, 0.07-0.17). Stratified by drug type, denosumab users had significantly lower risk of MRONJ after extraction (AOR 0.14; 95% CI, 0.07-0.27) compared to those on other medications. Factors of drug duration ≥ 24 months, < 3 months of interruption, and posterior mandibular tooth extraction posed the highest synergistic MRONJ risk (AOR 80.29; 95% CI, 33.05-195.09).

Conclusion: Our results suggest an association between a three-month ART interruption prior to tooth extraction and reduced MRONJ risk, especially in long-term ART patients undergoing posterior mandibular extractions. However, these findings require validation through prospective randomized controlled trials.

Clinical relevance: Scientific Rationale for Study: The study fills crucial knowledge gaps regarding MRONJ risks in osteoporotic patients undergoing dental extraction during antiresorptive therapy (ART), providing a foundation for informed clinical decisions.

Principal findings: Noteworthy findings include elevated MRONJ risk with older age and prolonged ART, the protective effect of a 3-month ART interruption, and denosumab users showing significantly reduced postextraction MRONJ risk.

Practical implications: Implementing a 3-month ART interruption before dental extraction is recommended to reduce MRONJ occurrences.

Background: REV7 is a multifunctional protein involved in various biological processes, including DNA damage response. REV7 expression in human cancer cells influences sensitivity to DNA-damaging agents, and its high expression level is reportedly associated with a poor prognosis in many carcinomas. However, the significance of REV7 expression in human papillomavirus 16-negative oropharyngeal squamous cell carcinoma (OPSCC) remains unclear.

Methods: REV7 expression was assessed by immunohistochemical analysis in 79 patients with HPV16-negative OPSCC. We evaluated the effects of inhibiting REV7 expression on the proliferation and cisplatin sensitivity of FaDu, an HPV16-negative pharyngeal SCC cell line.

Results: In patients with p16-negative OPSCC, the high-REV7-expression group experienced significantly shorter overall survival than the low-REV7-expression group (p = 0.03) in the Cox regression analysis. Furthermore, REV7-deficient FaDu cells showed suppressed cell growth and enhanced sensitivity to cisplatin in vitro.

Conclusions: REV7 expression is associated with a poor prognosis in HPV16-negative OPSCC.

Background: There is currently a lack of consensus regarding neuropsychiatric symptoms as an indication for parathyroidectomy in primary hyperparathyroidism (pHPT). The purpose of this study is to perform a systematic review and meta-analyses of pre- and postoperative Beck Depression Inventory-II (BDI-II) scores in patients with pHPT undergoing parathyroidectomy.

Methods: A search of the literature was performed using Embase, PubMed, Web of Science, PsycINFO, and OvidAll EBM Reviews. Studies were included if they evaluated BDI-II scores in pHPT patients before and after parathyroidectomy.

Results: The literature search returned 1554 studies, of which nine articles met criteria for inclusion. Baseline BDI-II scores were significantly higher in pHPT patients compared to control patients. pHPT patients experienced a statistically significant decrease in BDI-II scores at ≤ 1 and 6 months postoperatively.

Conclusions: Based on the results of this study, a BDI-II score ≥ 14 could potentially advocate for parathyroidectomy in patients with pHPT.

Background: Low skeletal muscle mass (SMM) is a predictive factor for complications in patients undergoing major head and neck cancer surgery. This study aims to identify the predictive value of low SMM for postoperative complications in patients who underwent free forearm flap (FAFF) reconstructions after oral cancer resections.

Methods: A retrospective study was performed with all patients who underwent FFAF between 2003 and 2020 for an oral cavity reconstruction after cancer ablation. Free flap related, any postoperative complications and hospital stay were investigated.

Results: Low SMM was associated with an increased risk of free flap associated complications (OR 2.14; 95% CI 1.02-4.39, p = 0.029). Low SMM was associated with severe complications (Clavien-Dindo ≥ III) (OR 1.46; 95% CI 1.20-2.09, p = 0.02).

Conclusions: Low SMM is a strong predictive factor for free flap related surgical complications in patients undergoing FAFF reconstruction after resection of oral cancer.

Background: Cisplatin (DDP) is one of the commonly used chemotherapeutic drugs for nasopharyngeal carcinoma (NPC) patients, and the resistance of tumor cells to cisplatin is main obstacle for NPC treatment. This study explored effect and possible mechanism of lncRNA small nucleolar RNA host gene 14 (SNHG14) on drug resistance of NPC cells to cisplatin.

Methods: Levels of SNHG14 and Notch2 in NPC tissues and cells were confirmed using RT-qPCR. Western blot detected Notch2 and ABCB1 expression in NPC cells. IC50 of cisplatin-treated NPC cells was tested utilizing 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT). Cell proliferation and apoptosis were evaluated utilizing colony formation experiment and flow cytometry, respectively. RNA immunoprecipitation (RIP) assay was utilized to validate the target genes of U2AF2. Notch2 mRNA stability was tested using actinomycin D.

Results: SNHG14 level was increased in both cisplatin-resistant NPC tissues and cell lines. SNHG14 silencing in HNE1/DDP cells resulted in inhibition of chemoresistance to cisplatin. Conversely, upregulation of SNHG14 in HNE1 cells enhanced their resistance to cisplatin. SNHG14 exhibited an interaction with U2AF2, leading to stabilization of Notch2 mRNA. Finally, Notch2 was involved in SNHG14-mediated cisplatin resistance in NPC cells.

Conclusion: Our findings demonstrate SNHG14 plays a significant role in promoting chemoresistance of NPC cells to cisplatin through U2AF2/Notch2 axis. These results highlight potential therapeutic targets for NPC treatment.

Background: This study aimed to compare the degree of scar contracture following artificial dermis grafting after excision of basal cell carcinoma on the nose categorized by defect location into three nasal subunits.

Methods: Anthropometric analysis was conducted on seven parameters using patients' photographs to compare changes between preoperative and postoperative measurements based on nasal subunits. Defect locations were classified as: (1) dorsum and sidewalls (D zone), (2) tip (T zone), and (3) alar lobule (A zone).

Results: The greatest change in alar height asymmetry was observed in zone A. Changes in nasal tip projection ratio and nasofrontal angle were the most significant in zone T. No other measurements showed statistically significant differences among the three zones.

Conclusions: Careful consideration is recommended when applying artificial dermis grafting in zones A and T. Conversely, zone D appears to be the most suitable for artificial dermis grafting.

Background: Cutaneous squamous cell carcinomas (cSCC) metastasizing to the parotid gland can cause facial nerve (FN) dysfunction secondary to direct invasion, perineural spread, or surgical ablation. This study aims to characterize the prevalence of preoperative FN involvement in metastatic cSCC to the parotid and identify risk factors resulting in FN sacrifice.

Methods: Patients with parotid metastases from cSCC, treated surgically with parotidectomy with curative intent were identified through a retrospective cohort analysis of a prospectively maintained Sydney Head and Neck database from 1992 to 2021.

Results: Of 408 patients identified, 39 (10%) were found to have preoperative FN weakness, of which 41% underwent concurrent temporal bone resection compared to 9.1% for the overall cohort. All patients with preoperative FN weakness underwent FN sacrifice. FN sacrifice occurred in n = 145 (36%), of which 88 (61%) required sacrifice of a trunk or division. The 5-year disease free survival and disease specific survival was worse for patients requiring sacrifice of the FN trunk compared to no sacrifice, however there was no difference in survival for patients requiring sacrifice of the FN division or branch. We found those with > 23.5 mm parotid deposits had an odds ratio of 9.9 for FN sacrifice (95% CI 3.0-32.8, p < 0.001).

Conclusions: Preoperative FN weakness was present in 10% of patients and 36% had some part of the FN sacrificed. There was no significant difference in outcomes for patients with and without preoperative FN weakness. Patients who undergo sacrifice of the FN trunk have worse survival compared to those not requiring FN sacrifice, however similar outcomes were observed in those requiring lessor degrees of FN sacrifice. The likelihood FN sacrifice rises with increasing parotid deposit size.