Primary Transoral Robotic Surgery +/‐ Adjuvant Therapy for Oropharyngeal Squamous Cell Carcinoma – a large observational single‐centre series from the United Kingdom

xlomafota13 shared this article with you from Inoreader Primary Transoral Robotic Surgery +/‐ Adjuvant Therapy for Oropharyngeal Squamous Cell Carcinoma – a large observational single‐centre series from the United Kingdom Via Clinical Otolaryngology Abstract Objectives To analyse the oncological outcomes following primary Transoral Robotic Surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC). Design Observational case series. Setting Tertiary centre; first TORS practice to commence in the UK. Participants All consecutive patients undergoing primary TORS with curative intent, with or without adjuvant treatment. Main outcome measures Descriptive analysis of patient and tumour pathology variables. Survival outcomes: Overall, Disease‐Specific, Progression‐Free, and Locoregional control. Results The cohort comprised of 120 patients undergoing TORS with minimum 12 month follow up data and the following characteristics: mean age 58 years, 91 males (76%), 78 tonsil (65%) and 34 base of tongue primaries (28%), 89% HPV related OPSCC. The surgical pathology revealed 14 (12%) with positive margins, 19 (16%) had close margins < 2mm and 31% with extranodal extension. The treatment was as follows: 39 (33%) treated with TORS alone, 50 (42%) received adjuvant radiotherapy, and 31 (26%) received adjuvant radiotherapy with chemotherapy. There were 15 recurrences. Estimated survival for all patients at 3 years (95% CI): overall 85% (78‐92), disease‐specific 90% (85‐96), progression‐free 86% (79‐92), locoregional control 90% (84‐96). The equivalent survival figures for the HPV‐related cases alone were: overall 88% (82‐94), disease‐specific 93% (87‐98), progression‐free 88% (81‐95), locoregional control 92% (87‐98). Conclusions Whilst TORS has become a common practice in the management of OPSCC in the UK, these are the first reported oncological outcomes. For selected patients, TORS with or without adjuvant therapy is an appropriate treatment modality. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nasopharyngeal Carcinoma in Dermatomyositis

xlomafota13 shared this article with you from Inoreader Nasopharyngeal Carcinoma in Dermatomyositis Via Clinical Otolaryngology Abstract The most common cancer associated with dermatomyositis in NPC‐endemic populations is NPC. 90% of dermatomyositis patients with NPC were diagnosed with cancer within a year of myositis onset, whereas the most delayed presentation of NPC occurred 22 months after myositis onset. There was a greater proportion of subclinical early‐stage cancer in NPC associated with dermatomyositis compared to general NPC. Dermatomyositis patients with early‐stage NPC have good survival outcomes while those with advanced‐stage NPC appear to have poorer prognosis compared to general NPC patients. Dermatomyositis patients with anti‐transcription intermediary factor (TIF)‐1ƴ antibodies had a 14.5‐fold higher risk of developing associated cancers compared with seronegative dermatomyositis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role of PD‐1/PD‐L1 inhibitors in the treatment of recurrent/metastatic head and neck squamous cell carcinoma: a systematic review and meta‐analysis

xlomafota13 shared this article with you from Inoreader Role of PD‐1/PD‐L1 inhibitors in the treatment of recurrent/metastatic head and neck squamous cell carcinoma: a systematic review and meta‐analysis Via Clinical Otolaryngology Abstract Background The use of immunotherapy to treat recurrent/metastatic squamous cell carcinoma of the head and neck has become a popular research topic in recent years, and many clinical trials have been carried out. Objectives To systematically evaluate the efficacy and safety of PD‐1/PD‐L1 inhibitors in the treatment of recurrent/metastatic head and neck squamous cell carcinoma. Methods We searched PubMed, Embase, Cochrane Library and other databases up to 1 November 2019 for publications reporting the use of PD‐1/PD‐L1 inhibitors in the treatment of squamous cell carcinoma of the head and neck. Revman 5.0 was used for combination analysis, and the overall survival (OS), progression‐free survival (PFS), overall response rate (ORR), and adverse events were determined. Results Five articles were included. Compared with other treatment methods, this meta‐analysis showed that treatment with PD‐1/PD‐L1 inhibitors can significantly improve OS (P < 0.0001), but there was no significant improvement in PFS or ORR. The risk of anaemia and nausea was significantly reduced by treatment with PD‐1/PD‐L1 inhibitors. Conclusions and Significance Treatment with PD‐1/PD‐L1 inhibitors alone can improve the overall survival rate for recurrent/metastatic squamous cell carcinoma of the head and neck but there is no obvious advantage in other aspects and adverse events. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A systematic review of outcomes of remote consultation in ENT

xlomafota13 shared this article with you from Inoreader A systematic review of outcomes of remote consultation in ENT Via Clinical Otolaryngology Abstract Aims Remote or tele‐consultation has become an emerging modality of consultation in many specialities, including ENT. Advantages include increasing accessibility, potential to reduce costs and, during the COVID‐19 pandemic, reduced risk of infection transmission. Here, we systematically collate and synthesise the evidence base on outcomes from remote consultation in adult and paediatric ENT services. Methods We performed a review in accordance with PRISMA guidelines. We searched Medline and Embase for relevant articles. Outcomes include specific patient pathway efficiency measures (including number of healthcare visits, lead time, touch time and handoff), patient/clinician satisfaction, cost analysis and safety implications. Results From 6325 articles screened, 53 met inclusion criteria. Publications included studies on remote consultation for initial, preoperative and follow‐up assessment (including postoperative). In most instances, remote consultation reduced costs and time from referral to assessment and was associated with high patient satisfaction. However, a face‐to‐face follow‐up appointment was required in 13%‐72% of initial consultations, suggesting that remote consultation is only appropriate in selected cases. Conclusion Remote consultation is appropriate and preferable for ENT consultation in specific conditions and circumstances. Future research should look to better define those conditions and circumstances, and report using recognised quality standards and outcome measures. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Patient perspectives on recall period and response options in patient reported outcome measures for chronic rhinosinusitis symptomatology

xlomafota13 shared this article with you from Inoreader Patient perspectives on recall period and response options in patient reported outcome measures for chronic rhinosinusitis symptomatology Via Clinical Otolaryngology Abstract Objective Patient reported outcome measures (PROMs) for assessment of chronic rhinosinusitis (CRS) employ a variety of recall periods and response scales for reporting CRS symptom burden. CRS patient perspective is unknown with respect to recall periods and response scales in PROMs. Design Cross‐sectional study. Setting Tertiary rhinology clinic. Participants 63 adults with CRS. Main outcome measures Participants were asked to choose which CRS symptom recall period – one day, two weeks, one month, or greater than one month – was most reflective of their current disease state and best to base treatment recommendations (including surgery) upon. Participants were also asked to report on which of six response scales (one visual analogue scale [VAS] and five Likert scales ranging from four to eight items) was easiest to use and understand, and most preferred. Results A majority of participants felt the current state of their CRS symptoms was best reflected by a recall period of two weeks to one month; however, patients preferred that recommendations about treatments, including endoscopic sinus surgery, be determined by symptoms experienced over at least a one‐month period. Participants generally found the VAS and seven‐item Likert scale to be the easiest to use and understand, and their most preferred scales. No patient characteristics associated with preferences for recall periods or response scales. Conclusion Future PROMs for CRS symptoms should consider assessment of symptoms over a one‐month time frame and use either a VAS or seven‐item Likert response scale to optimally balance reflection of current disease state, need for intervention and patient preference. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Referral pattern of oral and maxillofacial surgery cases

xlomafota13 shared this article with you from Inoreader Referral pattern of oral and maxillofacial surgery cases in Sudan: A retrospective age-and sex-specific analysis of 3,478 patients over four years Via Head and neck cancers by Musadak Ali Karrar Osman, Mohammed Hassan Ibrahem Aljezoli, Mohamed Alfatih Mohamed Alsadig, Ahmed Mohamed Suliman Oral and maxillofacial surgery (OMFS) is a specialty widening in its scope. An objective analysis of the referral pattern can provide essential information to improve healthcare. This four-year retrospective study was implemented in Khartoum Teaching Dental Hospital. Data (age, sex, diagnosis, and type of treatment) were collected from patient records. Disease frequency, as well as the effect of sex and age, were analyzed for each group. The frequency of treatment types was also assessed. Data were collected from a total of 3,478 patients over the four-year study period. There was a male predominance with the third decade of life being the most common age group. Pathological diseases were the most common (37%) reason for referral, followed by trauma (31%). Temporomandibular joint (TMJ) disorders and dentoalveolar extraction were the least frequently observed. Open reduction and internal fixation (ORIF) was the most commonly performed procedure (28%). These data represent the epidemio logy of oral and maxillofacial diseases in Sudan. Given that the third decade of life is the most represented age group, it is beneficial to learn the long-term consequences of these diseases in these young patients and to use modern surgical techniques to improve their lives. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Preventing cerebral spinal fluid leakage following endoscopy through a burr hole using a novel watertight closure: technical note

xlomafota13 shared this article with you from Inoreader Preventing cerebral spinal fluid leakage following endoscopy through a burr hole using a novel watertight closure: technical note Via leak of cerebrospinal fluid Br J Neurosurg. 2021 Mar 29:1-3. doi: 10.1080/02688697.2021.1903392. Online ahead of print. ABSTRACT BACKGROUND: Cerebrospinal fluid (CSF) leakage is a common complication after neuroendoscopic surgery through a burr hole and can lead to further complications including infection. METHODS: We describe the use of a dural substitute larger than the burr hole itself, placed over the burr hole and then secured underneath a burr hole cover by microscrews running through the graft itself into the underlying skull. RESULTS: This simple technical modification contributes to achieving a watertight seal to aid in preventing CSF leakage in this setting. CONCLUSIONS: Our technical modification of endoscopy through a burr hole may help to prevent postoperative CSF leak and secondary CSF infections. PMID:33779446 | DOI:10.1080/02688697.2021.1903392 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.