HEAD NECK

1. Head-neck rotational movements using DidRen laser test indicate children and seniors’ lower performance  Science.gov (United States) Pitance, Laurent; Brismée, Jean-Michel; Detrembleur, Christine; Dierick, Frédéric 2019-07-25  PubMed Central DOI: 10.1371/journal.pone.0219515  ISSN: 1932-6203  Volume: 14  Issue: 7 Sensorimotor control strategies during cervical axial rotation movements have been previously explored in narrow age ranges but never concurrently in Children and Seniors during a well-standardized task. However, the lifespan developmental approach provides a framework for research in human sensorimotor control of the head-neck complex. A cross-sectional design was used to investigate the influence of age on head-neck dynamic performance adopted by asymptomatic Children, Adults and Seniors using a standardized task (DidRen Laser test). Participants performed 5 cycles of left/right head-neck complex fast rotational movements toward 3 targets with 30° of angular separation. Dynamic performances were computed from total execution time of the test and kinematic variables derived from rotational motion of headmeasured by an optoelectronic system. Eighty-one participants, aged 8–85 yrs, were stratified in four groups: Children, Younger adults, Older adults and Seniors. Children were significantly slower than Younger (phead-neck visually elicited rotational dynamics, especially in Children. These results suggest that age should be taken into account when establishing normative data and assessing dynamic head-necksensorimotor control of patients with neck pain. PMID:31344044 2. A robotic neck brace to characterize head-neck motion and muscle electromyography in subjects with amyotrophic lateral sclerosis. Science.gov (United States) Zhang, Haohan; Chang, Biing-Chwen; Andrews, Jinsy; Mitsumoto, Hiroshi; Agrawal, Sunil 2019-08-07  PubMed DOI: 10.1002/acn3.50864  ISSN: 2328-9503 This paper presents the first study where a dynamic neck brace was used to characterize the head motion of ALS patients while concurrently recording the surface electromyography (EMG) of the neck muscles. Eleven ALS patients and 10 age-matched healthy controls consented and participated in an experiment. Each participant was asked to perform three single-plane motions of the head-neck that included flexion-extension in the sagittal plane, lateral bending in the coronal plane, and axial rotation in the transverse plane. Each motion was performed in a cycle and was repeated five times at self-selected speeds. During single-plane flexion-extension under gravity, compared to healthy peers, ALS patients showed a shorter duration to reach the maximum flexion and an earlier EMG onset in the neck extensors starting from the neutral. The brace measures in activation of the neck muscles in ALS patients were well correlated with clinically measured scores, such as the ALSFRS-r and the FVC. The activation duration of sternocleidomastoid, used to rotate the head, correlated well with the ALSFRS-r and FVC in ALS patients during axial rotation. The ability to synchronously activate a pair of muscles to execute single-plane motions in ALS patients seems to have been compromised due to the disease and potentially results in head drop. The neck brace measures can be adapted in the clinic to complement self-reporting in ALS patients and used to assess the head drop and progress of the disease. © 2019 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc. on behalf of American Neurological Association. 3. Head and neck cutaneous basal cell carcinoma: what should the otorhinolaryngology head and neck surgeon care about? Science.gov (United States) Castanheira, A; Boaventura, P; Clemente, M Pais; Soares, P; Mota, A; Lopes, J M 2019-07-31  PubMed DOI: 10.14639/0392-100X-2245  ISSN: 0392-100X Keywords: Basal cell carcinoma, ENT surgery, Head and neck, Review Carcinoma basocellulare della cute del distretto testa e collo: cosa dovrebbe valutare il chirurgo otorinolaringoiatra e cervico-facciale? 4. Head and neck cancer in living donor liver transplant recipients: Single center retrospective study. Science.gov (United States) Lin, Nan-Chin; Chen, Yao-Li; Tsai, Kuo-Yang 2019-08-01  PubMed DOI: 10.1097/MD.0000000000016701  ISSN: 0025-7974  Volume: 98  Issue: 31  Pages: e16701 The purpose of this study was to investigate the incidence and risk factors of head and neck cancer in living donor liver transplant (LDLT) recipients.This is a retrospective cohort study. A case-matched (1:4) comparison between recipients with and without developed head and neck cancer after LDLT was conducted. The differences between 2 groups were analyzed.The incidence of head and neck malignancy in our cohort was 9 of 453 (1.98%). Their cumulative survival rate was below 60% at 24 months after the diagnosis of head and neck cancer, and no recipients lived for more than 2 years after being diagnosed with stage IV cancer. In the case-control study, univariate analysis revealed that alcohol consumption (odds ratio [OR] = 8.75, 95% confidence interval [CI]: 1.55-49.56) and smoking (OR = 6.71, 95% CI: 1.20- 37.44) were factors associated with the incidence of head and neck cancer after LDLT.In the conclusion, recipients with head and neck cancer after LDLT may have a rather poor prognosis, especially those who are initially diagnosed with advanced-stage disease. Alcohol consumption and smoking may be the predisposing factors to head and neck cancer in LDLT recipients. 5. MET activation confers resistance to cetuximab, and prevents HER2 and HER3 upregulation in head and neck cancer. Science.gov (United States) Novoplansky, Ofra; Fury, Matthew; Prasad, Manu; Yegodayev, Ksenia; Zorea, Jonathan; Cohen, Limor; Pelossof, Raphael; Cohen, Liz; Katabi, Nora; Cecchi, Fabiola; Joshua, Ben-Zion; Popovtzer, Aron; Baselga, Jose; Scaltriti, Maurizio; Elkabets, Moshe 2019-08-01  PubMed DOI: 10.1002/ijc.32170  ISSN: 0020-7136  Volume: 145  Issue: 3  Pages: 748-762 Keywords: MET, cetuximab, drug resistance, head and neck cancer, signaling An understanding of the mechanisms underlying acquired resistance to cetuximab is urgently needed to improve cetuximab efficacy in patients with head and neck squamous cell carcinoma (HNSCC). Here, we present a clinical observation that MET pathway activation constitutes the mechanism of acquired resistance to cetuximab in a patient with HNSCC. Specifically, RNA sequencing and mass spectrometry analysis of cetuximab-sensitive (Cetux Sen ) and cetuximab-resistant (Cetux Res ) tumors indicated MET amplification and overexpression in the Cetux Res tumor compared to the Cetux Sen lesion. Stimulation of MET in HNSCC cell lines was sufficient to reactivate the MAPK pathway and to confer resistance to cetuximab in vitro and in vivo. In addition to the direct role of MET in reactivation of the MAPK pathway, MET stimulation abrogates the well-known cetuximab-induced compensatory feedback loop of HER2/HER3 expression. Mechanistically, we showed that the overexpression of HER2 and HER3 following cetuximab treatment is mediated by the ETS homologous transcription factor (EHF), and is suppressed by MET/MAPK pathway activation. Collectively, our findings indicate that evaluation of MET and HER2/HER3 in response to cetuximab in HNSCC patients can provide the rationale of successive line of treatment. © 2019 UICC. 6. Patient-derived Xenograft Models of Tumor From Patients With Head and Neck Cancer  Science.gov (United States) 2019-08-01  ClinicalTrials.gov Squamous Cell Carcinoma of the Head and Neck 7. Deep learning for automatic tumour segmentation in PET/CT images of patients with head and neck cancers  ArXiv.org Yngve Mardal Moe; Aurora Rosvoll Groendahl; Martine Mulstad; Oliver Tomic; Ulf Indahl; Einar Dale; Eirik Malinen; Cecilia Marie Futsaether 2019-08-02 Full Text Available An automatic segmentation algorithm for delineation of the gross tumour volume and pathologic lymph nodes of head and neck cancers in PET/CT images is described. The proposed algorithm is based on a convolutional neural network using the U-Net architecture. Several model hyperparameters were explored and the model performance in terms of the Dice similarity coefficient was validated on images from 15 patients. A separate test set consisting of images from 40 patients was used to assess the generalisability of the algorithm. The performance on the test set showed close-to-oncologist level delineations as measured by the Dice coefficient (CT: $0.65 \pm 0.17$, PET: $0.71 \pm 0.12$, PET/CT: $0.75 \pm 0.12$). 8. Consumption of minimally processed foods as protective factors in the genesis of squamous cell carcinoma of the head and neck in Brazil Science.gov (United States) Galvão De Podestá, Olívia Perim; Peres, Stela Verzinhasse; Salaroli, Luciane Bresciani; Cattafesta, Monica; De Podestá, José Roberto Vasconcelos; von Zeidler, Sandra Lúcia Ventorin; de Oliveira, José Carlos; Kowalski, Luiz Paulo; Ikeda, Mauro Kasuo; Brennan, Paul 2019-07-25  PubMed Central DOI: 10.1371/journal.pone.0220067  ISSN: 1932-6203  Volume: 14  Issue: 7 Background Head and neck cancer (HNC) is the sixth most common cancer, and two-fifths of cases could be avoided by changing lifestyle and eating habits. Methods This multicenter case-control study was conducted under the International Consortium on Head and Neck Cancer and Genetic Epidemiology, coordinated by the International Agency for Research on Cancer. This consortium evaluated associations between minimally processed food consumption and the risk of HNC in three Brazilian states. Results We evaluated 1740 subjects (847 cases and 893 controls). In multiple analyses including recognized risk factors for HNC, the consumption of apples and pears was associated with reduced risks of oral cavity and laryngeal cancers; the consumption of citrus fruits and fresh tomatoes was associated with a reduced risk of oral cavity cancer; the consumption of bananas was associated with a reduced risk of oropharynx cancer; the consumption of broccoli, cabbage, and collard greens was associated with reduced risks of laryngeal and hypopharyngeal cancers; and the consumption of carrots and fresh fruits was associated with a reduced risk of hypopharyngeal cancer. Conclusions The consumption of a heathy diet rich in fruits and vegetables was associated with a reduced risk of HNC. Public policies, including government subsidies, are essential to facilitate logistical and financial access to minimally processed foods, thereby strengthening environments that promote healthy behavior. PMID:31344089 9. Advancing interdisciplinary research in head and neck cancer through a multicenter longitudinal prospective cohort study: the NETherlands QUality of life and BIomedical Cohort (NET-QUBIC) data warehouse and biobank. Science.gov (United States) Verdonck-de Leeuw, I M; Jansen, F; Brakenhoff, R H; Langendijk, J A; Takes, R; Terhaard, C H J; de Jong, R J Baatenburg; Smit, J H; Leemans, C R 2019-08-05  PubMed DOI: 10.1186/s12885-019-5866-z  ISSN: 1471-2407  Volume: 19  Issue: 1  Pages: 765 Keywords: Biobank, Caregivers, Cohort study, Data warehouse, Head and neck cancer, Health related quality of life, Survival, Symptoms, Toxicity Worldwide, over 500,000 people are diagnosed with head and neck cancer each year, a disease with major impact on life expectancy and quality of life. The purpose of the Netherlands Quality of life and Biomedical Cohort study (NET-QUBIC) is to advance interdisciplinary research that aims to optimize diagnosis, treatment, and supportive care for head and neck cancer patients and their informal caregivers. Using an extensive assessment protocol (electronic clinical record form, patient reported outcome measures and fieldwork (interviews and physical tests)), clinical data and data on quality of life, demographic and personal factors, psychosocial (depression, anxiety, fatigue, pain, sleep, mental adjustment to cancer, posttraumatic stress), physical (speech, swallowing, oral function, malnutrition, physical fitness, neurocognitive function, sexual function), lifestyle (physical activity, nutrition, smoking, alcohol, drugs), and social factors (social function, social support, work, health care use, and costs) are collected and stored in the data warehouse. A longitudinal biobank is built with tumor tissue, blood and blood components, saliva samples, and oral rinses. An infrastructure for fieldwork and laboratory protocols is established at all participating centers. All patients fill out patient reported outcome measures before treatment and at 3, 6, 12, 24, 36, 48, and 60 months follow-up. The interviews, physical tests and biological sample collection are at baseline and 6, 12, and 24 months follow-up. The protocol for caregivers includes blood sampling and oral rinses at baseline and a tailored list of questionnaires, administered at the same time points as the patients. In total, 739 HNC patients and 262 informal caregivers have been included in 5 out of the 8 HNC centers in the Netherlands. By granting access to researchers to the NET-QUBIC data warehouse and biobank, we enable new research lines in clinical (e.g. treatment optimization in elderly patients), biological (e.g. liquid biopsy analysis for relapse detection), health related quality of life (e.g. the impact of toxicity on quality of life), and interrelated research (e.g. health related quality of life in relation to biomarkers and survival). 10. Evaluation of the efficacy of lipotransfer to manage radiation-induced fibrosis and volume defects in head and neck oncology. Science.gov (United States) Griffin, Michelle F; Drago, Jelovac; Almadori, Aurora; Kalavrezos, Nicholas; Butler, Peter E 2019-08-07  PubMed DOI: 10.1002/hed.25888  ISSN: 1043-3074 Keywords: fat grafting, head and neck oncology, lipotransfer, radiation-induced fibrosis, volume defects Multimodality treatment for head and neck cancer leads to substantial functional and esthetic impairment mainly manifested as radiation-induced skin fibrosis (RIF) in combination with volumetric defects and reduction in neck mobility. This study assessed the impact of lipotransfer as part of secondary surgical procedure(s) in patients treated for head and neck malignancies. Retrospective analysis was performed between 2005 and 2016. All patients with a history of head and neck malignancy, multimodal treatment including at least surgery or radiotherapy, and at least 2-year disease-free survival were included. Thirty-eight patients (22 men, 16 women) matched the inclusion criteria. Thirty seven (97%) reported esthetic and functional improvements in their RIF and volumetric defect at follow-up of 32 months. Major improvement in esthetic and functional outcome was reported by 24 (63%) patients and surgeons and minor by 13 patients and surgeons (34%) without causing any complications. Lipotransfer was also found to significantly improve patient's psychological health postoperatively as showed by significant improvements in Derriford Appearance Scale (DAS24), Short Form Health Survey (SF-36), and University of Washington Quality of Life Questionnaire (UW-QOL V4) scores (P head and neck defects. © 2019 Wiley Periodicals, Inc. 11. Interobserver variability in delineation of target volumes in head and neck cancer. Science.gov (United States) van der Veen, Julie; Gulyban, Akos; Nuyts, Sandra 2019-08-01  PubMed DOI: 10.1016/j.radonc.2019.04.006  ISSN: 0167-8140  Volume: 137  Pages: 9-15 Keywords: CTV definition, Contouring, Head and neck, Interobserver variability, Target volume, Volume delineation In the last decade precision of radiotherapy treatment execution increased, demanding more accurate delineations to fully exploit these developments. The aim of this study was to identify the extent of interobserver variability in delineation of head and neck cancer (HNC). In February 2017 all Belgian radiotherapy departments were invited to complete an online survey and submit clinical target volumes for five HNC reference cases. Clinical target volume of the primary tumour (CTVp) and elective nodal neck (CTVe) were submitted and compared between centres for CTVp and to the CTVe 'gold standard' (CTVeGS). Volume, DICE similarity coefficient (DSC) and median Hausdorff Distance (HD) were measured and calculated. Fourteen of 22 centres (64%) completed both survey and delineations. They all used delineation guidelines for CTVe and twelve confirmed the use of guidelines of Grégoire et al. Nine centres used CTVp guidelines, although none used the same ones. Median DSC for CTVe comparing centres with CTVeGS ranged between 0.67 and 0.82 and HD50 between 1.7 mm and 2.8 mm. Good agreement was shown for neck level II, III and IV, whilst worst consensus was observed for level Ib, V, VI, VIIa and VIIb. Improvement of DSC and HD50 was observed when the same levels as CTVeGS were selected. Median DSC and HD50 for CTVp ranged between 0.51 and 0.79 and 2.8 mm and 4.1 mm respectively, which both slightly improved when calculating it for only the centres using a 10 mm margin. Although nearly all participants used identical guidelines for CTVe there were large discrepancies in neck levels selected and volumes delineated. CTVp delineations were also heterogeneous although we expect improvement with implementation of recently published guidelines. Additional teaching in target volume delineation is necessary as this paper demonstrates that availability and implementation of guidelines alone is not enough to guarantee uniform delineation. Copyright © 2019 Elsevier B.V. All rights reserved. 12. Modern radiotherapy for head and neck cancer. Science.gov (United States) Alterio, Daniela; Marvaso, Giulia; Ferrari, Annamaria; Volpe, Stefania; Orecchia, Roberto; Jereczek-Fossa, Barbara Alicja 2019-07-26  PubMed DOI: 10.1053/j.seminoncol.2019.07.002  ISSN: 0093-7754 Keywords: Head and neck cancer, IMRT, Modern radiotherapy, Proton therapy Radiation therapy (RT) plays a key role in curative-intent treatments for head and neck cancers. Its use is indicated as a sole therapy in early stage tumors or in combination with surgery or concurrent chemotherapy in advanced stages. Recent technologic advances have resulted in both improved oncologic results and expansion of the indications for RT in clinical practice. Despite this, RT administered to the head and neck region is still burdened by a high rate of acute and late side effects. Moreover, about 50% of patients with high-risk disease experience loco-regional recurrence within 3 years of follow-up. Therefore, in recent decades, efforts have been dedicated to optimize the cost/benefit ratio of RT in this subset of patients. The aim of the present review was to highlight modern concepts of RT for head and neck cancers considering both the technological advances that have been achieved and recent knowledge that has informed the biological interaction between radiation and both tumor and healthy tissues. Copyright © 2019 Elsevier Inc. All rights reserved. 13. The effects of the orthopedic metal artifact reduction (O-MAR) algorithm on contouring and dosimetry of head and neck radiotherapy patients. Science.gov (United States) Sillanpaa, Jussi; Lovelock, Michael; Mueller, Boris 2019-07-30  PubMed DOI: 10.1016/j.meddos.2019.07.003  ISSN: 1873-4022 Keywords: Head and neck cancer, IMRT, Metal artifact correction, Treatment planning Metallic objects, such as dental fillings, cause artifacts in computed tomography (CT) scans. We quantify the contouring and dosimetric effects of Orthopedic Metal Artifact Reduction (O-MAR), in head and neck radiotherapy. The ease of organ contouring was assessed by having a radiation oncologist identify the CT data set with or without O-MAR for each of 28 patients that was easier to contour. The effect on contouring was quantified further by having the physician recontour parotid glands, previously drawn by him on the O-MAR scans, on uncorrected scans, and calculating the Dice coefficent (a measure of overlap) for the contours. Radiotherapy plans originally generated on scans reconstructed with O-MAR were recalculated on scans without metal artifact correction. The study was done using the Analytical Anisotropic Algorithm (AAA) dose calculation algorithm. The 15 patients with a planning target volume (PTV) extending to the same slice as the artifacts were used for this part of the study. The normal tissue doses were not significantly affected. The PTV mean dose and V95 were not affected, but the cold spots became less severe in the O-MAR corrected plans, with the minimum point dose on average being 4.1% higher. In 79% of the cases, the radiation oncologist identified the O-MAR scan as easier to contour; in 11% he chose the uncorrected scan and in 11% the scans were judged to have equal quality. A total of nine parotid glands (on both scans-18 contours in total) in 5 patients were recontoured. The average Dice coefficient for parotids drawn with and without O-MAR was found to be 0.775 +/- 0.045. The O-MAR algorithm does not produce a significant dosimetric effect in head and neck plans when using the AAA dose calculation algorithm. It can therefore be used for improved contouring accuracy without updating the critical structure tolerance doses and target coverage expectations. Copyright © 2019 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved. 14. Small Cell and Squamous Cell Carcinomas of the Head and Neck: Comparing Incidence and Survival Trends Based on Surveillance, Epidemiology, and End Results (SEER) Data. Science.gov (United States) Bean, Marta B; Liu, Yuan; Jiang, Renjain; Steuer, Conor Ernst; Patel, Mihir; McDonald, Mark William; Higgins, Kristin Ann; Beitler, Jonathan Jay; Shin, Dong Moon; Saba, Nabil F 2019-08-07  PubMed DOI: 10.1634/theoncologist.2018-0054  ISSN: 1083-7159 Keywords: Incidence and survival of head and neck cancer, Small cell carcinoma, Squamous cell carcinoma Small cell carcinomas of the head and neck (SmCCHNs) are rare neoplasms with an unfavorable prognosis. Population-based data describing survival and prognostic factors for SmCCHN are limited. Data were obtained from the U.S. National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database for 1973-2013. Patient and tumor-related characteristics for SmCCHN were compared with those for squamous cell carcinoma of the head and neck (SCCHN). Survival was compared by constructing Kaplan-Meier curves and Cox proportional hazard models with and without propensity score matching. The data set included 609 SmCCHN and 227,943 SCCHN cases. Both histological subtypes were more common in men than women and more common in white patients. SmCCHN was most likely to originate in the larynx, glottis and hypopharynx, or salivary glands and to present with more advanced stage and grade. SCCHN was most likely to originate in the oral cavity and was found infrequently in the salivary glands. Overall 5- and 10-year survival estimates were 27% and 18% for SmCCHN and 46% and 31% for SCCHN, respectively. In multivariable survival analyses adjusting for age, sex, race, marital status, year of diagnosis, stage, grade, and receipt of radiation, the hazard ratio (HR) comparing SmCCHN with SCCHN was 1.53 with a 95% confidence interval (CI) from 1.39 to 1.68. Average 5-year survival varied widely between the histologic types when comparing tumor sites: 14.5% for SmCCHN versus 48.9% for SCCHN in the oropharynx. In propensity score matched analyses, the corresponding HR was 1.27 (95% CI, 1.15-1.40). Compared with SCCHN, SmCCHN carries a worse survival and is more likely to present with more advanced stage. Small cell carcinoma of the head and neck (SmCCHN) is a rare subtype of head and neck cancer. In this Surveillance, Epidemiology, and End Results (SEER) data analysis, the characteristics and survival of SmCCHN are compared with those of the common squamous cell carcinoma of the head and neck. Results show that SmCCHN carries a worse prognosis and tends to present at a more advanced stage; SmCCHN also is ten times more likely to originate from the salivary glands. These findings may have implications for clinical practice, as location of the tumor may strongly associate with the pathologic diagnosis. If a SmCCHN is diagnosed, a disseminated disease is likely; hence vigilance in staging procedures is indicated. © AlphaMed Press 2019. 15. The SEA CHANGE Study: A Self Management Intervention for Head and Neck Cancer Survivors  Science.gov (United States) 2019-08-07  ClinicalTrials.gov Head and Neck Cancer 16. CASP9 c.-1339A>G and CASP3 c.-1191A>G polymorphisms alter susceptibility and clinical aspects of head and neck squamous cell carcinoma. Science.gov (United States) Costa, Ericka Francislaine Dias; Lopes-Aguiar, Leisa; Nogueira, Guilherme Silva; Lima, Tathiane Regine Penna; Rinck-Junior, José Augusto; Lourenço, Gustavo Jacob; Lima, Carmen Silvia Passos 2019-08-01  PubMed DOI: 10.1002/hed.25746  ISSN: 1043-3074  Volume: 41  Issue: 8  Pages: 2665-2670 Keywords: CASP3, CASP9, apoptosis, head and neck squamous cell carcinoma, single nucleotide polymorphisms Single nucleotide polymorphisms (SNPs) in genes that act in intrinsic apoptosis pathway may modulate cancer susceptibility. This study investigated the roles of CASP9 c.-1339A>G (rs4645978) and CASP3 c.-1191A>G (rs12108497) SNPs on risk and behavior of head and neck(HN) squamous cell carcinoma (SCC). DNA of 350 patients with HNSCC and 350 controls was analyzed by polymerase chain reaction method for genotyping. CASP3 c.-1191AG or GG genotype was more common in patients with HNSCC and oral cavity or oropharynx SCC than in controls; carriers of this genotype were under 2.15 and 2.81-fold increased risks of the respective tumors. CASP9 c.-1339AG or GG plus CASP3 c.-1191AG or GG genotypes were associated with oral cavity or oropharynx SCC early onset. These findings present, for the first time, preliminary evidence that inherited abnormalities related to CASP9 c.-1339A>G and CASP3 c.-1191A>G SNPs are determinants of HNSCC risk and clinical aspects. © 2019 Wiley Periodicals, Inc. 17. Factors Associated with Free Flap Failures in Head and Neck Reconstruction. Science.gov (United States) Crawley, Meghan B; Sweeny, Larissa; Ravipati, Prasanti; Heffelfinger, Ryan; Krein, Howard; Luginbuhl, Adam; Goldman, Richard; Curry, Joseph 2019-08-06  PubMed DOI: 10.1177/0194599819860809  ISSN: 0194-5998  Pages: 194599819860809 Keywords: free flap, head and neck reconstruction, surgical complications To investigate causes of failure of free flap reconstructions in patients undergoing reconstruction of head and neck defects. Case series with chart review. Single tertiary care center. Patients underwent reconstruction between January 2007 and June 2017 (n = 892). Variables included were clinical characteristics, social history, defect site, donor tissue, ischemia time, and postoperative complications. Statistical methods used include univariable and multivariable analysis of failure. The overall failure rate was 4.8% (n = 43). Intraoperative ischemia time was associated with free flap failures (odds ratio [OR], 1.062; 95% confidence interval [CI], 1.019-1.107; P = .004) for each addition of 5 minutes. Free flaps that required pedicle revision at time of initial surgery were 9 times more likely to fail (OR, 9.953; 95% CI, 3.242-27.732; P < .001). Patients who experienced alcohol withdrawal after free flap placement were 3.7 times more likely to experience flap failure (OR, 3.690; 95% CI, 1.141-10.330; P = .031). Ischemia time remained an independent significant risk factor for failure in nonosteocutaneous free flaps (OR, 1.105; 95% CI, 1.031-1.185). Alcohol withdrawal was associated with free flap failure in osteocutaneous reconstructions (OR, 5.046; 95% CI 1.103-19.805) while hypertension was found to be protective (OR, 0.056; 95% CI, 0.000-0.445). Prolonged ischemia time, pedicle revision, and alcohol withdrawal were associated with higher rates of flap failure. Employing strategies to minimize ischemic time may have potential to decrease failure rates. Flaps that require pedicle revision and patients with a history of significant alcohol use require closer monitoring. 18. Long Noncoding RNA, ANRIL, Regulates the Proliferation of Head and Neck Squamous Cell Carcinoma. Science.gov (United States) Matsunaga, Natsumi; Wakasaki, Takahiro; Yasumatsu, Ryuji; Kotake, Yojiro 2019-08-01  PubMed DOI: 10.21873/anticanres.13564  ISSN: 0250-7005  Volume: 39  Issue: 8  Pages: 4073-4077 Keywords: ANRIL, CDK inhibitor, cell cycle, head and neck squamous cell carcinoma ANRIL is a long noncoding RNA located on INK4 locus, which encodes p15 and p16 that cause G 1 phase arrest in the cell cycle. ANRIL positively regulates proliferation of several kinds of cancer cells such as lung and gastric cancers. This study, examined the effect of ANRIL in head and neck squamous cell carcinoma cells. Cells were transfected with siRNA oligonucleotides targeting ANRIL. Transfected cells were subjected to cell-cycle and quantitative reverse transcription-polymerase chain reaction (qRT-PCR) analysis. Depletion of ANRIL increased p15 mRNA in FaDu cells, and p15 and p16 mRNA in CAL27 cells and inhibited proliferation of these cells. Cell cycle analysis showed that depletion of ANRIL caused arrest at the G 1 phase of the cell cycle. ANRIL promotes G 1 phase progression by repressing p15 and p16, and thus promotes FaDu and CAL27 cell proliferation. Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved. 19. Quantitative parameters correlated well with differentiation of squamous cell carcinoma at head and neck: a study of dynamic contrast-enhanced MRI. Science.gov (United States) Dong Ji, Xiao; Yan, Shuo; Xia, Shuang; Guo, Yu; Shen, Wen 2019-08-01  PubMed DOI: 10.1177/0284185118809543  ISSN: 0284-1851  Volume: 60  Issue: 8  Pages: 962-968 Keywords: Dynamic contrast-enhanced magnetic resonance imaging, differentiation, grading, head and neck squamous cell carcinoma 20. A Comparison of Symptoms Among Patients with Head and Neck or Truncal Lymphedema and Normal Controls. Science.gov (United States) Doersam, Jennifer K; Dietrich, Mary S; Adair, Melissa A; Rhoten, Bethany; Deng, Jie; Ridner, Sheila H 2019-08-05  PubMed DOI: 10.1089/lrb.2019.0034  ISSN: 1539-6851 Keywords: head and neck cancer, lymphedema, midline, symptoms, truncal Background: Symptoms associated with midline lymphedema are not fully understood and it is unclear if symptoms associated with swelling in the head and neck are similar to those associated with swelling in the truncal region of the body. Objectives: Describe symptoms experienced by those with head and neck and truncal lymphedema. Compare symptom presence, intensity, and distress among those two groups and participants with no lymphedema. Methods: Cross-sectional descriptive study administered by online survey. Results: Nonlymphedema participants were younger than the lymphedema groups. Those with truncal lymphedema took more diuretic medications than the other groups. Participants with truncal lymphedema experienced a greater number of symptoms than the other groups ( p  head and neck group from the other groups ( p  head and neck and truncal) instead of one classification (midline) when assessing lymphedema-related symptoms is also supported.