2.	Patients with head and neck cancers' oral health knowledge, oral health-related quality of life, oral health status, and adherence to advice on discharge to primary dental care: A prospective observational study.
	Science.gov (United States)
	Abed, Hassan; Reilly, Damien; Burke, Mary; Daly, Blánaid
	2019-11-01  PubMed
	DOI: 10.1111/scd.12418  ISSN: 0275-1879  Volume: 39  Issue: 6  Pages: 593-602
	Keywords: adherence, head and neck neoplasm, oral health knowledge, oral health related quality of life, oral health status, osteoradionecrosis, radiotherapy
	This prospective observational study set out to assess patients' oral health knowledge, oral health related quality of life (OHRQoL) and status immediately posttherapy, and adherence with oral health behaviors posttreatment with radiotherapy for head and neck cancer (HaNC). A prospective observational study post HaNC therapy. At time one (T1), prior to discharge to primary dental care, oral health knowledge, OHRQoL, and status were assessed and dental health advice was delivered. At time two (T2), four weeks postdischarge, patients' adherence with dental health advice was reassessed. Thirty people postradiotherapy were recruited (mean age 58.9, SD ± 8.4). Twenty-three (77%) were men. Thirteen (45%) respondents reported they were not informed about the side effects of radiotherapy. On discharge to primary care, 20 (67%) of the respondents rated their oral health as fair or worse, while 47% were displeased with dental appearance. Respondents reported a mean of 8.6 impacts (SD ± 5.3) on OHRQoL. Five (17%) and two (7%) patients had an established or a new osteoradionecrosis, respectively, and 16 patients (53%) had greater than two new carious teeth. One month postdischarge (T2), adherence with dental advice was high, 93% were registered with a primary care dentist and all brushed their teeth daily. Within the limitations of this study in a single-center, adherence with oral health advice was high. However, participants felt they received little preparatory information about side effects and impacts of radiotherapy on oral and dental health, and how to maintain oral health after radiotherapy. © 2019 Special Care Dentistry Association and Wiley Periodicals, Inc.
3.	Femoral Head and Neck Fenestration Through a Direct Anterior Approach Combined With Compacted Autograft for the Treatment of Early Stage Nontraumatic Osteonecrosis of the Femoral Head: A Retrospective Study.
	Science.gov (United States)
	Wang, Qiuru; Li, Donghai; Yang, Zhouyuan; Kang, Pengde
	2019-10-30  PubMed
	DOI: 10.1016/j.arth.2019.10.043  ISSN: 0883-5403
	Keywords: bone graft, light bulb, minimally invasive, nonvascularized, osteonecrosis of the femoral head
	This study aimed to evaluate the effect of femoral head and neck fenestration combined with compacted autograft (light bulb procedure) through a direct anterior approach for early stage nontraumatic osteonecrosis of the femoral head. We conducted a retrospective cohort study investigating 66 hips undergoing the light bulb procedure through the direct anterior approach (light bulb group) and 59 hips undergoing traditional core decompression (control group). Visual analog scale pain scores and range of hip motion were evaluated before discharge to assess the quality of functional recovery. Follow-up was conducted at 6 weeks, 3 months, 6 months, and annually after surgery until 4 years. The clinical effectiveness was evaluated by Harris hip score and the University of California Los Angeles activity-level score. Patients were followed up with postoperative X-ray and computed tomography. Survival was compared between the 2 groups by radiographic progression and receiving total hip arthroplasty. There was no significant difference in quality of functional recovery between the 2 groups. There were no significant differences in clinical outcomes within 1 year after surgery. Patients in the light bulb group had significantly better Harris hip scores and University of California Los Angeles activity-level scores from 2 years after surgery to the end of follow-up. During the 4-year follow-up, significantly fewer patients in light bulb group had radiographic progression (22.7% vs 44.1%) or received total hip arthroplasty (15.2% vs 30.5%). The light bulb procedure through a direct anterior approach offers significantly better results for the treatment of early stage nontraumatic osteonecrosis of the femoral head compared with traditional core decompression. Copyright © 2019 Elsevier Inc. All rights reserved.
4.	Complications of tissue expansion in the head and neck.
	Science.gov (United States)
	Azzi, Jayson L; Thabet, Chloe; Azzi, Alain J; Gilardino, Mirko S
	2019-11-27  PubMed
	DOI: 10.1002/hed.26017  ISSN: 1043-3074
	Keywords: complications, head and neck, microtia, skin expansion, tissue expander
	The authors aim to present a comprehensive review detailing the present state of evidence with regard to complications following tissue expansion in the head and neck. A systematic literature search was conducted to identify all studies reporting complications of tissue expansion in the head and neck between 2000 and 2019. Subgroup comparisons based on expander locations and planes were conducted. A total of 7058 patients were included. Tissue expansion was associated with an overall complication rate of 8.73% (616/7058). The most common complications were extrusion (207/7009; 3.0%) and hematoma (200/7009; 2.9%). Overall complications were highest in the scalp (65/238; 27.3%) and lowest in the mastoid (347/5688; 6.1%). Complications were more common with expansion in the non-subcutaneous plane (63/590; 10.7%). In the absence of large clinical trials, systematic reviews such as these can help inform clinical guidelines and provide practitioners with an evidence-based reference to improve informed consent. © 2019 Wiley Periodicals, Inc.
5.	[Treatment of head and neck squamous cell carcinoma recurrences and distant metastases : Highlights of the 2019 ASCO Meeting].
	Europe PubMed Central
	Zech HB; Laban S; Schafhausen P; Bussmann L; Betz C; Busch CJ
	2019-12-01  HNO
	Volume: 67  Issue: 12  Pages: 898-904  PMID: 31701170
6.	Acute normovolemic hemodilution reduced allogeneic blood transfusion without increasing perioperative complications in patients undergoing free-flap reconstruction of the head and neck.
	Science.gov (United States)
	Takekawa, Daiki; Saito, Junichi; Kinoshita, Hirotaka; Hashiba, Eij I; Hirai, Naoki; Yamazaki, Yuma; Kushikata, Tetsuya; Hirota, Kazuyoshi
	2019-11-25  PubMed
	DOI: 10.1007/s00540-019-02714-5  ISSN: 0913-8668
	Keywords: Acute normovolemic hemodilution, Allogeneic blood transfusion, Free-flap reconstruction of the head and neck, Oncological surgery, Post-operative complication
	The present case-control study was conducted to evaluate whether acute normovolemic hemodilution (ANH) can reduce the need for perioperative allogeneic blood transfusion (ABT) and affect the incidence of perioperative complications in free-flap reconstruction of the head and neck. This single-center, retrospective, observational study included the perioperative data of 123 patients who underwent free-flap reconstruction of the head and neck following oncological surgery. Patients were divided into the following two groups according to whether they received ANH: ANH group and non-ANH group. We investigated whether ANH can reduce the need for perioperative ABT using propensity score-adjusted logistic regression analysis. Of the 123 patients, 113 patients were assessed; 57 patients were in the ANH group and 56 patients were in the non-ANH group. The rate [ANH group vs. non-ANH group, n (%): 2 (3.5%) vs. 23 (41.1%), p head and neck without increasing the incidence of post-operative complications.
7.	Myofascial pain, widespread pressure hypersensitivity, and hyperalgesia in the face, neck, and shoulder regions, in survivors of head and neck cancer.
	Science.gov (United States)
	Ortiz-Comino, L; Fernández-Lao, C; Castro-Martín, E; Lozano-Lozano, M; Cantarero-Villanueva, I; Arroyo-Morales, M; Martín-Martín, L
	2019-11-21  PubMed
	DOI: 10.1007/s00520-019-05173-6  ISSN: 0941-4355
	Keywords: Head and neck cancer, Hyperalgesia, Neck dissection, Pain, Trigger points
	Medical treatment for head and neck cancer may induce the presence of inflammation, pain, and dysfunction. The purpose of the current study was to assess the presence of myofascial trigger points (TrPs) and their relationship with widespread pressure hypersensitivity and hyperalgesia in survivors of head and neck cancer (sHNC). TrPs and pressure-pain thresholds (PPTs) were quantified in different muscles/joints in the head and neck of 30 sHNC (59.45 ± 13.13 years) and 28 age- and sex-matched controls (58.11 ± 12.67 years). The sHNC had more TrPs in all muscles on the affected side (p < 0.05) than did the healthy controls, and in the temporalis, masseter, and suboccipitalis muscles on the unaffected side (p < 0.05). They also had lower PPTs in all places (p < 0.05) except for the temporalis muscle (p = 0.114) and C5-C6 joint (p = 0.977). The intensity of cervical pain correlated positively with the presence of upper trapezius TrPs. sHNC suffering cervical and/or temporomandibular joint pain have multiple active TrPs and experience widespread pressure hypersensitivity and hyperalgesia, suggestive of peripheral and central sensitization.
8.	Characterization of a head and neck cancer-derived cell line panel confirms the distinct TP53-proficient copy number-silent subclass.
	Science.gov (United States)
	van Harten, Anne M; Poell, Jos B; Buijze, Marijke; Brink, Arjen; Wells, Susanne I; René Leemans, C; Wolthuis, Rob M F; Brakenhoff, Ruud H
	2019-11-01  PubMed
	DOI: 10.1016/j.oraloncology.2019.09.004  ISSN: 1368-8375  Volume: 98  Pages: 53-61
	Keywords: Copy number silent, Fanconi anemia, Head and neck squamous cell carcinoma, Low-coverage whole genome sequencing, TP53 wild-type, Target-enrichment sequencing, Targeted treatment, p53 pathway
	Head and neck squamous cell carcinomas (HNSCC) arise in the mucosal lining of the upper aerodigestive tract. Risk factors are exogenous carcinogen exposure, human papillomavirus (HPV) infection, and genetic predisposition such as Fanconi anemia (FA). Clinically, tumors are stratified based on stage, site and HPV-status. The majority of HPV-positive and -negative HNSCC is characterized by frequent copy number (CN) changes and an abrogated p53-pathway. A third genetically-defined HPV-negative subclass of HNSCC is emerging: tumors that lack gross chromosomal changes (CN-silent), are mostly TP53-proficient, and have a relatively favorable prognosis. A representative panel of HPV-positive, HPV-negative and FA-HNSCC-derived cell lines was genetically characterized. Despite apparent differences in etiology, FA-HNSCC cell lines show comparable genetic alterations as sporadic non-FA-HNSCC-derived cell lines. Furthermore, we identified a near diploid CN-silent HPV-negative HNSCC line: VU-SCC-040. Molecular characterization uncovers the absence of TP53 mutations, a functional p53-pathway and a CASP8 mutation. TP53 gene knockout using CRISPR-Cas9 resulted in resistance to MDM2 inhibition. Whereas p53-status is often proposed as a predictive biomarker for treatment response, TP53-knockout did not change sensitivity to cisplatin, Chk1 and Wee1 inhibition. Additionally, 84 CN-silent tumors were identified in the HNSCC PanCancer cohort and shown to be enriched for female gender, HRAS and CASP8 mutations. FA-derived HNSCC cell lines share comparable CN-profiles and mutation patterns as sporadic HPV-negative HNSCC. In contrast, a subclass of CN-silent, HPV-negative and TP53 wild-type HNSCC separates from the majority of HNSCC tumors. We show that VU-SCC-040 is a HNSCC cell model representative of this subclass. Copyright © 2019 Elsevier Ltd. All rights reserved.
9.	Mapping the University of Washington Quality of life questionnaire onto EQ-5D and HUI-3 indices in patients with head and neck cancer.
	Science.gov (United States)
	Stephens, Robert F; Noel, Christopher W; Su, Jie Susie; Xu, Wei; Krahn, Murray; Monteiro, Eric; Goldstein, David P; Giuliani, Meredith; Hansen, Aaron R; de Almeida, John R
	2019-11-24  PubMed
	DOI: 10.1002/hed.26031  ISSN: 1043-3074
	Keywords: EQ-5D, QALYs, University of Washington Quality of life questionnaire, cross-walking, head and neck cancer (HNC), health state utility values (HSUVs), health utilities index mark 3, health-related quality of life (HRQoL), mapping algorithms, multi-attribute utility instruments (MAUIs), preference-based measures
	There is no mechanism to predict health utility (HU) values from the University of Washington Quality of Life Questionnaire (UWQoL) scores. We sought to develop a mapping algorithm capable of using UWQoL data to approximate HU scores. Outpatients with head and neck cancer completed the UWQoL, EQ-5D, and the Health Utilities Index-Mark 3 (HUI-3). Results of the UWQoL were mapped onto both EQ-5D and HUI-3 scores using ordinary least-squares regression models. Two-part models were explored. The predictive power of the model was assessed using 10-fold cross-validation. A total of 209 patients were recruited. The reduced model converting UWQoL data into EQ-5D scores performed best (adjusted R 2 = 0.628, root mean square error = 0.076). Both models demonstrated construct validity by discriminating between clinical indices of disease severity. The abovementioned algorithms enable researchers to perform health economic evaluations with existing UWQoL data in cases where prospectively collected HU values are not available. © 2019 Wiley Periodicals, Inc.
10.	Two for the price of one: Prevalence, demographics and treatment implications of multiple HPV mediated Head and Neck Cancers.
	Science.gov (United States)
	Strober, William; Shishido, Sachie; Wood, Burton; Lewis, James S; Kuhs, Krystle; Ferris, Robert L; Faden, Daniel L
	2019-11-22  PubMed
	DOI: 10.1016/j.oraloncology.2019.104475  ISSN: 1368-8375  Volume: 100  Pages: 104475
	Keywords: Epidemiology, Head and Neck Cancer, Incidence, Oropharyngeal neoplasms, Papillomavirus infections, SEER program, Second primary neoplasm, Squamous cell carcinoma of head and neck, Systematic review
	HPV mediated head and neck squamous cell carcinoma (HPVmHNSCC) is increasing in prevalence in the United States, as are reports of patients with multiple HPVmHNSCCs. The prevalence, demographics, and treatment implications of this emerging clinical entity are poorly understood. We performed a multitiered assessment of patients with multiple HPVmHNSCC including: 1. systematic review of the literature, 2. query of the 2017 Surveillance, Epidemiology and End Results (SEER) database and 3. institutional level reporting at two high volume academic centers. Systematic literature review: 13 articles met inclusion criteria (48 patients with multiple HPVmHNSCC). Pooled prevalence rate of multiple HPVmHNSCC was 2.64%. SEER database: 60(0.95%) patients with HPVmHNSCC had two tumors. Patients with multiple HPVmHNSCC were more likely to be younger and present with a lower T and N stage (p < 0.025 for all). The second identified tumor was more likely to be contralateral, found synchronously, of smaller size, and to occur in the tonsil (p < 0.05 for all). Institutional reporting: 17(1.69%) patients with HPVmHNSCC had two primary tumors. Similar to the SEER database, patients with multiple HPVmHNSCC were more likely to present with a low T stage and tonsil location (p < 0.007 for both). Multiple HPVmHNSCCs occur in a subset of HPVmHNSCC cases with distinct characteristics. Thorough interrogation of all oropharyngeal subsites should be performed as part of the initial workup for HPVmHNSCC, with consideration given to contralateral tonsillectomy at the time of surgical resection for HPV mediated tonsil cancers due to the prevalence of contralateral tonsil primaries. Copyright © 2019 Elsevier Ltd. All rights reserved.
11.	A Nomogram to Predict the Outcome of Fine Needle Aspiration Cytology in Head and Neck Masses.
	Science.gov (United States)
	Kotowski, Ulana; Brkic, Faris F; Koperek, Oskar; Pablik, Eleonore; Grasl, Stefan; Grasl, Matthaeus Ch; Erovic, Boban M
	2019-11-22  PubMed
	DOI: 10.3390/jcm8122050  ISSN: 2077-0383  Volume: 8  Issue: 12
	Keywords: cancer, fine needle aspiration cytology, neck lumps, nomogram, salivary gland
	Fine needle aspiration cytology (FNAC) is an important diagnostic tool for tumors of the head and neck. However, non-diagnostic or inconclusive results may occur and lead to delay in treatment. The aim of this study was to evaluate the factors that predict a successful FNAC. A retrospective search was performed to identify all patients who received an FNAC at the Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna. The variables were patients' age and sex, localization and size of the punctured structure, previous radiotherapy, experience of the head and neck surgeon, experience of the pathologist and the FNAC result. Based on these parameters, a nomogram was subsequently created to predict the probability of accurate diagnosis. After performing 1221 FNACs, the size of the punctured lesion ( p = 0.0010), the experience of the surgeon and the pathologist ( p = 0.00003) were important factors for a successfully procedure and reliable result. FNACs performed in nodes smaller than 20 mm had a significantly worse diagnostic outcome compared to larger nodes ( p = 0.0004). In conclusion, the key factors for a successful FNAC are nodal size and the experience of the head and neck surgeon and the pathologist.
12.	[Update on HPV-associated head and neck cancer-highlights from the 2019 ASCO Annual Meeting].
	Europe PubMed Central
	Tribius S; Würdemann N; Laban S; Hoffmann TK; Sharma SJ; Klussmann JP
	2019-12-01  HNO
	Volume: 67  Issue: 12  Pages: 912-917  PMID: 31701169
13.	[Oncologic treatment concepts for head and neck cancer : Important results from the world's largest cancer congress, 2019].
	Europe PubMed Central
	Hoffmann TK
	2019-12-01  HNO
	Volume: 67  Issue: 12  Pages: 896-897  PMID: 31768584
14.	[Studies on radiotherapy of head and neck cancer : Highlights of the 2019 ASCO Annual Meeting].
	Europe PubMed Central
	Ott S; Wiegel T; Hoffmann TK; Petersen C; Tribius S; Laban S
	2019-12-01  HNO
	Volume: 67  Issue: 12  Pages: 918-924  PMID: 31659379
15.	The Potential Impact of Connexin 43 Expression on Bcl-2 Protein Level and Taxane Sensitivity in Head and Neck Cancers-In Vitro Studies.
	Science.gov (United States)
	Gurbi, Bianka; Brauswetter, Diána; Varga, Attila; Gyulavári, Pál; Pénzes, Kinga; Murányi, József; Zámbó, Veronika; Birtalan, Ede; Krenács, Tibor; Becker, David Laurence; Csala, Miklós; Vályi-Nagy, István; Peták, István; Dános, Kornél
	2019-11-22  PubMed
	DOI: 10.3390/cancers11121848  ISSN: 2072-6694  Volume: 11  Issue: 12
	Keywords: Bcl-2, connexin 43, head and neck cancer, paclitaxel
	The poor prognosis of head and neck squamous cell carcinoma (HNSCC) is partly due to the lack of reliable predictive markers. Connexin 43 (Cx43) protein and its cell-communication channels have been assigned tumor suppressor functions while the anti-apoptotic Bcl-2 (B-cell lymphoma-2) protein has been associated with negative prognostic significance in cancer. This study aimed to test the role of Cx43 protein on Bcl-2 expression, tumor progression and response to taxane-based treatment in HNSCC. Human papillomavirus (HPV) negative HNSCC cell lines were tested for paclitaxel sensitivity through measuring apoptosis induction, cell viability and changes in Cx43 and Bcl-2 levels using flow cytometry, cell viability assay, immunocytochemistry and western blot. Inhibition of Cx43 expression using siRNA increased Bcl-2 protein levels in SCC25 (tongue squamous cell carcinoma) cells, while forced Cx43 expression reduced Bcl-2 levels and supported paclitaxel cytotoxicity in FaDu (hypopharynx squamous cell carcinoma) cells. In vitro results were in line with protein expression and clinicopathological features tested in tissue microarray samples of HNSCC patients. Our data demonstrate that elevated Cx43 and reduced Bcl-2 levels may indicate HNSCC sensitivity to taxane-based treatments. On the contrary, silencing of the Cx43 gene GJA1 (gap junction protein alpha-1) can result in increased Bcl-2 expression and reduced paclitaxel efficiency. Clinical tumor-based analysis also confirmed the inverse correlation between Cx43 and Bcl-2 expression.
16.	Association of insurance type with time course of care in head and neck cancer management.
	Science.gov (United States)
	Itamura, Kyohei; Kokot, Niels; Sinha, Uttam; Swanson, Mark
	2019-11-22  PubMed
	DOI: 10.1002/lary.28423  ISSN: 0023-852X
	Keywords: Head and neck, health policy, radiation therapy
	To determine differences in time course of care based on major insurance types for patients with head and neck squamous cell carcinoma (HNSCC). Retrospective cohort study. Retrospective study of Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Medicare patients with biopsy-proven diagnosis of HNSCC referred to an academic tertiary center for tumor resection and adjuvant therapy. In addition to patient demographic information and tumor characteristics, duration of chief complaint and the following time points were collected: biopsy by referring physician, first specialty surgeon clinic appointment, surgery, and adjuvant radiation start and stop dates. There was a statistically significant increase in time interval for HMO (n = 32) patients from chief complaint to biopsy (P = .003), biopsy to first specialty surgeon clinic appointment (P < .001), and surgery to start of adjuvant radiation (P < .001) compared to that of Medicare (n = 31) and PPO (n = 41) patients. Adjuvant radiation was initiated ≤6 weeks after surgery in 22% of HMO (mean duration of 59 ± 17 days), 48% of Medicare (44 ± 13 days), and 61% of PPO (41 ± 12 days) patients. Compared to PPO and Medicare patients, HMO patients begin adjuvant radiation after surgery later and experience treatment delays in transitions of care between provider types and with referrals to specialists. Delaying radiation after 6 weeks of surgery is a known prognostic factor, with insurance type playing a possible role. Further investigation is required to identify insurance type as an independent risk factor of delayed access to care for HNSCC. 4 Laryngoscope, 2019. © 2019 The American Laryngological, Rhinological and Otological Society, Inc.
17.	The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis.
	Science.gov (United States)
	Mahmoud, Nesreen Fawzy; Hassan, Karima A; Abdelmajeed, Salwa F; Moustafa, Ibraheem M; Silva, Anabela G
	2019-11-26  PubMed
	DOI: 10.1007/s12178-019-09594-y  ISSN: 1935-973X
	Keywords: Forward head, Meta-analysis, Neck pain, Posture, Systematic review
	Forward head posture (FHP) is the most common cervical postural fault in the sagittal plane that is found with different severity levels in almost all populations. Despite claims that FHP may be related to neck pain, this relation seems to be controversial. Thus, our purpose is to determine whether FHP differs between asymptomatic subjects and those with neck pain and to investigate if there is a relationship between head posture and neck pain. A total of 15 cross-sectional studies were eligible for inclusion for this systematic review and meta-analysis. Ten studies compared FHP between a group of asymptomatic participants and a group of participants with neck pain and an overall mean difference (MD) of 4.84 (95% CI = 0.14, 9.54), indicating a significant between-group difference, contrary to adolescent (MD = - 1.05; 95% CI = - 4.23, 2.12). Eight studies showed significant negative correlations between FHP and neck pain intensity (r = - 0.55; 95% CI = - 0.69, - 0.36) as well as disability (r = - 0.42; 95% CI = - 0.54, - 0.28) in adults and older adults, while in adolescents, only lifetime prevalence and doctor visits due to neck pain were significant predictors for FHP. This systematic review found that age played an important role as a confounding factor in the relation between FHP and neck pain. Also, the results showed that adults with neck pain show increased FHP when compared to asymptomatic adults and that FHP is significantly correlated with neck pain measures in adults and older adults. No association was found between FHP and most of neck pain measures in adolescents.
18.	Prevalence of Human Papilloma Virus Sub Genotypes following Head and Neck Squamous Cell Carcinomas in Asian Continent, A Systematic Review Article.
	Science.gov (United States)
	Bukhari, Naeem; Joseph, Joe P; Hussain, Sayed Sajid; Khan, Muhammad Adeeb; Wakim, Marcel Jose Yibirin; Yahya, Esam Bashir; Arif, Amina; Saleem, Afshan; Sharif, Nadeem
	2019-11-01  PubMed
	DOI: 10.31557/APJCP.2019.20.11.3269  ISSN: 1513-7368  Volume: 20  Issue: 11  Pages: 3269-3277
	Keywords: Central Asia, HNSCCs, HPV, Middle East, South Asia
	In current era of blue brain intelligence and technology access at ease, standardization of disease etiology demands extensive research to drop-down human papilloma virus associated head and neck squamous cell carcinomas impact at large. Present retrospection aims to estimate comparative association of human papilloma virus sub-genotypes in head and neck squamous cell carcinomas, critical analysis of existing research gap, treatment progress, co-infection, gender association, national status and challenges following Human papilloma virus led head and neck squamous cell carcinomas among world largest continent. Head and neck squamous cell carcinomas are not just like malignancies of uterine cervix, lymph nodes and breast cancers. Human papilloma virus led head and neck squamous cell carcinomas treatment directly impact Central nervous system in humans. Intriguingly, human papilloma virus mediated immune response increases patient survival, which indirectly transmit human papilloma virus in future generations and act as a potential threat developing neurogenic disorders. An objective based search strategy, following comprehensive and specific search approaches were made to retrieve recent 12 years research data from five different NCBI databases. Out of 300 shortlisted articles, only 24 principal studies met the inclusion criteria. Highest human papilloma virus prevalence (10.42 %) was found in South Asia, 5.8 % in South East Asia, 5.7 % East Asia, 2.5% in west Asia and no relevant updated data was found from central Asian continent. Highest prevalence (10%) of HPV genotype-16 was recorded in Asia among 3, 710 enrolled cases including 2201 males, 1149 females and 360 cases of unknown gender. While undifferentiated multiple HPV genotype prevalence was 5.5 % (204 cases). Lowest percentage of HPV sub-types 68, 72, 57, 39 were recorded respectively. Pakistan ranked top reporting highest number of HPV-16 cases, Taiwan HPV-18, India HPV-31, Japan HPV-35 and Singapore in HPV-16 and HPV-18 co-infection rates respectively. Exact prevalence of HPV associated head and neck squamous cell carcinomas among Asian population is still debatable. Due to higher heterogeneity (Phead and neck squamous cell carcinomas aetiology..
19.	Opioid sparing multimodal analgesia treats pain after head and neck microvascular reconstruction.
	Science.gov (United States)
	Lee, Thomas S; Wang, Lexie L; Yi, Dae Ik; Prasanna, Praveen D; Kandl, Christopher
	2019-11-25  PubMed
	DOI: 10.1002/lary.28402  ISSN: 0023-852X
	Keywords: Ketamine, free flap, gabapentin, head and neck reconstruction, opioids
	To compare pain control (opioid consumption and postsurgical pain scores) in head and neck (H&N) free flap reconstruction patients who undergo traditional means of postoperative analgesia including use of opioids versus a novel protocol that includes ketamine and gabapentin. Single-institution retrospective cohort study. Eighty-six patients who underwent H&N free flap reconstruction from 2015 to 2018 were included. Forty-three patients were in the control cohort treated with opioids only, and 43 patients were in the treatment group. There was a statistically significant decrease in opioid consumption in each of the first 5 postoperative days ranging from 80% to 83% in the treatment group. The daily pain scores were significantly lower in the treatment group in the first 2 postoperative days. At the 1-month postoperative visit, there was no significant difference in pain scores between the groups; however, by the 2-month visit, the treatment group reported significantly lower pain scores than the control group (P = 0.001). No adverse outcomes of ketamine or gabapentin were experienced. Ketamine and gabapentin are safe and effective analgesics in H&N free flap surgery that significantly decrease opioid use in the acute postoperative setting and may improve pain control. 3a Laryngoscope, 2019. © 2019 The American Laryngological, Rhinological and Otological Society, Inc.
20.	The role of allied healthcare professionals in head and neck cancer surveillance: A systematic review.
	Science.gov (United States)
	Rocke, John; Mclaren, Oliver; Hardman, John; Garas, George; Smith, Matthew E; Ishii, Hiro; Constable, James; Tikka, Theofano; Wie Liu, Zi; Williams, Richard
	2019-10-31  PubMed
	DOI: 10.1111/coa.13471  ISSN: 1749-4478
	Keywords: allied health personnel, dentists, follow-up care, head, interdisciplinary health team, neck, neoplasms, nurse clinicians, nutritionists, physical therapy speciality, psychology, speech-language pathology, surveillance
	The roles of Allied Health Care Professionals (AHPs) in Head and Neck Cancer (HNC) are wide ranging but not clearly defined. Inter-regional variability in practice results from a lack of standardisation in approaches to the Multidisciplinary Team (MDT) make-up and structure. Traditionally, the follow-up of HNC patients is clinician led with multiple scheduled follow-up appointments. The increasing population of HNC patients provides logistical, monetary and efficiency challenges. This systematic review presents the roles of the multiple AHP sub-groups in HNC with the aim of presenting how their differing skill sets can be integrated to modernise our approach in follow-up. We searched MEDLINE, Embase, the Cochrane Library, NIHR Dissemination Centre, The Kings Fund Library, Clinical Evidence, National Health Service Evidence and the National Institute of Clinical Excellence to identify multiple subgroups of AHPs (Dentists, Speech and Language Therapists, Dieticians, Physiotherapists, Psychologists, Clinical Nurse Specialists) and evidence of their role in HNC follow-up. Evidence not directly relating to HNC follow-up was excluded. This Systematic Review was undertaken online by the Integrate (UK ENT Trainee National Collaborative) Head and Neck Subcommittee. Most evidence was of low-quality, and the broad nature of the protocol provided a wide variety of study models. Two authors screened the articles for relevance to the topic before final analysis. The main role identified was improvement in Quality of Life and symptom control rather than detecting recurrence. We also demonstrate that it is possible to stratify HNC follow-up patients using their received treatment modality and Distress Thermometers to identify groups who will require more intensive AHP input. HNC follow-up covers a broad group of patients with differing needs. As such, a blanket approach to this phase of treatment is likely to be less effective than a patient-led model where the group of AHPs are employed on a needs basis rather than at set time points. This will likely lead to greater patient satisfaction, earlier detection of recurrence and efficiency savings. © 2019 John Wiley & Sons Ltd.