Self‐reported medication adherence in differentiated thyroid cancer survivors: Role of illness perception and medication beliefs

xlomafota13 shared this article with you from Inoreader Self‐reported medication adherence in differentiated thyroid cancer survivors: Role of illness perception and medication beliefs Via Head & Neck Abstract Background To investigate medication adherence (MA) to Levothyroxine in differentiated thyroid cancer survivors and analyze the related factors for nonadherence. Methods The Medication Adherence Report Scale (MARS), Hospital Anxiety and Depression Scale (HAD), Brief Illness Perception Questionnaire (B‐IPQ), and Beliefs about Medicines Questionnaire (BMQ) were used to assess MA. Results Nonadherence was reported in 77 of 197 patients (39.1%). Socioeconomic status and education levels were found to be significantly related to MA. The HAD scores, all items of B‐IPQ, and BMQ were associated with MA and showed a correlation with the MARS scores. The primary predictors of MA were greater confidence in treatment modality (odds ratio [OR]: 0.48, 95% confidence interval (CI): 0.37‐0.63) and greater belief that the medication had minimal risk of harm (OR: 3.35, 95% CI: 1.50‐7.49). Conclusions Special attention should be paid to educational programs for differentiated thyroid carcinoma patients concerning the effectiveness and low risk of harm of medication in order to improve MA. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The importance of smoking status at diagnosis in human papillomavirus‐associated oropharyngeal cancer

xlomafota13 shared this article with you from Inoreader The importance of smoking status at diagnosis in human papillomavirus‐associated oropharyngeal cancer Via Head & Neck Abstract Background Smoking status at point of diagnosis is not used in defining risk groups for human papillomavirus (HPV)‐associated oropharyngeal cancer (OPC) despite its prognostic value in head and neck cancer. Methods Retrospective analysis of consecutive patients treated with chemoradiotherapy between January 2005 and July 2017 was performed with multivariable analysis to explore the impact of smoking status at diagnosis (current/former/never) on overall survival (OS), cancer‐specific survival (CSS) and progression‐free survival (PFS). Results Median follow‐up was 61 months. Four hundred and four patients were included. Current smokers had inferior OS versus never and former smokers [adjusted HR 2.37 (95% CI 1.26–4.45, p < 0.01) and 2.58 (95% CI 1.40–4.73, p < 0.01), respectively] and inferior PFS versus never smokers [adjusted HR 1.83 (95% CI 1.00–3.35, p = 0.04)]. Smoking status did not predict for CSS. Conclusion Detailed smoking behavior should be considered in refining risk groups in HPV‐associated OPC treated with radiotherapy and in future trial design eligibility and stratification. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role of the temporoparietal fascia free flap in salvage total laryngectomy

xlomafota13 shared this article with you from Inoreader Role of the temporoparietal fascia free flap in salvage total laryngectomy Via Head & Neck Abstract The procedure for salvage total laryngectomy (STL) is burdened by a high rate of postoperative complications as a result of delayed wound healing in previously irradiated tissue. Several observational studies have investigated the role of prophylactic vascularized flaps to aid pharyngeal closure after STL and prevent the development of PCF. The use of a temporoparietal fascia free flap (TFFF) as an overlay flap for STL has been described previously in two published studies and both sets of authors agreed that the most obvious benefit of the TFFF in STL is a reduced PCF rate with low site morbidity and good functional outcomes. The aim of this video is to illustrate the use of the temporoparietal fascia flap to provide an adjunctive reinforcement layer in the reconstruction of the pharynx. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Middle turbinate mucosal flap: A low‐morbidity option in the management of skull base defects

xlomafota13 shared this article with you from Inoreader Middle turbinate mucosal flap: A low‐morbidity option in the management of skull base defects Via Head & Neck Abstract Background To describe the low morbidity of middle turbinate mucosal flap (MTMF) to repair anterior skull base defects. Methods Skull base endonasal endoscopic surgeries performed at a tertiary hospital between 2015 and 2018 were analyzed. Patients were divided into two groups according the existence or not of a significant intraoperative cerebrospinal fluid (CSF) leak. In Group 1 (n = 28), gasket seal and a pedicled endonasal flap were used to repair the defect: 13 nasoseptal flaps (NSF), 8 inferolateral wall flaps (ILF), and 7 MTMF. In Group 2 only an endonasal flap was used: 9 NSF, 4 ILF, and 18 MTMF. Surgical and recovery time were analyzed (Student's t test). Our favorite surgical technique is described. Results Fifty‐nine patients were included. Average surgical time was 27.7, 41.6, and 11.3 min for NSF, ILF, and MTMF, respectively. MTMF showed a faster recovery. Conclusion MTMF is a safe reconstructive option for anterior skull base defects. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

What is the best method for prevention of postparotidectomy Frey syndrome?

xlomafota13 shared this article with you from Inoreader What is the best method for prevention of postparotidectomy Frey syndrome? Network meta‐analysis Via Head & Neck Abstract Background Prevention of Frey syndrome (FS) after parotidectomy using an interposition barrier has long been gaining a wide popularity; however, there is no clear evidence regarding which preventive technique is more effective. The aim of this network meta‐analysis (NMA) is to answer the question: What is the best method for prevention of FS after parotidectomy? Methods A comprehensive search of the PubMed, Embase, SCOPUS, and Cochrane library was conducted to identify the eligible studies. The outcome was the incidence of subjective Frey syndrome (SFS) and objective Frey syndrome (OFS). The Bayesian NMA accompanied with a random effects model and 95% credible intervals (CrIs) were calculated using GeMTC R package. Results Thirty‐four studies (n = 2987 patients) with five interventions, namely Alloderm (ADM), temporoparietal fascia (TPF), sternocleidomastoid muscle (SCM), superficial musculoaponeurotic system (SMAS), and free fat graft (FFG), were compared together and with no interposition barrier (NB). The results of NMA showed a statistically significant reduction in both SFS and OFS when ADM, TPF, SMAS, FFG, and SCM were compared with NB. No statistical differences were observed when comparing ADM, SCM, SMAS, FFG, and TPF. TPF ranked the best of all treatments (59.4%) and was associated with the least incidence of SFS; whereas ADM ranked the best of all treatments (61.1%) and was associated with the least incidence of OFS. Conclusions All interventions (TPF flap, ADM, FFG, SMAS, and SCM) were associated with a significant reduction in the incidence of FS when compared with NB. TPF and ADM showed the best outcome with the least incidence of SFS and OFS, respectively. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laryngeal soft tissue sarcoma

xlomafota13 shared this article with you from Inoreader Laryngeal soft tissue sarcoma: A systematic review and individual patient data analysis of 300 cases Via Head & Neck Abstract Background Laryngeal sarcoma is rare. We performed a systematic review and individual patient analysis to evaluate the patterns of care, prognostic factors, and role of radiotherapy in laryngeal soft tissue sarcoma. Methods A systematic search on PubMed and Google scholar was done. An individual patient data analysis was done. Results Of the 300 cases of laryngeal sarcoma, 80% underwent surgery. 44% underwent larynx preservation surgery and 25% received radiotherapy with surgery. Median progression free survival (PFS) was 48 months and overall survival (OS) of 224 months for the entire cohort. Patients with large primary, cartilage invasion, and positive margins had numerically worse PFS. Cartilage invasion and primary tumor size >3 cm were the most common risk factors for adjuvant radiation therapy. Patients receiving radiotherapy were not associated with better survival. Conclusion Laryngeal sarcoma associated with a good survival. Larynx preservation surgery is feasible in nearly half patients. Adjuvant radiotherapy may be warranted in patients poor prognostic factors. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dental radiation dosimetric maps from intensity‐modulated radiation therapy planning for head and neck cancers

xlomafota13 shared this article with you from Inoreader Dental radiation dosimetric maps from intensity‐modulated radiation therapy planning for head and neck cancers Via Head & Neck Abstract Background The purpose of this study was to create dental radiation maps to calculate the mean dose to individual teeth, maxilla and mandible using intensity‐modulated radiation therapy (IMRT). Methods Eighteen common clinical settings were chosen. Radiation plans were extracted, and each tooth was contoured at its junction with the gingiva and labeled based on the Universal/American numbering system. Results All patients were treated with prescribed doses of 50–70 Gy in 1.66–2 Gy/fraction. Patients receiving mean doses >50 Gy to the teeth, mandible, and maxilla included those with advanced tumors of the oral cavity and gross lymphadenopathy of level 1b. Conclusion We believe this to be the first study generating dosimetric maps of estimated doses to each tooth and each third of the mandible and the maxilla for common examples of head and neck cancer faced by radiation oncologists. Adoption of these dental maps may help improve clinical workflow efficiency. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Low‐ and high‐dose radioiodine ablation for low‐/intermediate‐risk differentiated thyroid cancer

xlomafota13 shared this article with you from Inoreader Low‐ and high‐dose radioiodine ablation for low‐/intermediate‐risk differentiated thyroid cancer in China: A large randomized clinical trial Via Head & Neck Abstract Background To determine whether 1.1 GBq radioiodine therapy is as effective as 3.7 GBq for ablation in Chinese patients with differentiated thyroid cancer (DTC). Methods In this single‐center randomized study, we compared the successful radioiodine ablation rates of 1.1 GBq and 3.7 GBq for patients with DTC. Results At 6–8 months after radioiodine ablation, there were 95 (39%) patients in the 1.1 GBq group and 79 (32%) patients in the 3.7 GBq group with thyroid hormone withdrawal (THW), and ablation success rates were 84% versus 80%, respectively; and 149 (61%) patients in the 1.1 GBq group and 169 (68%) patients in the 3.7 GBq group without THW, and ablation success rates were 89% versus 90%, respectively. In total, the ablation was successful in 412 (87%) of the 474 patients, and it was similar between the two groups. Conclusions Low‐dose radioiodine ablation was as effective as high dose in Chinese DTC patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Redefining risk of contralateral cervical nodal disease in early stage oropharyngeal cancer in the human papillomavirus era

xlomafota13 shared this article with you from Inoreader Redefining risk of contralateral cervical nodal disease in early stage oropharyngeal cancer in the human papillomavirus era Via Head & Neck Abstract Background The optimal extent of surgery and/or radiation to the contralateral lymph node region is unknown in early‐stage human papillomavirus (HPV)–related oropharyngeal squamous cell carcinoma (OPSCC). Methods To investigate the pathologic incidence of and risk factors for contralateral nodal disease (CND) in cT1‐T2 HPV‐related OPSCC treated with transoral robotic surgery (TORS) and bilateral neck dissection (BND), the records of 120 patients were reviewed. Results Eleven patients displayed pathologic contralateral nodal disease (pCND), including 7.1% of tonsil and 10.9% of base of tongue (BOT) cases. Medial hemistructure involvement and cN2 disease were significantly associated with pCND. Zero cN0 patients had pCND, and on multivariate analysis only cN classification remained significantly associated with pCND. Four percent of BOT patients and 2% of tonsil patients with a well‐lateralized primary and cN0/N1 neck demonstrated pCND. Conclusions HPV‐related OPSCC that are cN0‐N1 have exceedingly low rates of pCND. Well‐lateralized HPV‐related BOT primaries with limited clinical nodal disease may be candidates for ipsilateral only treatment. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Respiratory‐swallow coordination and swallowing impairment in head and neck cancer

xlomafota13 shared this article with you from Inoreader Respiratory‐swallow coordination and swallowing impairment in head and neck cancer Via Head & Neck Abstract Background The aim of the study was to determine the link between frequency of optimal respiratory‐swallow coordination, swallowing impairment, and airway invasion in head and neck cancer (HNC) patients. Method A cross‐sectional study of a heterogeneous group of HNC patients (49), precancer (N = 30) or postcancer treatment (N = 29), participated in a single Modified Barium Swallow Study (MBSS) with synchronized respiratory data. Results Spearman correlation coefficients revealed significant negative correlations between optimal respiratory‐swallow phase pattern and objective measures of swallowing impairment: penetration‐aspiration scale max, pharyngeal total, and oral total scores with Spearman correlation coefficients of −0.53 (z .001), −0.50 (P < .001), and −0.43 (P = .002), respectively. Optimal respiratory‐swallow pattern was significantly decreased (P = .03) in patients after cancer treatment compared with another patient group before cancer treatment. Conclusion These findings indicate that as the percentage of optimal respiratory‐swallow phase patterns increase, swallowing impairment decreases in the HNC patient population. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A new landmark for lingual artery identification during transoral surgery: Anatomic‐radiologic study

xlomafota13 shared this article with you from Inoreader A new landmark for lingual artery identification during transoral surgery: Anatomic‐radiologic study Via Head & Neck Abstract Background A landmark for the identification of the lingual artery (LA) through a transoral perspective can provide surgeons with an easy method to prevent and manage intraoperative bleeding during transoral approach to the base of tongue (BOT). Methods Thirteen tongue and five head and neck specimens were dissected to identify and assess the reliability of the lingual point (LP) as a new landmark for the LA at BOT. The pathway of 42 LAs was radiologically evaluated; axial depth and vertical offset were measured for each LA. Results Dissection study: a description of LP is provided; the LA was easily identified in all specimens (36/36 sides) using LP as a landmark. Radiologic study: the mean depth of the LA was 4.2 mm, the mean vertical offset was 1.3 mm. Conclusions LP is a simple and reliable landmark for identification of the LA, potentially helping surgeons to prevent and manage intraoperative bleeding. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.