Lesions Of Oropharynx Research Articles

Examination of Ulcero-Proliferative Lesions of Oropharynx and Oral Cavity- A Clinical Perspective

 Introduction Patients often present with ulcero-proliferative lesions of the oropharynx and oral cavity in the outpatient department (OPD). These lesions have a negative impact on the patients' health, so it's critical to make an accurate diagnosis and administer the right care.  Aim of the Study: To determine the proportion of patients who exhibit different ulcero-proliferative lesions clinical characteristics in the oropharynx and oral cavity.  Patients and Methodology: This is prospective study done at Department of ENT, Guntur Medical College, spanning a period of 18 months. This study included patients with ulcero- membranous lesions in the oropharynx and oral cavity, regardless of age. This study excluded Patients who had radiation therapy soon before developing the illness and who had traumatic injuries but no infection. Detailed history including personal, family and medical history were noted. Local and general examination was done. Selected patients were subjected to investigations like routine blood investigations, gram stain, albert’s stain, KOH mount, culture and sensitivity, peripheral smear, serology, FNAC, HPE, USG, chest x ray, CT neck, MRI.  Results In the current study, men dominated women (65.69%) and the most prevalent age group participating was 41–60 years old (45.09%). The most typical symptoms of the throat were odynophagia, burning sensation, dysphagia, and throat pain. 5.9% of the patients had nose issues and 14.7% had associated ear complaints. General symptoms included fever in 10.7% of cases, weight loss in 23.5%, general weakness in 15.6% of cases, and skin lesions in 6.9% of cases. Systemic disorders such as HIV was present in 3.9%, hypertension in 25.4%, and diabetes in 34.3% of cases. Risk factors include chewing tobacco (17.6%), drinking alcohol (14.7%), smoking (43.1%), and having previously been exposed to radiation (0.9%). The tongue was the most frequently afflicted site in this study (44.1%), followed by the palate (29.4%), the buccal mucosa (15.6%), the tonsils (8.8%), the lips (7.8%), the alveolus (2.9%), and the RMT (1.9%). Neoplastic etiology accounted for 41.1% of the total etiology discovered. It was followed by inflammatory (31.3%), infectious (20.5%), and miscellaneous (6.8%) etiologies. 52.9% of patients had conservative care, 36.2% had oncosurgery team treatment through surgery, and 10.7% had radiation therapy. Of the patients with neoplastic etiology, 10.7% had radiation therapy.  Conclusion: The incidence of cancers rises in the adult population with increased habits like smoking and chewing nicotine in any form. A high degree of suspicion is required when treating oral ulcers, particularly those that are chronic. The gold standard for confirming the diagnosis is always a biopsy and a histopathological examination.

A bird's-eye view of pathologist over diagnostic confusion of oral cavity lesions.

Oral cavity can be host to multitude of neoplastic, premalignant or non neoplastic pathological lesions. Diagnosis of lesions of oral cavity is always of interest to clinician and pathologist and rely on clinical appearance of lesions. There can be variation in diagnosis of clinical lesion with histopathology. Many oral carcinomas arise within the sites that previously had premalignant lesion. Incidence of oral cancers in population has increased among younger generations related to habits and lifestyle. These lesions during clinical presentation are misleading and create diagnostic dilemma owing to age, sex and distribution of lesions. Understanding distribution of oral mucosal lesions helps to diagnose lesions of oral cavity. Purpose of this study is to observe the variation in clinical diagnosis with histopathological diagnosis in patients with inflammatory, premalignant, benign and malignant lesions of oral cavity and oropharynx and also clinical distribution of lesions of oral cavity and oropharynx lesions by histopathology. Out of total 105 lesions, ulcer in oral cavity seen in 58 (55.23%) of patients, followed by swelling or feeling of lump in oral cavity in 36 (34.29%) of patients and foreign body sensation in 23 (21.90%) of patients with tongue as most frequent site for most of lesions of oral cavity accounting in 33 (31.43%) of cases, and less frequently lesions were seen in retro molar trigone area in 2 (1.90%) patients. Histopathological diagnosis of premalignant, non neoplastic and inflammatory lesions was made in 24 (22.85%) cases, benign tumours were diagnosed in 14 (13.33%) cases and rest of 67 (63.81%) lesions were malignant. Mucocoel were seen in five (4.76%) cases, radicular cyst was seen in one (0.95%) case of female patient and four cases of Leukoplakia with one case showing mild dysplasia. Among benign tumours 11 (10.47%) patients presented with gingivitis turned out to be squamous papillomas were seen in five (4.76%) cases, fibroma was diagnosed in four (3.80%) cases, pyogenic granuloma was diagnosed in four (3.80%) cases most commonly seen over gingiva and myoepithelioma of minor salivary gland was observed in one (0.95%) case over soft palate. Out of 67 cases of malignant lesions squamous cell carcinomas were seen in 59 (88.05%) cases followed by verrucous carcinoma in 3 (4.47%) cases, 2 (2.99%) cases were basaloid squamous cell carcinomas, mucoepidermoid carcinoma was seen in 2 (2.99%) cases and 1 (1.49%) case of adenoid cystic carcinoma was seen. Majority of squamous cell carcinomas cases in study were well differentiated in 49 (73.13%) cases followed by moderately differentiated in 16 (23.88%) cases and poorly differentiated in 2 (2.99%) cases. Malignant transformation of tonsil tissue post operatively was observed in 1 (0.95%) patients on histopathology. One (2.5%) case of myoepithelioma was seen in 60 years male over soft palate. Of all oral biopsies reported in study, increasing trend of malignancies in lower age groups of population making it an emerging threat to community and highlighting need to take effective measures to increase public awareness about risk factors and consequences of this condition. Screening programmes targeted to population over 25 years are recommended to overcome this.

Recurrence of premalignant oral cavity and oropharynx lesions after pulsed diode laser treatment

PurposeLeukoplakia is common with a 1 % incidence in the population and may harbor preneoplastic changes. Diode lasers provide both precision and coagulation for excision of superficial lesions in clinical and operative settings with little damage to deeper tissue. We aim to determine the rate of oral and oropharyngeal hyperkeratosis and dysplasia recurrence after treatment with diode laser. Materials and methodsPatients with oral or oropharyngeal hyperkeratotic or mild dysplastic lesions treated with pulsed diode laser between 2013 and 2020 at a tertiary academic institution were analyzed. The main outcome measure was recurrence of hyperkeratosis and dysplasia after treatment. ResultsFourteen patients received diode laser treatment for hyperkeratotic or mild dysplastic lesions of the oral cavity or oropharynx. Demographic features included 9 (64.3 %) females and mean age of 66.6 years. In these 14 patients, 18 distinct lesions were identified. Eleven (61.1 %) lesions were located on the oral tongue, 4 (22.2 %) on the buccal mucosa, 2 (11.1 %) on the hard palate, and 1 (5.6 %) on the soft palate. Average time from lesion clinical diagnosis to the first diode laser treatment was 8.3 months with an average number of 1.4 treatments per lesion. Three (16.7 %) lesions experienced recurrence after the most recent treatment. None of the lesions underwent malignant transformation. None of the patients experienced bleeding, tethering, or dysarthria after treatment. One patient developed pyogenic granuloma and reported chronic tongue pain. ConclusionsPulsed diode laser treatment of leukoplakia was well tolerated with low complication rates and reasonable control of precancerous lesions.

Deep Learning for Automatic Segmentation of Oral and Oropharyngeal Cancer Using Narrow Band Imaging: Preliminary Experience in a Clinical Perspective.

IntroductionFully convoluted neural networks (FCNN) applied to video-analysis are of particular interest in the field of head and neck oncology, given that endoscopic examination is a crucial step in diagnosis, staging, and follow-up of patients affected by upper aero-digestive tract cancers. The aim of this study was to test FCNN-based methods for semantic segmentation of squamous cell carcinoma (SCC) of the oral cavity (OC) and oropharynx (OP).Materials and MethodsTwo datasets were retrieved from the institutional registry of a tertiary academic hospital analyzing 34 and 45 NBI endoscopic videos of OC and OP lesions, respectively. The dataset referring to the OC was composed of 110 frames, while 116 frames composed the OP dataset. Three FCNNs (U-Net, U-Net 3, and ResNet) were investigated to segment the neoplastic images. FCNNs performance was evaluated for each tested network and compared to the gold standard, represented by the manual annotation performed by expert clinicians.ResultsFor FCNN-based segmentation of the OC dataset, the best results in terms of Dice Similarity Coefficient (Dsc) were achieved by ResNet with 5(×2) blocks and 16 filters, with a median value of 0.6559. In FCNN-based segmentation for the OP dataset, the best results in terms of Dsc were achieved by ResNet with 4(×2) blocks and 16 filters, with a median value of 0.7603. All tested FCNNs presented very high values of variance, leading to very low values of minima for all metrics evaluated.ConclusionsFCNNs have promising potential in the analysis and segmentation of OC and OP video-endoscopic images. All tested FCNN architectures demonstrated satisfying outcomes in terms of diagnostic accuracy. The inference time of the processing networks were particularly short, ranging between 14 and 115 ms, thus showing the possibility for real-time application.

Expression of e-cadherin and vimentin in lesions of oropharynx

Background: Oral squamous cell carcinoma is the 6th most common malignancy in the world and ranks as first in males in Indian sub-continent. Vimentin is an intermediate filament found in mesenchymal cells and e-cadherin is an adhesion molecule found in epithelial cells. The objective of the study is to evaluate the expression of e-cadherin and vimentin in lesions of oropharynx and to assess the sensitivity, specificity and positive predictive value of e - cadherin and vimentin in oropharyngeal squamous cell carcinoma (OPSCC), against routine H and E stained histopathological diagnosis.Methods: 100 oropharyngeal biopsy specimens taken and routine H and E stained histopathological slide diagnosis made. E-cadherin and vimentin expression studied in OPSCC, moderate to severe dysplasia, mild dysplasia and benign cases and its sensitivity, specificity, positive predictive value and negative predictive value analysed using appropriate statistical tools.Results: Vimentin positivity was observed in 70 out of 79 OPSCC, 2 out of 3 cases of moderate - severe dysplasia, 0 out of 2 mild dysplasia and 2 out of 16 benign lesions. Out of 79 cases of OPSCC, 15 were e-cadherin negative, 27 showed low and 37 cases showed high membraneous positivity.Conclusions: We observed a significant decrease in e-cadherin membrane expression from dysplasia to carcinoma insitu to invasive carcinoma and a significant increase in vimentin expression with progression of the tumor. E-cadherin is a good prognostic marker whereas vimentin expression indicates a poor prognosis.

Etiological and clinical profile of patients with lesions of oral cavity and oropharynx

Oral lesions contribute a major part in head neck diseasesIn India, head and neck cancers (HNCA) account for 30-40% cancers at all sites, out of which 9.4% being oral cancers. Oral cavity and oropharynx lesions have a major impact on physical, social and economic condition of the patient. To study the etiological and clinical profile of patients with lesions of oral cavity and oropharynx.Prospective study. Total 100 samples of oral cavity and oropharynx lesions were studied. Data collected with pre tested questionnaire. Data included sociodemographic data, history, risk factors associated with disease, clinical examination and pathological report of the patient. Appropriate statistical tests.Present study includes 100 cases of oral cavity and oropharyngeal lesions out of which 19% were inflammatory lesions, 10% tumour like lesions, 4% benign lesions, 4% premalignant lesions and 63% malignant lesions. Male to female ratio of 1.7:1. Among malignant lesions in our study, 60.3% had history of tobacco consumption, 17.5% consumed both alcohol and tobacco, 9.5% were alcoholics and 12.7% patients did not have any habits.

Histopathological spectrum of tumor and tumor like lesions of oral cavity and oropharynx in tertiary care hospital

Background: Oropharyngeal cancers are most commonly observed cancers in Indian population. Oropharyngeal cancers have a poor prognosis. A histopathological study of lesions will give the exact cause and helps in initiation of optimal therapy at the earliest. Settings and design: Prospective study Aims: To study the histopathological changes in tumour and tumour like lesions of oral cavity and oropharynx Material and Methods: A prospective study was carried out in patients of oral cavity and oropharynx lesions. Total 100 biopsies and resected specimens were studied. Data included sociodemographic data, clinical features and histopathological diagnosis of the specimen. Statistical analysis used: Appropriate statistical tests Results and Conclusion: In our study we observed 10% tumor like lesions, 4% benign lesions, 4% premalignant lesions and 63% malignant lesions. Mucocele was the commonest tumor like lesion. Squamous cell carcinoma was the most common malignant lesion in our study seen in 95.2% cases. Out of 60 Squamous cell carcinoma cases, 11.6% had lymph node metastases and 3.3% showed lymphovascular invasion. In TNM staging of 14 cases who underwent resection with modified radical neck dissection, maximum number of cases belonged to Stage II (35.71%) and Stage IV (35.71%). Keywords: Histopathology, Oral cavity, Oropharynx, Tumor, Tumorlike.

Survival Rates According to Tumour Location in Patients With Surgically Treated Oral and Oropharyngeal Squamous Cell Carcinoma.

We evaluated survival rates in surgically-treated oral and oropharyngeal squamous cell carcinoma patients at our clinic, and determined whether survival differed by tumour locations. In a retrospective study, tumour lesions in 1,486 patients were categorized into 6 groups according to tumour location. Patients' age, sex, tumour-node-metastasis classification, resection status, 5-year and disease-specific survival rates were statistically analysed between groups. A significantly inferior disease-specific and lower 5-year survival rates for tumours located at the base of the tongue and oropharynx, and maxilla, due to higher T-stage and incomplete resection status were shown. Cervical lymph node metastasis and distant metastatic spread were more frequently observed with base of the tongue and oropharynx lesions. Attentive inspection and precise clinical examinations of specific oral and oropharyngeal regions are crucial for early diagnosis and treatment. Oral and oropharyngeal tumour locations play important roles in disease prognosis.

Role of narrow band imaging in the detection of malignant lesions of the oropharynx and the laryngopharynx

Objective:To explore the role of narrow band imaging (NBI) endoscopy in the diagnosis of oropharyngeal and laryngopharyngeal lesions. Method:NBI and white light (WLI) endoscopy were performed on 90 patients with oropharyngeal and laryngopharyngeal lesions from August 2016 to May 2017. NBI findings were classified into 5 types according to the Ni classification and were compared with histopathological results. Accuracy of NBI on premalignant and malignant lesions were compared with WLI. The connection between NBI findings and phathological results were explored. Result:Sensitivity, specificity, PPV, and NPV of NBI vs WLI were 988% vs 83.7%, 89.2% vs 86.5%, 95.5% vs 93.5%, and 97.1% vs 69.6%, respectively NBI findings were highly consistent with the phathological results (kappa=0.901,P<0.01). However, consistency between WLI findings and the phathological results was relatively low (kappa=0.657,P<0.01). NBI was more accurate in diagnosing both premalignant (P<0.01) and malignant lesions (especially for high-grade intraepithelial neoplasia, (P<0.01) than WLI. NBI findings correlated with the phathological results (r=0.820, P<0.01). Conclusion:NBI shows high accuracy in detecting premalignant and malignant lesions of oropharynx and laryngopharynx; Ni's NBI classification helps to diagnose the premalignant and early malignant lesions and evaluate tumor invasion. Thus, NBI can contribute more in the diagnosis and minimally invasive treatment of premalignant and malignant lesions of oropharynx and laryngopharynx.

A Pedunculated Fibrolipomatous Polyp of Tonsil: A Rare Case Report

Lipoma being the most common mesenchymal tumour of the body is rare in head and neck region. Fibrolipoma is a rare benign tumour of palatine tonsil which may present a pedunculated lesion in oropharynx and can cause dysphagia, foreign body sensation in throat, sleep disturbance and voice change. Our patient presented with foreign body sensation in throat. Examination showed pedunculated polypoidal mass arising from right palatine tonsil, treated with tonsillectomy under general anaesthesia. Histopathological examination confirmed as fibrolipoma of tonsil. Malignant transformation in fibrolipoma is very rare but some cases have been reported. Hence patient was followed up for two years and no recurrence noted.

Difficult Airway Control in a Neonatal Patient with Oropharynx Mass

Tracheal intubation using direct laryngoscopy has become an essential part in the anesthesia management of the surgical patient. Big oropharynx mass can cause serious problems depending on their locations. Mass lesions of oropharynx may lead to difficult intubation. In this letter, we present a successful application of airway management with general anesthesia in a neonatal patient with big oropharynx mass.

Oral Ulcer as the First Sign of Miliary Tuberculosis: A Case Report

Tuberculosis is a chronic granulomatous disease that usually involves the lungs. However, any part of the body can be affected. A 34-year-old male presented an ulcerated lesion in oropharynx and complained of dysphagia. The lesion had appeared 1 year before and increased recently, affecting multiple sites. Cervical lymphadenopathy was also present. Lately, he had severe weight loss and regular fever. The diagnostic hypotheses included Wegener's granulomatosis and tuberculosis. Histopathological examination of the oral lesion revealed several granulomas with Langhans giant cells. Several acid-fast bacilli were identified with Fite–Faraco stain. Examination of the pulmonary and lymph node biopsy specimens produced similar findings, indicating miliary tuberculosis. The patient received anti-tuberculosis therapy but died a few weeks later. Although uncommon, oral tuberculosis can be the first sign of a severe systemic infection. This case highlights the importance of an accurate diagnosis.

Erythema multiforme induced by clindamycin diagnosed by patch test

Results A 17 years of age male was admitted in a University Hospital In Sao Paulo, Brazil, because he had been a victim of a car accident in May 2012. He suffered a tibia open fracture and was submitted to a surgical treatment. Three days after the procedure he developed face rash, cutaneous itching, target lesions in oropharynx and lower limbs peeling. He was being treated with Clindamycin, Ciprofloxacin, Dipyrone, Ketoprofen and Tramadol. The patient evolved with fever and leucocytosis, without eosinophilia. This reaction was diagnosed as EM major by Dermatology Unit and he was successfully treated with antihistamines and corticosteroids, besides suspected drugs substitution. After been discharged the patient was referred to the Allergy Unit to perform a drug hypersensitivity investigation. He was submitted to patch test with all the suspected drugs diluted in petrolatum 10%. Only the clindamycin patch test was positive, which was confirmed with a second patch test. The patient also presented reactivation of previous lesions. Conclusions As far as we know, this is the first patient who had developed erythema multiforme due to clindamycin. The patch test was essential to confirm the diagnosis and the use of all other drugs which were present at the time of the reaction could be released.

Radiotherapy (RT) potentiation with weekly (q1w) or standard every 3 weeks (q3w) cisplatin chemotherapy (CT) for locally advanced head and neck squamous cell carcinoma (HNSCC).

6056 Background: Q3w CT is standard RT potentiation for HNSCC but its toxicity requires to look for new treatment’s modalities. The aim was to explore if q1w CT could be a safe and effective alternative. Methods: Patients (pts) treated by chemoradiation (CT-RT) for a HNSCC were retrospectively included. Study population was first described. Then overall (OS) and progression-free survival since the RT onset were performed. Survival distributions were estimated by Kaplan-Meier method and compared between CT groups using the Log-Rank test. Prognostic effect of CT group was explored using Cox model. Results: 266 pts treated between January 2004 and December 2008 were included: 170 and 96 pts respectively received q1w and q3w CT. At diagnosis, 46% had oropharynx lesions, 20% larynx, 17% hypopharynx and 14% oral cavity. 70% pts experienced surgery, 39% CT induction and a median dose of radiation of 64 Gy without any significant difference between CT groups. However, median age at diagnosis was significantly different between q1w and q3w CT (58 vs 54, p&lt;0.001) as well as alcohol consumption (79% vs 68, p=0.047), stage at diagnosis (30%-60% stage III-IV vs 13% -80%, p=0.003), IMRT use (4% vs 13%, p=0.011) and median weight before RT (66 kg vs71kg, p=0.014). Q3w CT was more toxic than q1w in terms of weight loss (87% vs 75%, p=0.012), renal failure (50% vs 35%, p=0.022), worse CT plan completion (42% vs 66%, p&lt;0.001). Moreover, grade 3/4 toxicities, such as mucositis (34% vs 13%, p&lt;0.001) and dermatitis (7% vs 1%, p=0.012), were more frequent. More pts needed parenteral nutrition (10% vs 2%, p=0.008), analgesics (91% vs 70%, p&lt;0.001), secondary hospitalization (31% vs 8%, p&lt;0.001), RT interruption &gt;= 3 days (8% vs 2%, p=0.037) and had long-term toxicities (24% vs 12%, p=0.014). With a median follow-up of 42 months 95% CI [36.8-48.8], a trend in favour of q3w CT was found:2-years OS of 83% (95% CI [73-90]) vs 74% (95% CI [66-80]), p=0.089. However, after adjustment on prognostic factors CT group was not significantly associated with OS nor with PFS. Conclusions: Q1w RT-CT is safer than q3w and may be as efficient. Follow-up data will be updated to reinforce efficacy results.

Multiple ′skip′ lesions in oropharynx and contralateral synchronous primary in hypopharynx detected on FDG PET/CT in case of oral cavity cancer

Multiple ′skip′ lesions in oropharynx and contralateral synchronous primary in hypopharynx detected on FDG PET/CT in case of oral cavity cancer

TU‐C‐T‐6C‐05: How Much Complexity Is Necessary for IMRT?

The key to simplifying IMRT is keeping the intensity patterns as simple as possible. Of course, any simplification of the intensity distributions might degrade the quality of the final treatment plan. A major problem is that it is hard for the dosimetrist to determine if a current iteration of a treatment plan is as good as possible. Not knowing if changing the dose constraints one more time will give a better result, it is difficult to justify simplifying the intensity pattern as part of the inverse planning process. However, the drawbacks associated with busy intensity patterns are well known. There are basically two problems that are related, but affect the overall process in different ways. First, complex intensity patterns can increase the number of segments needed to model the distribution. This can increase multileaf collimator wear and extend treatment times. Second, complex intensity patterns can drive up monitor units with a likely increase in the leakage radiation reaching the patient's total body. There are some delivery systems that can relatively easily handle busy intensity patterns. Examples are tomotherapy and dynamic multileaf delivery. It is not clear that these approaches avoid the basic problems that are the justification for trying to simplify the intensity patterns. This presentation argues that it is important to optimize the dose optimization process such that the quality of the dose distribution is within acceptable limits while keeping the intensity pattern as simple as possible. There are methods for evaluating the quality of treatment plans developed during the inverse planning process. In addition to relying on previous experience in planning similar cases at your institution, it is possible to review readily available RTOG protocols to determine how a group of experts define acceptable dose volume histograms for treating a particular disease site with IMRT. There is a nasopharynx protocol and another for treating oropharynx lesions. Other RTOG protocols have been written or amended to include IMRT as an option. These additional protocols have more expanded statements of the required DVH constraints needed to accommodate the use of IMRT. The information that exists in RTOG protocols helps the dosimetrist set the dose volume constraints that must be met during the inverse IMRT planning process, and then concentrate on simplifying the intensity pattern as much as possible while staying within these stated limits. There are a number of methods available for simplifying the intensity patterns obtained from the inverse planning process: 1) It is possible to use an inverse planning algorithm that inherently produces simple intensity patterns. 2) Some interpreter software used to model the intensity pattern reduces the number of segments and monitor units. 3) Deriving the field segments during the optimization process (Direct Apertrure Optimization) can decrease segments and monitor units. 4) Up‐front geometric aperture design reduces the number of segments that the inverse planning algorithm can use in finding an acceptable solution to the treatment planning problem. This presentation will discuss the techniques available for simplifying the overall IMRT process.

Paracoccidioidomycosis: a clinical and epidemiological study of 422 cases observed in Mato Grosso do Sul

Clinical and epidemiological features of 422 cases of paracoccidioidomycosis attended at University Hospital of Universidade Federal de Mato Grosso do Sul (Campo Grande, Mato Grosso do Sul, Brazil) from January 1980 to August 1999, were analysed. The mean age was 43.4 years old and the male: female ratio was 10:1. Nearly half (45.5%) of the patients were agricultural workers at the moment of diagnosis. In the acute/subacute form (juvenile type) the phagocytic-monocytic system was very much impaired and mainly marked by lymphadenopathy (95.4%), hepatomegaly (40%), splenomegaly (23.1%). The chronic form (adult type) presents more lesions in oropharynx (66.4%), dysphonia (31.4%) and cough (50.7%). Mycological diagnosis was obtained by direct microscopy of wet mounts in 185/365 (50.7%) patients and by histopathological examination of biopsies in 294/302 (97.3%) patients. The treatment of choice was Sulfamethoxazole/ trimethoprim (Co-trimoxazole), used in 90.3% patients. Sequelae occurred in 30.3% and death in 7.6% of the cases.

Oral and oropharyngeal squamous cell carcinoma in young adults: A report on 13 cases and review of the literature

Objective: Squamous cell carcinoma (SCC) of the head and neck is rare in patients younger than 45 years. Patients aged 18 to 45 years with SCC of the oral cavity (OC) and oropharynx (OP) were retrospectively compared with older control subjects. Methods: Twenty of 127 patients with OC/OP SCC were young adults. Thirteen patients (10 men) comprise the present series; 9 had OC lesions. Seven case controls were identified. Results: Overall, 15.75% of patients with OC/OP SCC were 18 to 45 years old. Seven OC lesions were early stage, and 2 were late stage; OP lesions were evenly divided. Eleven of 13 patients were disease free at the time of their last visit; 2 died of disease. Thirty-one percent of young patients were heavy drinkers; 77% of them smoked. Conclusions: Young adults’ survival rate resembles that reported for all patients with head and neck cancer stage for stage. Tobacco and alcohol abuse prevention among young people is imperative. Health care providers who encounter a young patient with a suspicious head or neck lesion must include malignancy in their differential diagnosis. (Otolaryngol Head Neck Surg 1999;120:828-33.)