Neck Oncology Research Articles

Stage of presentation and survival rates of head and neck cancer in Western Cape, South Africa

Background: The Western Cape province in South Africa has a high age-standardised mortality from cancer. Most literature reports significantly poorer access to healthcare, more advanced cancers and worse survival for rural and remote populations. This study investigates if significant disparities exist with regard to stage at presentation and overall survival of patients with head and neck cancer (HNC) between geographical areas within the Western Cape province in South Africa.Methods: A retrospective chart review was conducted on all patients managed at the Combined ENT Head and Neck Oncology clinic at Groote Schuur from January 2010 to December 2014. Ethics approval was granted by the University of Cape Town Human Research Ethics Committee (HREC, 351-2017).Results: Although we observed no significant difference in TNM clinical stages or overall survival between metropolitan and remote patients, there were statistically and clinically significant differences in terms of both stages of HNC and overall survival between some individual metropolitan and remote areas. The remote area of Eden had a median overall survival of more than 6 months less than that of the Southern subdistrict of the City of Cape Town.Conclusion: Differences in HNC stages and overall survivals between some subdistricts of the City of Cape Town and remote areas are not only statistically significant but also clinically relevant.Contribution: This article highlights the need to improve on diagnostic and referral pathways for management of patients with HNC in the Western Cape.

Reappraisal of p16 for Determining HPV Status of Head and Neck Carcinomas Arising in HPV Hotspots.

In an era of head and neck oncology where HPV status will soon dictate patient management, reliable HPV detection is critical. P16 immunohistochemistry (IHC) is currently recommended as the test of choice for oropharyngeal squamous cell carcinomas (OPSCCs). The purpose of this study was to determine the performance characteristics of p16 IHC based on a large clinical experience of squamous cell carcinomas (SCC) arising from HPV hot-spot regions of the head and neck. Consecutive OPSCCs, sinonasal SCCs, and metastatic SCCs of unknown primary sites were evaluated for the presence of HPV by p16 IHC and PCR-based HPV DNA testing as part of clinical care. For discrepant cases, high-risk HPV E6/E7 mRNA in situ hybridization (ISH) and, when possible, matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry (MassArray) genotyping were performed. 746 cancers underwent HPV testing by p16 IHC and DNA PCR genotyping. There was a 95.6% concordance between the 2 assays. Of the 33 discrepant cases, 32 cases (4.3%) were p16 positive but HPV DNA negative. In these cases, 68% were positive for mRNA ISH, invariably related to a non-16 HPV genotype. P16 IHC had an overall accuracy of 98.8%, a sensitivity of 99.8%, and a specificity of 92.1%. P16 IHC is a sensitive and specific assay for determining HPV status. HPV DNA PCR appears vulnerable to HPV genotype diversity and is prone to missing rare non-16 genotypes. HPV mRNA ISH is a practical and reliable direct measure of HPV that may help eliminate the small number of false-positive p16 cases and avoid potential patient harm related to erroneous HPV classification.

The COVID-pandemic and specialist training in Head and Neck oncology: A Survey among Physicians

The COVID-19 pandemic has had a profound impact on the healthcare system and medical education. In this publication, the influence of the pandemic on the education of physicians active in Head and Neck oncology was examined using a survey. A survey comprising 53 questions was conducted to gather data on work settings, daily activities, team events, and educational aspects during the pandemic. A total of 497 oncologists participated, including 131 individuals working in the field of Head and Neck oncology. This subgroup consisted of 99 (75.6%) radiation oncologists, 10 (7.6%) maxillofacial specialists, and 22 (16.8%) otolaryngologists. Nearly half of the participants reported experiencing increased clinical burden, which resulted in reduced engagement in scientific activities. Digital platforms became the predominant mode of continuing education, albeit with reduced accessibility. The pandemic significantly impacted clinical training that involved direct patient interaction. On the other hand, positive effects were observed in terms of cost and availability for external educational events such as conferences. The findings highlight the detrimental effects of the COVID-19 pandemic on various aspects of medical education. While digitalization has accelerated in response, many physicians expressed a lack of professional interaction. Developing alternative digital learning platforms can provide a means to better cope with similar situations in the future. However, the importance of personal contact with colleagues and supervisors should not be overlooked when considering the quality of teaching.

Head and Neck Soft Tissue Sarcoma Patient: Age and Tumor Region Are Predictive in Disease-Free Survival and Overall Survival

Head and neck soft tissue sarcoma (HNSTS), rare and heterogeneous malignancies, are treated primarily treated with surgery. However, prognostic indicators that might guide HNSTS management are poorly defined. Main purpose of this study is to find variables linked to HNSTS patients' prognosis. Assessment of the Tumor, Node, Metastatis (TNM) system is the secondary purpose. This study is a retrospective cohort performed on HNSTS patients who received surgery at the Department of Oral and Maxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital School of Medicine, Shanghai Jiao Tong University from January 1, 2006, to December 31, 2014. Strict inclusion criteria were applied. The predictor variable was a set of heterogenous risk factors and were grouped into the following categories: demographic (age and gender), clinical (primary tumor, tumor region, tumor size, and TNM stage), and treatment (surgical margin, treatment therapy). The primary outcome variables were time to 5-year disease-free survival (DFS) and 5-year overall survival (OS). The secondary outcome variables were time to 5-year tumor local recurrence and metastasis. Not applicable. Descriptive statistical analysis was carried out. Pearson χ2 test was employed in univariate analysis. Cox regression was modified for multiple variable analysis with components that had significant P values in univariate analysis or variables with potential prognostic value. Log-rank test was applied to compare survival situations under various variables. P value less than .05 was statistically significant. The sample was composed of 100 subjects with a mean age of 43.47 (standard deviation: 16.15) years old and 56 (56%) were male. The 5-year DSF and OS were 59 and 60%, respectively. Variables associated with poor DFS and OS were age > 60years (P=.003, hazard ratio [HR]: 4.95, 95% confidence interval [CI]: 1.71,14.1; P=.005, HR: 4.48, 95% CI: 1.57,12.8) and non-primary tumors (P＜.001, HR: 8.41, 95% CI: 2.85,24.8; P=.002, HR: 6.90, 95% CI: 2.46,19.4), respectively. Maxilla and skull base cancers had local recurrence (12/18, 66.7%) more common. T2 (TNM) tumor displayed higher tendency in DFS(P=.009, HR: 4.20, 95% CI: 1.42,12.4) and metastasis(P=.09, HR: 3.51, 95% CI: 0.82,15.0) than T1 (TNM) tumors. Poor prognosis is associated with maxilla and skull base tumors as well as patients over 60years. TNM stage appeared to have limited prognostic significance.

178 Implementation challenges of artificial intelligence-based radiomics in head and neck oncology: A systematic review

178 Implementation challenges of artificial intelligence-based radiomics in head and neck oncology: A systematic review

270 Radiologic diagnosis of Extranodal Extension (ENE) in patients with HPV-positive oropharyngeal cancer: consensus diagnosis and influence on prognosis

Tumor often progresses through the weakest part of any surrounding tissues. The extent of tumor invasion depends on: a. Aggressiveness of the tumor cells (e.g. number and invasive character of stem cells), b. robustness of the surrounding tissues and their composition (e.g. vessels), and c. time to allow the tumor to proliferate. The lymph node (LN) capsule comprises dense connective tissue stroma and collagenous fibers, and is a natural barrier that generally prevents further tumor progression. Permeation of tumor through the nodal capsule into surrounding tissues is termed “extranodal extension”. The idiosyncratic and inconsistent mechanism of ENE is imprecisely understood, but it is thought to be due to either tumor cell proliferation that outpaces the capacity of nodal capsular expansion (“ruptures” the LN capsule), or factors within the tumor or tumor microenvironment that facilitate the “breach” of the capsule. The latter might explain ENE in small LNs, or a “neglected” tumor (lengthy intranodal tumor growth with eventual “rupture” through an expanded nodal capsule). Several biomarkers (e.g. podoplanin) that are often associated with tumor aggressiveness have been reported to have a high expression in ENE+ LN. ENE represents a spectrum of tumor nodal invasion. The early sign of ENE can only be visible under the microscope (pathologic ENE); when ENE progresses further, the radiographic signal changes become apparent, making it visible on imaging (iENE). Most advanced ENE causes emergence of clinical surrogates (e.g. peau d'orange, or a “fixed” nodal mass), rendering it detectable by regular clinical examination (ENEc). iENE has been reported to be one of the strongest anatomic prognostic factors for overall survival (mainly due to increased risk of distant metastasis) in HPV-positive oropharyngeal carcinoma (HPV+ OPC), and is able to identify a subgroup of stage I disease with poor prognosis. Several deintensification trials (NRG-HN002, ORATOR, ORATOR2, E3311) have excluded HPV+ OPC with some form of iENE from trial enrolment. Several authors have proposed that iENE be included in future clinical N classification for HPV+ OPC. However, adoption of iENE in clinical care remains challenging because it is not a well-defined radiologic feature among the radiology community. Various definitions / descriptions of iENE have been used in literature. There is also insufficient awareness of the prognostic importance of this parameter in head and neck oncology community. The international iENE Expert Panel was convened under the HNCIG comprised expert internationally renowned neuroradiologists and clinicians. Several rounds of Delphi process were conducted to consolidate iENE definition. The consensus recommendations on the terminology and diagnostic criteria for iENE were generated. The experts in the consensus process recognized the following as criteria for the diagnosis of iENE: clear evidence of irregular or indistinct nodal margin/border; extension into perinodal fat; extension into adjacent structures, and conglomerate/matted/coalescent nodes. These recommendations have been endorsed by 19 national organisations, representing 34 countries. With increased awareness and consolidated definition as well as training, iENE could become an important baseline factor for risk stratification and staging in HPV+ OPC.

Canadian French Translation and Validation of the Neck Dissection Impairment Index: A Quality of Life Measure for the Surgical Oncology Population.

Neck dissections (ND) are a routine procedure in head and neck oncology. Given the postoperative functional impact that some patients experience, it is imperative to identify and track quality of life (QoL) symptomatology to tailor each patient's therapeutic needs. To date, there is no validated French-Canadian questionnaire for this patient-population. We therefore sought to translate and validate the Neck Dissection Impairment Index (NDII) in Canadian French. A 3-phased approach was used. Phase 1: The NDII was translated from English to Canadian French using a "forward and backward" translational technique following international guidelines. Phase 2: A cognitive debriefing session was held with 10 Canadian French-speaking otolaryngology patients to evaluate understandability and acceptability. Phase 3: The final version was administered prospectively to 30 patients with prior history of ND and 30 control patients. These patients were asked to complete the questionnaire 2 weeks after their first response. Test-retest reliability was calculated with Spearman's correlation. Internal consistency was elicited using Cronbach's alpha. NDII was successfully translated and validated to Canadian French. Cronbach's alpha revealed high internal consistency (0.92, lower 95% confidence limit 0.89). The correlation for test-retest validity were strong or very strong (0.61-0.91). NDII is an internationally recognized QoL tool for the identification of ND-related impairments. This validated Canadian French version will allow clinicians to adequately assess the surgery-related QoL effect of neck surgery in the French-speaking population, while allowing French institutions to conduct and/or participate in multisite clinical trials requiring the NDII as an outcome measure.

Characterizing Tobacco Usage in Otolaryngology Patients to Target Smoking Cessation Efforts.

Smoking cessation is critical in reducing incidence of head and neck cancers (HNC) and improving postoperative outcomes. Accurate documentation of tobacco usage is necessary to understand prevalence in patients to target smoking cessation. This study aims to characterize tobacco usage documentation, including electronic nicotine delivery systems (ENDS) use, among otolaryngology patients. Retrospective chart review. Penn State Health Milton S. Hershey Medical Center (PSHMC). A retrospective chart review was conducted on adult otolaryngology patients seen from January 1, 2020 - December 31, 2020. Patient demographics, details of alcohol and tobacco usage, including type of tobacco, and subspecialty seen were collected. Associations were evaluated using chi-square tests and a multivariable logistic regression model. Patients (n = 2137) were an average of 58.4years old ±18.0, 59.3% female, and 78.0% white. Of participants with documented tobacco history (n = 944), 56.7% were never users, 28.9% were former users, and 14.4% were current users. Among current users (n = 308), 86.4% used cigarettes, and 5.2% used ENDS. The remainder used chew (4.9%) and cigars (3.25%). Odds of tobacco use were 1.5x greater for males (95% CI 1.19-2.00), 1.6x greater for unmarried patients (95% CI 1.24-2.09), 2.1x greater for those with no insurance vs government (95% CI 1.43-3.18), and 2.4x greater for those diagnosed with HNC (95% CI 1.64-3.49). Most patients report cigarette smoking when asked about tobacco use. Taking into consideration the rise of ENDS use, our sample showed ENDS use that was higher than the national average. There is significant opportunity for improved history taking, especially within general and head and neck oncology subspecialties for more comprehensive treatment.

A visiting otolaryngology team in northern Ontario - demographics, clinical presentation and barriers to access.

Approximately 20% of Canadians reside in rural or remote communities where access to medical specialties such as otolaryngology remains challenging due to long wait times and distance to services. The purpose of this study was to characterize patient demographics, common clinical diagnoses, and barriers to accessing otolaryngology services, in a remote Northern Ontario setting. A secondary objective was to describe a care model that provides multi-subspecialty otolaryngology services to a remote community. A team of academic otolaryngologists provided annual (2020-2021) subspecialty services in otology, neurotology, rhinology, head and neck oncology, and pediatrics to a remote hospital with admitting, general anesthesia and surgical resources. Data regarding patient demographics, otolaryngology-related diagnosis, wait times and distance travelled were recorded. Data were obtained for 276 patients treated in the clinic. The median age was 47 years (range 0-85 years). The most common otolaryngological conditions were hearing loss (n=62) and nasal obstruction (n=34). Nearly 30% of patients traveled further than 150 km to access care, and 62% waited 3-6 months for a consultation. This is the first study to characterize the demographics and range of otolaryngological disorders encountered in a remote Northern Ontario setting. The results have identified specific otolaryngology needs and barriers to access to care. The data can be used to guide healthcare providers and administrators on resource allocation to optimize the delivery of otolaryngology services.

Chronomodulated chemotherapy for locoregionally advanced nasopharyngeal carcinoma: A phase II randomized controlled trial

ObjectiveTo validate the safety and efficacy of chronochemotherapy for locoregionally advanced nasopharyngeal carcinoma (NPC). MethodsParticipants for this phase II randomized controlled trial were recruited from the Department of Head and Neck Oncology at the Affiliated Cancer Hospital of Guizhou Medical University. Patients enrolled (128 in total, 112 in the final analysis) between April 1, 2017, and February 28, 2018, were randomly divided into the chronochemotherapy and conventional chemotherapy groups. In the chronochemotherapy group, docetaxel was intravenously administered between 3:30 a.m. and 4:30 a.m. on day 1, followed by intravenous administration of cisplatin between 10:00 a.m. and 10:00 p.m. from day 1to day 5. In addition, 5-fluorouracil was administered through a continuous intravenous pump between 10:00 p.m. and 10:00 a.m. (2nd day) from day 1 to day 5. In the conventional chemotherapy group, docetaxel (on day 1), cisplatin (on day 2), and 5-fluorouracil (from day 1 to day 5, 120 ​h in total) were administered without time-specific constraints. Both groups underwent intensity-modulated radiation therapy with 6-MV X-rays. The gross target volume (GTV) comprised the nasopharyngeal GTV and cervical lymph node GTV. The primary endpoint was immune function, quantified by measuring dendritic cell and lymphocyte subsets, whereas the secondary endpoints were therapeutic efficacy and incidence of adverse events. Pearson Chi-square test was applied to compare total events between the groups, Mann-Whitney U test was used to compare the DC subsets and toxicities, and Wilcoxon signed-rank test ​was used to compare the continuous variables between the two groups. ResultsChronochemotherapy preserved immune function, as evidenced by elevated levels of myeloid dendritic cells (P ​= ​0.394) and higher CD4/CD8 ratio (P ​= ​0.781). No significant difference in overall response rate, measured as the sum of complete and partial response rates, was observed between the groups (P ​= ​0.711). A reduction in the incidence of vomiting (P ​= ​0.002), stomatitis (P ​= ​0.028), and mucositis (P ​= ​0.028) was observed in the chronochemotherapy group. Leukopenia incidence rate was 83.3 ​% and 92.3 ​% in the chronochemotherapy and conventional chemotherapy groups, respectively (P ​= ​0.232). ConclusionsIn patients with locoregionally advanced NPC, the overall response rate of chronochemotherapy is comparable to that of conventional chemotherapy; however, chronochemotherapy shows fewer adverse events.

Surgical Margin Definition and Assessment in Head and Neck Oncology: A Cross-Sectional Survey of Canadian Head and Neck Surgeons.

Head and neck squamous cell carcinomas (HNSCC) are responsible for a significant amount of morbidity and mortality in Canada. Surgical margins are one of the most important factors used to guide treatment; however, currently there is a lack of consensus on the ideal surgical margin definition, sampling, and assessment method. To understand the current perspectives and practice patterns of Canadian head and neck surgeons with respect to surgical margin: (1) definition, (2) sampling, (3) pathological assessment. A 24-question cross-sectional survey was sent via email through the Canadian Society of Otolaryngology-Head & Neck Surgery (CSOHNS), and responses were gathered from December 19, 2023, to March 12, 2024. Responses were aggregated and reported using descriptive statistics. The survey was conducted in Canada among self-reported staff head and neck oncology surgeons with membership in the CSOHNS. A total of 36 staff head and neck oncology surgeons responded from across Canada. The most common (58.3%) definition of a negative surgical margin for oral cavity HNSCC was ">5 mm formalin fixed paraffin embedded distance." To obtain surgical margins, surgeons were split with 44.1% using only a tumor bed approach and 32.4% using only a specimen-driven approach. A dedicated head and neck pathologist is always available more commonly for final pathological assessment (63.6%) versus intraoperative frozen section assessment (15.5%). Finally, most surgeons reported having a synoptic standardized reporting system for annotating margin status (78.8%). The results of this survey provide a current-state analysis of head and neck surgeons across Canada and set the stage for future efforts to be directed toward standardizing the collection method and reporting criteria for surgical margins in HNSCC.

A rapid recovery protocol for head and neck oncology patients undergoing resection, free flap reconstruction, and tracheostomy: a feasibility study

Enhanced recovery after surgery (ERAS) for head and neck oncology patients was first introduced in 2017 and was found to improve patient outcomes, in line with results from other surgical specialties. This article presents a rapid recovery protocol (RRP) to further enhance perioperative care in conjunction with the ERAS protocol, for patients undergoing ablative surgery together with free flap reconstruction and tracheostomy. A prospective multidisciplinary approach was adopted to identify a specific cohort of patients who would benefit from the RRP. Of 26 patients who fulfilled the eligibility criteria, 16 completed the RRP. On average, these patients spent 5 days less with a tracheostomy and were discharged 7 days sooner when compared to a matched control group of nine patients on the standard postoperative care pathway. This resulted in an approximate monetary saving of £ 9955 per patient for the hospital trust. These results demonstrate that the feasibility study should be rolled out further, as the RRP not only decreased the length of stay but also provided substantial monetary savings without compromising patient outcomes.

Association Between Pre-operative 25-Hydroxy Vitamin D Deficiency and Surgical Site Infection After Oral Cavity Oncology Surgery: a Cross-Sectional Study in a Tertiary Cancer Center in Northwestern India.

Surgical site infections (SSI) following head and neck oncology surgery can lead to significant morbidity and healthcare costs. This cross-sectional study was used to investigate a potential link between pre-operative 25-hydroxy vitamin D deficiency and an increased risk of surgical site infections in patients undergoing oral cavity oncology surgery. This cross-sectional study was conducted at a tertiary center in northwestern India from May 2022 to May 2023. Patients scheduled to undergo oral cavity oncology surgery during this period were eligible for inclusion. Patients with complete pre-operative 25-hydroxy vitamin D levels and documented post-operative wound infection status were included in the analysis. A total of 85 patients who underwent oral cavity oncology surgery were included in the study. Among them, 30.58% (26 patients) had pre-operative vitamin D deficiency, The overall incidence of surgical site infection (SSI) was 36.47% (31 patients). Among the patients with pre-operative vitamin D deficiency, 23 (88.5%) developed surgical site infections. Finally, pre-operative levels of 25-hydroxy vitamin D, pre-operative poor oral hygiene, and low albumin were confirmed as statistically significant independent predictors of SSI. After doing multivariate analysis, vitamin D deficiency was found to be a significant predictor of post-op wound infection [adjusted odds ratio - 0.71 (95% CI 0.61-0.82); p value < 0.001]. This study highlights the significant association between pre-operative 25-hydroxy vitamin D deficiency and an increased risk of surgical site infections in patients. Vitamin D plays a crucial role in modulating the immune response, promoting antimicrobial peptides, and enhancing wound healing. These findings support the importance of assessing and addressing vitamin D deficiency in patients scheduled for oral cavity oncology surgery to potentially reduce the incidence of SSIs.

Validation of the "Rome" Classification for Squamous Cell Carcinoma of the Nasal Vestibule.

Squamous cell carcinoma of the nasal vestibule is considered a rare malignancy that differs from other sinonasal malignancies in many respects. Four staging systems currently exist for this disease, the most recent addition being the "Rome" classification. This study assesses the use of this new classification and its prognostic value regarding various outcome measures. A retrospective multicenter cohort study of patients with a primary squamous cell carcinoma of the nasal vestibule who were treated in three tertiary head and neck oncology referral centers was conducted. A total of 149 patients were included. The median follow-up duration was 27 months. Five-year locoregional control (LRC), disease-specific survival (DSS), and overall survival (OS) were 81.6%, 90.1, and 62.5% respectively. A statistically significant association was observed between the Rome classification and all survival outcomes in both univariable and multivariable analyses. Moreover, it appeared to perform better than the Union for International Cancer Control TNM classification for tumors of the nasal cavity and paranasal sinuses. The new Rome classification can be used effectively and is associated with LRC, DSS, and OS. However, it requires further validation in a larger (prospective) study population.

P001 Retrospective analysis of consent for major head and neck oncology surgery, a regional center perspective

P001 Retrospective analysis of consent for major head and neck oncology surgery, a regional center perspective

Recent advances in head and neck surgical oncology.

In recent years, the field of head and neck oncology has witnessed a remarkable transformation with unprecedented advances that have revolutionized the management of complex tumors in this region. As an intricate subspecialty within oncology, head and neck surgical procedures demand detailed knowledge of the complex anatomy meticulous precision in surgical technique, and expertise to preserve vital functions while ensuring optimal oncological outcomes. With the relentless pursuit of improved patient outcomes, the integration of innovative technologies has significantly enhanced the surgical armamentarium. Robotics, endoscopic platforms, and image-guided navigation have revolutionized the surgical approach, enabling precise tumor resection and sparing healthy tissues. Furthermore, the application of advanced imaging modalities and molecular biomarker profiling has opened new avenues for personalized treatment strategies. From targeted therapies and immunotherapies to adaptive radiation techniques, clinicians are now equipped with an array of tailored options, ushering in a new era of personalized care for patients with head and neck malignancies. This article delves into the unfolding narratives of clinical triumphs, exploring the transformative potential of emerging therapies and the collaborative efforts propelling head and neck surgical oncology toward a future of hope and healing.

The Use of Artificial Intelligence Algorithms in the Prognosis and Detection of Lymph Node Involvement in Head and Neck Cancer and Possible Impact in the Development of Personalized Therapeutic Strategy: A Systematic Review.

Given the increasingly important role that the use of artificial intelligence algorithms is taking on in the medical field today (especially in oncology), the purpose of this systematic review is to analyze the main reports on such algorithms applied for the prognostic evaluation of patients with head and neck malignancies. The objective of this paper is to examine the currently available literature in the field of artificial intelligence applied to head and neck oncology, particularly in the prognostic evaluation of the patient with this kind of tumor, by means of a systematic review. The paper exposes an overview of the applications of artificial intelligence in deriving prognostic information related to the prediction of survival and recurrence and how these data may have a potential impact on the choice of therapeutic strategy, making it increasingly personalized. This systematic review was written following the PRISMA 2020 guidelines.

Assessment of oral emergency services during COVID-19: a retrospective study of 14,885 cases in Shanghai

BackgroundTo assess the impact of coronavirus disease-2019 (COVID-19) in its outbreak stage (Spring Festival in 2020) on oral emergency services.MethodsOral emergency cases in Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, during the Spring Festival after the outbreak of the COVID-19 epidemic in 2020 were collected and compared with those in 2018 and 2019. Electronic medical records including the visited department, age, sex, time, date, region, and diagnosis were collected and analyzed. The results were statistically analyzed using Pearson’s Chi-square test and one-way analysis of variance (ANOVA).ResultsCompared with that in 2018 and 2019, the total number of patients decreased during the Spring Festival in 2020 (p < 0.001), but the proportions of patients visiting Oral Surgery and Oral, Head, and Neck Oncology Emergency departments increased. The average age of patients increased, and the number of night visits decreased. Toothache diseases involving endodontic and periodontal diseases increased, while the proportion of maxillofacial trauma decreased. The wasn’t a linear association between diagnosis or genders (P > 0.001) across years. However, a linear-by-linear association between age groups and years, visited departments and years were observed (P < 0.001).ConclusionsThe study revealed that the transmission of COVID-19 affected the patient population and structure of disease types and oral services in 2020 during the Spring Festival, compared with those in the previous two years. The visits to oral emergency departments and the proportions of patients who were children and adolescents reduced; meanwhile, the percentage of the elderly people increased during the outbreak of COVID-19. The clear trend of age groups and visiting divisions could be used as a marker to reflect the severity of the COVID-19 pandemic. These results may serve as a reference for dental practitioners involved in oral emergency services and to allocate the limited emergency health resources.

Treatment Methods For Neck And Head Cancer

Treatment for people diagnosed with cancer does not end after the completion of active therapy. The treating physician will continue to check for cancer recurrence, monitor all sorts of side effects, and monitor your overall health. This is called follow-up. It consists of regular medical examinations and tests. Treatment of malignant tumors is accompanied by various side effects. Long-term effects persist after therapy period. Delayed side effects can take months or even years to develop. Long-term and long-term effects can include physical and emotional changes. The standards of medical care for head and neck oncology are the best of modern treatment methods. As one of the treatment options, doctors recommend considering clinical trials. With the help of clinical trials, a new approach to treatment is being tested. Experts want to know if the new treatment is safe and effective. Clinical trials are an option for treatment and cancer care at all stages of cancer. An important factor in treatment is not only the elimination of the tumor, but also the preservation of the functions of the surrounding nerves, tissues and organs. In the treatment of head and neck oncology, the following techniques are used: surgery, radiation, targeted and chemotherapy

Head & Neck Oncology Track: Carotid Resection is an Effect Method for Locoregional Control in Very Advanced Head and Neck Cancer

Head & Neck Oncology Track: Carotid Resection is an Effect Method for Locoregional Control in Very Advanced Head and Neck Cancer