Neck Dissection Technique Commonality and Variance: A Survey on Neck Dissection Technique Preferences among Head and Neck Oncologic Surgeons in the American Head and Neck Society

Abstract Introduction Neck dissection (ND) technique preferences are not well reported. Objective The objective of this study is to educate practitioners and trainees about surgical technique commonality and variance used by head and neck oncologic surgeons when performing a ND. Methods Online survey of surgeon members of the American Head and Neck Society (AHNS). Survey investigated respondents' demographic information, degree of surgical experience, ND technique preferences. Results In our study, 283 out of 1,010 (28%) AHNS surgeon members with a mean age of 50.3 years (range 32-77 years) completed surveys from 41 states and 24 countries. We found that 205 (72.4%) had completed a fellowship in head and neck surgical oncology. Also, 225 (79.5%) respondents reported completing more than 25 NDs per year. ND technique commonalities (>66% respondents) included: preserving level 5 (unless with suspicious lymph nodes (LN)), only excising the portion of sternocleidomastoid muscle involved with tumor, resecting lymphatic tissue en bloc, preservation of cervical sensory rootlets, not performing submandibular gland (SMG) transfer, placing one drain for unilateral selective NDs, and performing a ND after parotidectomy and thyroidectomy and before transcervical approaches to upper aerodigestive tract primary site. Variability existed in the sequence of LN levels excised, instrument preferences, criteria for drain removal, the timing of a ND with transoral upper aerodigestive tract primary site resections, and submandibular gland preservation. Results showed that 122 (43.1%) surgeons reported that they preserve the submandibular gland during the level 1b portion of a ND. Conclusions The commonalities and variances reported for the ND technique may help put individual preferences into context.

A comparative study between the application of apos therapy and knee brace in pain, range of motion and functional disability in osteo arthritis knee.

Background & Objectives: Osteoarthritis is chronic degenerative disorder of joint having many etiological factors. It is estimated to be the fourth leading cause of disability with prevalence of 22% to 39% in India. There is availability of less evidence of physiotherapy treatment for OA. Hence the need of the study is to find the individual and comparative effect of Apos therapy and knee brace in aspect of pain, range of motion and functional disability in patients with O.A. knee. Method: 30 subjects with osteoarthritis of Tibiofemoral joint were selected for the study and randomly divided in to two groups (A&B) of 15 subjects. Group A received Apos therapy and Group B received knee brace. Both groups treated with active exercises plus IFT. Pain was measured by VAS, Range of motion was measured by Goniometer and functional disability was measured by WOMAC scale. Results :Intra-group comparison of VAS , ROM and WOMAC score showed significant improvement in both the group but Apos therapy group showed highly significant (p< 0.001) improvement. Conclusion: In this study both groups have shown significant difference in reducing pain, improving ROM, and improving functional disability but Apos therapy showed more improvement than application of knee brace.

Detection of Coronary Artery Diseases: Comparative Study of Multidetector Computed Tomography Angiogram (64 slice scanner) and Conventional Angiogram.

Methods: It was cross sectional comparative study conducted in National Institute of Cardiovascular Diseases and Bangabandhu Sheikh Mujib Medical University. Total 80 patients were included in the study who underwent MDCT and coronary angiogram. Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy or efficacy for single vessel disease were 87.5%, 96.4%, 91.3%, 94.7% and 93.75% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy or efficacy for double vessel disease were 84.0%, 94.5%, 87.5%, 92.85% and 91.25% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy or efficacy for triple vessel disease were 69.5%, 91.22%, 76.19%, 88.13% and 85.0% respectively. Conclusion: Coronary angiography is a promising technology that already appears to have high performance to assess patient base, vessel base and segment base sensitivity, specificity, positive predictive value, negative predictive value and accuracy in detecting coronary artery stenosis.