Effect of Complex Decongestive Therapy on Quality of Life and Physical Parameters in Head and Neck Lymphedema.

OBJECTIVE: To assess the effect of complex decongestive therapy treatment (CDT) on quality of life, neck disability, cervical range of motion, and facial and neck lymphedema size using specific anatomical landmark points. METHODS: This prospective study was conducted in a tertiary cancer center in Turkey. Thirty patients included in the study were treated with CDT for 21 days. The patients were evaluated before and after CDT with MD Anderson Cancer Center Head and Neck Lymphedema (MDACC HNC) staging system, The Neck Disability Index, European Organization for Research and Treatment of Cancer Quality of Life 30 (EORTC-QLOC30), Facial Composite score and Neck Circumferences, cervical range of motion. RESULTS: Median follow-up was 7.2 months. After treatment of 30 patients significant cognitive function, emotional function, and social function (p < 0.001). After CDT treatment, the quality of life sub-parameters of EORTC QLQ-C30 showed significant improvement (p < 0.001). The facial composite score and neck circumferences indices showed significant improvement (p < 0.001). A decrease of 2% or more in the facial composite score and neck circumferences was observed in all patients participating in the study. CONCLUSION: There have been few studies on the effectiveness of CDT on the EORTC QLQ-C30, facial composite score, and neck circumferences in head and neck lymphedema. In patients with head and neck lymphedema following head and neck cancer, our study demonstrated the positive effects of complex decongestive therapy (CDT) on neck disability, range of motion, quality of life, and facial and neck lymphedema tissue size. LEVEL OF EVIDENCE: 4 Laryngoscope, 134:3152-3157, 2024.

Is intensity-modulated radiotherapy superior to conventional techniques to prevent late ear complications of nasopharyngeal cancer?

PURPOSE: This study analyzed the late ear complications of radiotherapy for nasopharyngeal cancer (NPC) and compared the conventional and intensity-modulated radiotherapy (2D-RT and IMRT, respectively). METHODS: At 2-21 years after the end of NPC treatment, 104 ears of 52 patients were evaluated with the otoscopic examination, pure tone audiometry test, tympanometry, and subjective complaints by being blinded to the radiotherapy technique. RESULTS: There were no differences in terms of the pathology of the external, middle or inner ear, air and bone-conduction hearing thresholds, and the air-bone (A-B) gap at 500, 1000, 2000, and 4000 Hz, and tympanometry types between 2D-RT and IMRT groups (p > 0.05). There were positive correlations between the values of A500 and A1000 thresholds; gap 500, 4000, and mean cochlear RT dose (p < 0.05). There were positive correlations between the values of A500, A1000, and A4000 thresholds; gap 500, 1000, 2000, 4000, and maximum cochlear RT dose (p < 0.05). CONCLUSION: IMRT was not found to be superior to 2D-RT to prevent RT-induced ear complications. The solution of the middle ear problems must be the goal of the strategies for complications treatment.

Microscopic Transnasal Approach: A New Technique for the Reconstruction of Frontoethmoidal Meningoencephalocele.

Frontoethmoidal meningoencephalocele is a rare congenital malformation, which occurs due to a deficiency in neural tube closure. It may present as an external mass over the nose, nasal obstruction, rhinorrhea and attacks of central nervous system infections. Herein, the authors present a 3-month-old infant with naso-ethmoidal form of frontoethmoidal meningoencephalocele, who was operated on using a newly described approach that was performed under microscope.