ABSTRACT
OBJECTIVE: The aim of this study is to analyze oncologic outcomes and complications rate after common or internal carotid artery (CCA/ICA) resection for head and neck squamous cell carcinoma (HNSCC). METHODS: This study was conducted in conformity with the PRISMA statement. A systematic review and pooled analysis was performed for overall survival (OS), disease specific survival (DSS) (primary outcomes), and perioperative death rate (secondary outcome). RESULTS: A total of 276 patients (males: 76.7%, n = 191/249) with a median age of 59 years (n = 239/276; 95% CI 55.0-61.7) who underwent CCA/ICA resection for HNSCC were included. The median follow-up time was 11 months (n = 276). Estimated pooled OS rates (95% CI) at 1 and 2 years were 52.7% (46.9-59.2) and 29.8% (24.3-36.5), respectively. The median OS (95% CI) was 14 months (12-17). Estimated pooled DSS rates (95% CI) at 1 and 2 years were 58.6% (52.7-65.2) and 34.6% (28.5-41.9), respectively. The median DSS (95% CI) was 16 months (14-19). The perioperative death rate was 6.9% (n = 19/276). CONCLUSIONS: CCA/ICA resection should be considered as a treatment option for accurately selected patients. Multicentric prospective studies are recommended to develop a predictive score guiding the decision-making process.
Subject(s)
Head and Neck Neoplasms , Postoperative Complications , Squamous Cell Carcinoma of Head and Neck , Humans , Head and Neck Neoplasms/surgery , Head and Neck Neoplasms/mortality , Squamous Cell Carcinoma of Head and Neck/surgery , Squamous Cell Carcinoma of Head and Neck/mortality , Postoperative Complications/mortality , Postoperative Complications/epidemiology , Female , Carotid Artery, Internal/surgery , Male , Middle Aged , Survival Rate , Carotid Artery, Common/surgerySubject(s)
Plastic Surgery Procedures , Surgical Flaps , Humans , Surgical Flaps/blood supply , Neck , Arteries/surgeryABSTRACT
Introduction: To present a complex case of giant meningoencephalocele after a canal wall down mastoidectomy and describe our preferred approach to repair meningoencephalic herniation of the temporal bone. Case Report: A 20-year-old patient, who had previously undergone type III tympanoplasty with total ossicular reconstruction prosthesis for an attic cholesteatoma, presents with clinical and imaging features compatible with the diagnosis of a giant temporal meningoencephalocele. We performed a combined approach -transmastoid plus minicraniotomy- to repair the skull base defect. A multilayer reconstruction of the defect with septal cartilage and temporal fascia was performed. After a 48 months follow-up, the patient remains symptom free without signs of tissue herniation. Conclusions: Transmastoid plus minicraniotomy combined approach is a safe and feasible technique in case of large and anterior skull base defects with low surgical morbidity, allowing a safe and multilayered reconstruction, even in the context of a simultaneous active chronic otitis media.
ABSTRACT
Glomus tumors are rare and the hand is classically the most commonly affected site. The present study performed a literature review on the topic and reported on an unusual case of neck glomangiomyoma in a female adult patient. A 31-year-old woman presented with a 4-year history of a growing submandibular tumor with localized non-irradiated pain. A previous fine needle aspiration biopsy had suggested a glomus tumor, and immunohistochemical analysis showed positive staining for smooth muscle actin, H-caldesmon, muscle-specific actin and collagen type IV. The MRI revealed a well-defined nodular lesion measuring 38x28x33 mm. The patient underwent surgery with no complications. After the histopathological examination and immunohistochemical staining, a diagnosis of glomangiomyoma was established. Glomangiomyomas are extremely rare but should be considered in the differential diagnosis of an adult presenting with a neck mass and localized tenderness, especially if no other risk factors for head and neck tumors are present.
