Unilateral vs Bilateral Transoral Surgery for Tonsillar Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.

Importance: Transoral surgery via a radical tonsillectomy followed by pathology-guided adjuvant therapy is standard of care for tonsillar squamous cell carcinoma (SCCa). There is significant variation in the management of the contralateral tonsil without clinical evidence of disease.

Objective: To assess the second primary tumor rates, oncologic survival, functional outcomes, and complications between bilateral and unilateral transoral surgery for tonsillar SCCa.

Establishing an integrated approach to head and neck cancer treatment and prevention: The Robert Ebert and Greg Stubblefield Head and Neck Tumor Center Model.

The newly established Robert Ebert and Greg Stubblefield Head and Neck Tumor Center (HNTC) at Washington University and Barnes Jewish Hospital in St. Louis, Missouri offers one model for integrated head and neck cancer care. This article presents the HNTC's guiding principles and its goals to achieve excellence in patient-centered head and neck cancer care.

Unilateral vs Bilateral Transoral Robotic Surgery for HPV-Positive Tonsillar Squamous Cell Carcinoma.

Importance: The palatine tonsil is the most common subsite of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (SCC). There is debate on how to manage the contralateral clinically uninvolved tonsil in patients undergoing a primary surgical approach via transoral robotic surgery (TORS).

Objective: To assess postoperative complications, functional outcomes, contralateral tonsil second primary rates, and survival in patients undergoing unilateral vs bilateral TORS with pathology-guided adjuvant treatment.

Predictors and Implications of Bony Union of Osseous Free Flaps for Oromandibular Reconstruction.

Background: Optimal contouring of osseous free flaps for mandibulectomy often requires osteotomies. The impact of malunion or nonunion on hardware extrusion is not well-documented. This study assesses postoperative bony union, its correlation with plate extrusion, and related demographic and surgical predictors.

Immunotherapeutic strategies in head and neck cancer: challenges and opportunities.

HNSCC remains a substantial health issue, with treatment options including surgery, radiation, and platinum-based chemotherapy. Unfortunately, despite progress in research, only modest gains have been made in disease control, with existing treatments resulting in significant functional and quality-of-life issues. The introduction of immunotherapy in the treatment of HNSCC has resulted in some improvements in outlook for patients and is now standard of care for populations with both recurrent and metastatic disease.

Tumor extracellular vesicle-derived PD-L1 promotes T cell senescence through lipid metabolism reprogramming.

The limited success of cancer immunotherapy has posed challenges in treating patients with cancer. However, promising strides could be made with a deeper understanding of the factors that cause T cell dysfunction within the tumor microenvironment and by developing effective strategies to counteract tumor-induced immune suppression. Here, we report that tumor-derived extracellular vesicles (tEVs) can induce senescence and suppression in T cells.

Use of Intraoperative Frozen Section to Assess Surgical Margins in HPV-Related Oropharyngeal Carcinoma.

Importance: Given the favorable overall prognosis of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) and the morbidity of increased adjuvant therapy associated with positive surgical margins, large-scale studies on the accuracy of frozen sections in predicting final surgical margin status in HPV-related OPSCC are imperative. Final surgical margin status is the definitive assessment of tumor clearance as determined through surgeon-pathologist collaboration based on permanent analysis of frozen section margins, main specimens, and supplemental resections.

Objectives: To assess the accuracy and testing properties of intraoperative frozen section histology (IFSH) in assessing final surgical margin status in patients undergoing transoral surgery for HPV-related OPSCC.

A hybrid epithelial/mesenchymal state in head and neck cancer: A biomarker for survival with differential prognosis by self-reported race.

Background: Head and neck squamous cell carcinoma (HNSCC) is the 6 leading cause of cancer-related mortality, with racial disparities amplifying the challenges in treatment. Although the relationship between hybrid epithelial/mesenchymal (E/M) states and tumor progression is of interest, no studies have characterized the clinical relevance of hybrid E/M states in head and neck cancer outcomes among self-reported racial cohorts.

Methods: Given the overlap in gene expression between hybrid E/M malignant cells and cancer-associated fibroblasts, we utilized deconvolution of bulk RNA sequencing data from oral cavity and laryngeal squamous cell carcinoma tumors from The Cancer Genome Atlas.

Neighborhood socioeconomic status and race are associated with incidence disparities in oral cavity cancers.

Objectives: To determine the association between neighborhood socioeconomic status (nSES), race and incidence rate trends of oral cavity cancer (OCC).

Materials And Methods: We used data from the SEER (Surveillance, Epidemiology, and End Results) 18 Census Tract-level SES and Rurality Database (2006-2018) database of the National Cancer Institute to create cohorts of OCC patients between 2006 and 2018. Annual incidence rates were calculated and trends in rates were estimated using joinpoints regression.

Polyamine transport inhibition and cisplatin synergistically enhance tumor control through oxidative stress in murine head and neck cancer models.

Background: Surgery and/or platinum-based chemoradiation remain standard of care for patients with head and neck squamous cell carcinoma (HNSCC). While these therapies are effective in a subset of patients, a substantial proportion experience recurrence or treatment resistance. As cisplatin mediates cytotoxicity through oxidative stress while polyamines play a role in redox regulation, we posited that combining cisplatin with polyamine transport inhibitor, AMXT-1501, would increase oxidative stress and tumor cell death in HNSCC cells.

Interrogation of T Cell-Enriched Tumors Reveals Prognostic and Immunotherapeutic Implications of Polyamine Metabolism.

Metabolic features of the tumor microenvironment (TME) antagonize anti-tumor immunity. We hypothesized that T cell infiltrated tumors with a known antigen should exhibit superior clinical outcomes, though some fare worse given unfavorable metabolic features leveraging T cell-infiltrated (Thi), human papillomavirus-related (HPV+) head and neck squamous cell carcinomas (HNSC) to test this hypothesis. Expression of 2,520 metabolic genes were analyzed among Thi HPV+ HNSCs stratified by high-risk molecular subtype.

Exposure of Pedicle Screws due to Chronic Vertebral Erosion by Tracheostomy Tube Cuff Balloon: A Case Report.

Case: We report a patient with permanent tracheostomy in the context of muscular dystrophy presented for pneumonia. On bronchoscopy, a pedicle screw was seen penetrating the trachea. Computed tomography revealed significant anterior erosion of the T1-T3 vertebrae due to chronic pressure injury from the tracheostomy cuff, exposing pedicle screws implanted >10 years earlier.

Recurrent Human Papillomavirus-Related Head and Neck Cancer Undergoes Metabolic Reprogramming and Is Driven by Oxidative Phosphorylation.

Purpose: Human papillomavirus (HPV) infection drives the development of some head and neck squamous cell carcinomas (HNSCC). This disease is rapidly increasing in incidence worldwide. Although these tumors are sensitive to treatment, approximately 10% of patients fail therapy.

Neutron Therapy for High-Grade Salivary Carcinomas in the Adjuvant and Primary Treatment Setting.

Objectives/hypothesis: Our primary objective was to compare differences in survival of patients with high-grade salivary gland carcinomas (SGCs) receiving adjuvant neutron versus photon radiotherapy using a hospital-based national cohort and restricted mean survival time (RMST) analysis. Our secondary objective was to compare survival of similar patients treated with primary neutron versus photon radiation.

Study Design: Multicenter, retrospective population-based study of patients within the National Cancer Database from 2004 to 2014.

The role of elective neck dissection in high-grade parotid malignancy: A hospital-based cohort study.

Objectives/hypothesis: The role of elective neck dissection (END) in patients with clinically N0 (cN0), high-grade parotid carcinoma is unclear. The objective of this study was to assess the association between END and survival in patients with cN0, high-grade parotid carcinoma.

Study Design: Retrospective, multicenter cohort study.

The mutational landscape of recurrent versus nonrecurrent human papillomavirus-related oropharyngeal cancer.

Background: Human papillomavirus-related (HPV-related) oropharyngeal squamous cell carcinomas (OPSCCs) have an excellent response rate to platinum-based chemoradiotherapy. Genomic differences between primary HPV-related OPSCCs that do or do not recur are unknown. Furthermore, it is unclear if HPV-related OPSCCs that recur share a genomic landscape with HPV-negative head and neck cancers (HNCs).

A Phase I Clinical Trial of AZD1775 in Combination with Neoadjuvant Weekly Docetaxel and Cisplatin before Definitive Therapy in Head and Neck Squamous Cell Carcinoma.

The WEE1 tyrosine kinase regulates G-M transition and maintains genomic stability, particularly in p53-deficient tumors which require DNA repair after genotoxic therapy. Thus, a need arises to exploit the role of WEE1 inhibition in head and neck squamous cell carcinoma (HNSCC) mostly driven by tumor-suppressor loss. This completed phase I clinical trial represents the first published clinical experience using the WEE1 inhibitor, AZD1775, with cisplatin and docetaxel.

Skills transfer to sinus surgery via a low-cost simulation-based curriculum.

Background: Surgical skill development outside the operating room aims to improve technique and subsequent patient safety. The purpose of this study was to evaluate the correlation between technical and cognitive skills with cadaveric endoscopic sinus surgery (ESS) performance and change in ESS performance before and after implementation of a dedicated ESS simulation-based and knowledge-based curriculum.

Methods: A before-after study design was implemented among 10 medical students and 10 junior otolaryngology residents.

Anatomical Region Segmentation for Objective Surgical Skill Assessment with Operating Room Motion Data.

 Most existing objective surgical motion analysis schemes are limited to structured surgical tasks or recognition of motion patterns for certain categories of surgeries. Analyzing instrument motion data with respect to anatomical structures can break the limit, and an anatomical region segmentation algorithm is required for the analysis.  An atlas was generated by manually segmenting the skull base into nine regions, including left/right anterior/posterior ethmoid sinuses, frontal sinus, left and right maxillary sinuses, nasal airway, and sphenoid sinus.

An Automated Methodology for Assessing Anatomy-Specific Instrument Motion during Endoscopic Endonasal Skull Base Surgery.

 Describe instrument motion during live endoscopic skull base surgery (ESBS) and evaluate kinematics within anatomic regions.  Case series.  Tertiary academic center.

Region-Specific Objective Signatures of Endoscopic Surgical Instrument Motion: A Cadaveric Exploratory Analysis.

 The objective of this study was to evaluate region-specific surgical instrument kinematics among novice and experienced surgeons performing endoscopic endonasal skull base surgery.  Cadaveric experimental study.  Tertiary academic center.

Navigation Guidance During Free Flap Mandibular Reconstruction: A Cadaveric Trial.

Importance: Segmental mandibulectomy for tumors that distort the buccal surface of the mandible present a reconstructive challenge.

Objective: To determine whether mandible alignment after navigation-guided mandible reconstruction is better than alignment after non-template-assisted freehand reconstruction and as good as template-assisted reconstruction in a cadaveric trial.

Design, Setting, And Participants: A cadaveric trial using 10 specimens was conducted at a tertiary academic center.

Green tea epigallocatechin 3-gallate accumulates in mitochondria and displays a selective antiapoptotic effect against inducers of mitochondrial oxidative stress in neurons.

Epigallocatechin-3-gallate (EGCG) is a major flavonoid component of green tea that displays antiapoptotic effects in numerous models of neurotoxicity. Although the intrinsic free radical scavenging activity of EGCG likely contributes to its antiapoptotic effect, other modes of action have also been suggested. We systematically analyzed the antiapoptotic action of EGCG in primary cultures of rat cerebellar granule neurons (CGNs).