MyMedR

Fulltext Three cases of head and neck schwannomas: varied clinical presentation

Philip R, Chong AW, Rosalind S, Gurdeep S, Kalyani S

Med J Malaysia, 2007 Jun;62(2):175-6.

Schwannomas are benign tumors. A series of three unusual cases involving the head and neck region at the Department of ENT, Hospital Ipoh from July 2004 to June 2005 is presented. The first case was a pedunculated schwannoma of the tongue base. The second was a schwannoma of the cervical sympathetic chain who developed a transient Horner's Syndrome upon fine needle aspiration cytology. The third case was a bilobed cervical vagal schwannoma which developed immediate vocal cord palsy postoperatively which was evident at six months follow-up. All tumors were removed surgically.

Matched MeSH terms: Head and Neck Neoplasms/surgery

Dermatofibrosarcoma protuberans of the scalp: therapeutic challenges

Kanesen D, Zakaria Z, Ch'ng ES, Nandrajog P, Kandasamy R

ANZ J Surg, 2019 03;89(3):261-264.

PMID: 28513108 DOI: 10.1111/ans.14040

Matched MeSH terms: Head and Neck Neoplasms/surgery*

Fulltext Mature cystic teratoma: unusual presentation as anterior neck swelling

Rahman MT, Jaafar H, Naik VR, Ghazali MZ, Hassan S

Singapore Med J, 2004 Mar;45(3):130-1.

PMID: 15029417

The unusual presentation of a mature mediastinal cystic teratoma as an anterior neck swelling in a 29-year-old Malay woman is reported.

Matched MeSH terms: Head and Neck Neoplasms/surgery

Fulltext Cervical schwannoma: report of four cases

Rohaizam J, Tang IP, Jong DE, Tan TY, Narihan MZ

Med J Malaysia, 2012 Jun;67(3):345-8.

PMID: 23082435 MyJurnal

Extracranial schwannomas in the head and neck region are rare neoplasms. The tumours often present as asymptomatic, slowly enlarging lateral neck masses and determination of the nerve origin is not often made until the time of surgery. Preoperative diagnosis maybe aided by imaging studies such as magnetic resonance imaging or computed tomography, while open biopsy is no longer recommended. The accepted treatment for these tumors is surgical resection with preservation of the neural pathway. We report four cases of cervical schwannomas that we encountered at our center during four years of period. The clinical features, diagnosis and origin, management and pathological findings of these benign tumors are discussed.

Matched MeSH terms: Head and Neck Neoplasms/surgery

Fulltext An extensive cervical vagal nerve schwannoma: a case report

Chiun KC, Tang IP, Prepageran N, Jayalakshmi P

Med J Malaysia, 2012 Jun;67(3):342-4.

PMID: 23082434 MyJurnal

Vagal nerve schwannoma is extremely rare. The majority of cases present with a slow growing neck swelling without neurological deficit. Magnetic resonance imaging is the gold standard investigation to establish a pre-operative diagnosis. We report a case of a 32-year-old man with an extensive right vagal nerve schwannoma involving the right jugular foramen and parapharyngeal space. The tumour was resected via a transcervical approach. Complete excision of the tumour is the key to prevent recurrence.

Matched MeSH terms: Head and Neck Neoplasms/surgery

Papillary carcinoma arising in a thyroglossal duct cyst

Jayalakshmi P, Prepageran N, Jayaram G, Gopalakrishnan

Malays J Pathol, 2002 Jun;24(1):67-70.

PMID: 16329558

A 21-year-old lady was admitted with a one year history of painless swelling in the neck. The clinical features and radiological findings suggested a thyroglossal duct cyst. Histology of the excised duct cyst showed papillary carcinoma. Ultrasound examination of the thyroid gland was normal. The patient is on regular follow-up and is well two years following surgery.

Matched MeSH terms: Head and Neck Neoplasms/surgery

Fulltext The treatment of neck lymphangioma with intralesional injection of bleomycin

Zulfiqar MA, Zaleha AM, Zakaria Z, Amin T

Med J Malaysia, 1999 Dec;54(4):478-81.

PMID: 11072465

We report our experience with intralesional injection of bleomycin in the treatment of neck lymphangioma. From May 1995 to April 1998, 11 patients aged between 6 to 22 months were treated with intralesional bleomycin injection. Ultrasonography and computed tomography were used to assess and select the cases suitable for sclerotherapy. Patients with lesions encasing the internal jugular vein and the carotid artery were chosen. With the patient under sedation and using ultrasound guidance, the cysts were aspirated and bleomycin was injected at a dose of 0.5 mg/kg body weight. The number of procedures varied from 1 to 4 over a period of 8 months to 1 year. Patients were initially followed-up 3 monthly, then 6 monthly and subsequently yearly. In 4 patients, the neck mass was no longer visible (excellent response). In 5 patients, the neck mass had reduced to a size (more than 50% reduction) that was cosmetically acceptable (good response). There were 2 failures (poor response). There were no complications. Our results suggest that intralesional injection of bleomycin can be effectively used to treat selected cases of neck lymphangiomas.

Matched MeSH terms: Head and Neck Neoplasms/surgery

Fulltext Pectoralis major myocutaneous flap in head and neck surgery

Gurbachan I, Gomez AC, Noor N

Med J Malaysia, 1985 Jun;40(2):107-14.

PMID: 3834280

The experiences gained through the use of pectoralis major myocutaneous flap in reconstructive head and neck cancer surgery in 15 cases is presented. It is our method choice for a one-stage reconstruction in head and neck The flap has survived in 14 out of 15 cases. It has definite advantages over other flaps used in head and neck reconstruction.

Matched MeSH terms: Head and Neck Neoplasms/surgery*

Initiatives to reduce postoperative surgical site infections of the head and neck cancer surgery with a special emphasis on developing countries

Haque M, McKimm J, Godman B, Abu Bakar M, Sartelli M

Expert Rev Anticancer Ther, 2019 01;19(1):81-92.

PMID: 30394844 DOI: 10.1080/14737140.2019.1544497

Introduction: Surgery in patients with head and neck cancers is frequently complicated by multiple stages of procedure that includes significant surgical removal of all or part of an organ with cancer, tissue reconstruction, and extensive neck dissection. Postoperative wound infections, termed 'surgical site infections' (SSIs) are a significant impediment to head-and-neck cancer surgery and recovery, and need to be addressed. Areas covered: Approximately 10-45% of patients undergoing head-and-neck cancers surgery develop SSIs. SSIs can lead to delayed wound healing, increased morbidity and mortality as well as costs. Consequently, SSIs need to be avoided where possible, as even the surgery itself impacts on patients' subsequent activities and their quality of life, which is exacerbated by SSIs. Several risk factors for SSIs need to be considered to reduce future rates, and care is also needed in the selection and duration of antibiotic prophylaxis. Expert commentary: Head and neck surgeons should give personalized care especially to patients at high risk of SSIs. Such patients include those who have had chemoradiotherapy and need reconstructive surgery, and patients from lower and middle-income countries and from poorer communities in high income countries, who often have high levels of co-morbidity because of resource constraints.

Matched MeSH terms: Head and Neck Neoplasms/surgery*

Fulltext Thyroglossal duct carcinoma

Kahairi A, Ahmad RL, Wan Islah L, Hasmah H

Singapore Med J, 2009 Dec;50(12):e404-6.

PMID: 20087540

We report a 56-year-old Malay woman with a tumour that involved the skin and caused hyoid bone erosion. There was no clinical or radiological evidence of regional lymph node involvement. A modified radical neck dissection with preservation of the accessory nerve and internal jugular vein was performed, followed by an "extended" Sistrunk operation. The surgical defect was reconstructed with a pectoralis major myocutaneous flap. Our literature review showed that this is the first reported thyroglossal duct carcinoma which involved the skin and required a pedicle flap reconstruction.

Matched MeSH terms: Head and Neck Neoplasms/surgery

Fulltext Branchial fistula--a review

Lee ST, Krishnan MM

Singapore Med J, 1991 Feb;32(1):50-2.

PMID: 2017707

Congenital branchial fistula and their embryology is well described in the literature. The accepted standard treatment method includes stepladder excision for extensive fistulas. This paper presents two cases (Case 1 and 2) which are embryologically typical of second and third arch origin respectively; and a third case (Case 3) which has not been previously described. Case 3 appears to be a hitherto unreported combination of first and second arch origin. Case 1 and 2 were treated via a standard stepladder excision approach. A different newer approach was utilised in Case 3, that is, stripping of the fistulous tract with Myer's vein stripper. Unlike the stepladder approach, this is simple and avoids extensive time consuming dissection. However, being a blind procedure, it is not generally advocated if vital structures exist in the proximity.

Matched MeSH terms: Head and Neck Neoplasms/surgery

Risk factors for osteoradionecrosis after head and neck radiation: a systematic review

Nabil S, Samman N

Oral Surg Oral Med Oral Pathol Oral Radiol, 2012 Jan;113(1):54-69.

PMID: 22669065 DOI: 10.1016/j.tripleo.2011.07.042

This systematic review aimed to answer the clinical question, "What is the current risk of developing osteoradionecrosis of the jaws among irradiated head and neck cancer patients?"

Matched MeSH terms: Head and Neck Neoplasms/surgery

Evaluation of tracheal diameter after surgical tracheostomy

Sivakumar K, Prepageran N, Raman R

Am J Otolaryngol, 2006 Sep-Oct;27(5):310-3.

PMID: 16935173 DOI: 10.1016/j.amjoto.2006.01.007

PURPOSE: The aim of this study was to evaluate the narrowing of the trachea in head and neck surgical patients who had undergone elective tracheostomy.
MATERIALS AND METHODS: This is a prospective study. Twenty-five patients were included in this study. All these patients had a preoperative elective tracheotomy, preceding major head and neck surgery for head and neck malignancies. An x-ray of the lateral soft tissue neck was taken after a minimum of 6 weeks after the dissimulation of tracheotomy tube. Diameter of the trachea above the stoma (around 2 cm below the cricoid ring that can be clearly seen in lateral x-ray corresponding to the second tracheal ring) was taken as controls. Data were entered into a computer database and statistically analyzed using SPSS for Windows (version 12.0; SPSS, Chicago, Ill). In addition to descriptive statistics for all patients, inferential statistics were used to compare the 2 tracheal diameters across all patients and within the subgroups of men and women. Associations between outcome and other variables were evaluated statistically using an chi 2 test for the categorical data. Other parametric and nonparametric statistical tests were used when appropriate. Criterion for statistical significance was set at P < .05 (Student t test and 2-tailed test).
RESULTS: From this study, 92% (23/25) patients developed narrowing of trachea, all less than 50%. Very early decanulation of tracheotomy shows low or no narrowing at all. There is gradual narrowing in patients in whom dissimulations were performed after 14 days. Ethnicities of Indian decent (13/25) predominate in this study population. Male patients in this study have shorter decanulation period compared with female.
CONCLUSIONS: Elective surgical tracheotomy is a relatively safe procedure resulting in minimum asymptomatic tracheal stenosis.
Study site: University Malaya Medical Centre, Kuala Lumpur, Malaysia

Matched MeSH terms: Head and Neck Neoplasms/surgery

Recurrent occipital dermatofibrosarcoma protuberans tackled with wide local excision: A case report and current management

Kho JPY, Ng BHK, John R

Med J Malaysia, 2019 02;74(1):82-84.

PMID: 30846668

Dermatofibrosarcoma protuberans (DFSP) is a slowgrowing, locally invasive tumour of the dermis. It commonly presents in the trunks and proximal extremities but is seen to a lesser extent in the head and neck regions. We present a case report of a recurrent DFSP in a 48-year-old Iban woman at the occipital region. The patient underwent wide local excision and removal of outer table of cranium, dressing followed by split thickness skin graft. Histopathological examination confirmed dermatofibrosarcoma protuberans with clear lateral surgical margins and a deep margin of 0.5mm. She is currently undergoing radiotherapy and is planned for 50Grey 25cycles.

Matched MeSH terms: Head and Neck Neoplasms/surgery*

Enteral glutamine supplementation in surgical patients with head and neck malignancy: A randomized controlled trial

Azman M, Mohd Yunus MR, Sulaiman S, Syed Omar SN

Head Neck, 2015 Dec;37(12):1799-807.

PMID: 24992652 DOI: 10.1002/hed.23839

Glutamine supplementation is a novel approach to perioperative nutritional management.

Matched MeSH terms: Head and Neck Neoplasms/surgery*

Fulltext Surgical access to parapharyngeal space tumours--the Manipal experience

Hazarika P, Dipak RN, Parul P, Kailesh P

Med J Malaysia, 2004 Aug;59(3):323-9.

PMID: 15727377

A few series of parapharyngeal space tumours have been reported earlier but recently not many series have been published in English literature. It is rare for any medical center, let alone an individual surgeon, to develop sufficient experience in evaluating these tumours. We present our experience in the treatment of 41 cases of parapharyngeal tumours from January 1992 to December 2001. FNAC, ultrasound and CT scan of the presenting mass was done in most of the patients as the main pre-operative work-up. The strategic location and extension of the tumour may occasionally alter the surgical approach for tumour excision.

Matched MeSH terms: Head and Neck Neoplasms/surgery

Feasibility of Salvage Selective Neck Dissection after Primary Irradiation of Pharyngeal and Laryngeal Carcinoma

Mat Lazim N, Abdullah K, Karakullukcu B, Tan IB

ORL J Otorhinolaryngol Relat Spec, 2018;80(1):10-18.

PMID: 29428959 DOI: 10.1159/000486371

INTRODUCTION: The concept of neck dissection (ND) in the management armamentarium of head and neck squamous cell carcinoma has evolved throughout the years. Nowadays, ND becomes more functional.

METHODOLOGY: A retrospective study of 865 patients was performed at Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital to investigate the feasibility of selective ND (SND). All patients with squamous cell carcinoma of the pharynx and larynx who received primary radiation and underwent salvage ND were included in the study.

RESULT: A total of 29 NDs were analyzed. In 17 neck sides, viable metastases were found (58%), whereas in the other 12 specimens there were no viable metastases. In 16 of the 17 necks (94%), the metastases were located either in level II, III, or IV or in a combination of these 3 levels. Level V was involved in only 1 case (6%).

CONCLUSION: It is well justified to perform a salvage SND (levels II, III, and IV) for pharyngeal and laryngeal carcinoma after primary radiation. In carefully selected cases of supraglottic and oropharyngeal carcinoma, a superselective ND also appears as an efficient option.

Matched MeSH terms: Head and Neck Neoplasms/surgery*

Predictive factors for osteoradionecrosis of the jaws: A retrospective study

Sathasivam HP, Davies GR, Boyd NM

Head Neck, 2018 Jan;40(1):46-54.

PMID: 29149496 DOI: 10.1002/hed.24907

BACKGROUND: Osteoradionecrosis of the jaw (ORNJ) is a well-recognized complication of radiotherapy. The purpose of this study was to assess predictive factors for the development of ORNJ.

METHODS: A retrospective study of 325 patients with head and neck squamous cell carcinoma (HNSCC) treated at one institution between January 1, 1999, and December 31, 2008, was conducted. Outcome measure was the presence/absence of ORNJ. Time to event was recorded and Cox proportional hazard regression analysis was used to determine statistically significant predictive factors.

RESULTS: Fifty-nine patients had ORNJ. Statistical analysis using Cox regression analysis identified several statistically significant variables: dentoalveolar surgery; peri-resective surgery of the jaw; continued tobacco usage after radiotherapy, diabetes mellitus type 2 (DM2); and total radiation dose.

CONCLUSION: Patients at greater risk of developing ORNJ can be identified and measures can be instituted to reduce its incidence and expedite management when it does occur.

Matched MeSH terms: Head and Neck Neoplasms/surgery

Fulltext Dopamine-secreting phaeochromocytomas and paragangliomas: clinical features and management

Foo SH, Chan SP, Ananda V, Rajasingam V

Singapore Med J, 2010 May;51(5):e89-93.

PMID: 20593136

Most functional phaeochromocytomas/paragangliomas produce noradrenaline and/or adrenaline. Those that produce dopamine are rare. We describe the distinguishing clinical features of dopamine-secreting phaeochromocytomas and paragangliomas from those that secrete noradrenaline/adrenaline and the impact on their management. We present a case of a dopamine-secreting paraganglioma from our institution and review 14 case reports of dopamine-secreting phaeochromocytomas/paragangliomas published between 1984 and 2008. As observed in the literature, 80% of the tumours were extra-adrenal. Most patients presented with non-specific symptoms or mass effect without the classical presentation of catecholamine excess. The majority were diagnosed with urinary or plasma dopamine. Five patients had malignant tumours and 12 patients underwent surgical resection of the primary tumours. Unlike noradrenaline/adrenaline-secreting phaeochromocytomas/paragangliomas, dopamine-secreting tumours lack a classical presentation, are extra-adrenal and have a higher malignant potential. A routine inclusion of urinary or plasma dopamine as part of catecholamine screening in all suspected phaeochromocytomas and paragangliomas is recommended.

Matched MeSH terms: Head and Neck Neoplasms/surgery

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