The aim of this study was to demonstrate the impact of COVID-19 pandemic on the number and characteristics of head and neck cancer patients in two consecutive periods, pre-pandemic and pandemic. For ...this purpose, we performed a retrospective analysis of patients with primary carcinomas of head and neck mucosal sites, salivary gland tumors, as well as neck metastases. Two pre-COVID-19 years (2018-2019) and two pandemic years (2020-2021) were compared. Demographic data, overall number of patients, TNM classification of the two most affected sites (oral cavity and larynx), time from symptom onset to first outpatient admission to our department, and time from first admission to treatment initiation were noted. Study results revealed a higher number of patients during the pandemic period and difference in the distribution of tumor sites (x2=33.68, df=9, p<0.001). Oral cavity cancer prevailed over laryngeal cancer during the pandemic period. A statistically significant difference was observed in delay of initial presentation to head and neck surgeon for oral cavity cancer during the pandemic period (p=0.019). Furthermore, significant delay was found for both sites concerning time from initial presentation to the beginning of treatment (larynx: p=0.001 and oral cavity: p=0.006). Despite these facts, there were no differences in TNM stages comparing two observed periods. Study results indicated that there was a statistically significant delay of surgical treatment for both cancer sites observed (oral cavity and larynx) during the COVID-19 pandemic. A survival study is necessary in the future to definitely reveal the true consequences of COVID-19 pandemic on treatment outcomes. Keywords: COVID-19; Head and neck cancer; Pandemic; Delay in care Cilj ove studije bio je utvrditi utjecaj pandemije COVID-19 na broj bolesnika s karcinomima glave i vrata te njihove karakteristike u vremenu prije i za vrijeme pandemije. U tu svrhu provedena je retrospektivna studija kod bolesnika s primarnim sluznicnim karcinomima glave i vrata, ?lijezda slinovnica i onih s metastazama na vratu. Provedena je usporedba dviju godina prije pandemije COVID-19 (2018. i 2019.) i dviju pandemijskih godina (2020. i 2021.). Izracunati su i prikazani demografski podaci, ukupan broj bolesnika, TNM klasifikacija dvaju najucestalijih sijela (usna ?upljina i grkljan), vrijeme potrebno da se bolesnik od pojave prvih simptoma javi specijalistu na?eg Odjela (1. razdoblje) i vrijeme od prvog specijalistickog pregleda do pocetka terapije (2. razdoblje). Rezultati su pokazali veci broj bolesnika u razdoblju pandemije i razliku u distribuciji tumorskih sijela u odnosu na dvije godine prije pandemije (chi square=33,68, df=9, p<0,001). Za vrijeme pandemije karcinom usne ?upljine bio je ucestalilji od karcinoma grkljana. U pandemijskom razdoblju utvrdeno je statisticki znacajno produljenje vremena do prvog specijalistickog pregleda kod bolesnika s karcinomom usne ?upljine (p=0,019), kao i vremena od prvog pregleda specijalista do pocetka terapije za oba sijela (grkljan: p=0,001, usna ?upljina: p=0,006). Usprkos tomu nije bilo razlika u TNM stupnjevima bolesti izmedu dvaju promatranih razdoblja. Ovi rezultati pokazuju znacajno produljeno vrijeme do pocetka lijecenja tumora tijekom pandemije, i to za oba sijela, usnu ?upljinu i grkljan. U buducnosti je potrebno provesti studiju pre?ivljenja koja bi otkrila posljedice pandemije COVID-19 na ishode lijecenja ovih bolesnika. Kljucne rijeci: COVID-19; Karcinom glave i vrata; Pandemija; Odgodeno lijecenje
Metastaze lateralnih regija vrata papilarnog karcinoma štitnjače pojavljuju se u oko 30–80% bolesnika. Uvriježeno je stajalište kako se njihova prisutnost povezuje s većom mogućnosti pojave lokalnog ...recidiva, a ne utječe negativno na preživljenje, no njihov značaj još nije do kraja razjašnjen. Cilj je ovog istraživanja analizirati kliničko-patohistološke karakteristike metastaziranja papilarnog karcinoma štitnjače u lateralne regije vrata u bolesnika s papilarnim karcinomom i metastazama u lateralnim regijama vrata te učestalost pojave lokoregionalnih recidiva i udaljenih metastaza redovitim praćenjem bolesnika. Metode: Proveli smo prospektivno istraživanje u koje smo uključili 135 bolesnika s papilarnim karcinomom i metastazama u lateralnim regijama vrata, kojima je u razdoblju od 2011. do 2020. učinjena totalna tireoidektomija sa selektivnom disekcijom vrata (regije II–VI). Analizirali smo demografske i kliničke čimbenike u bolesnika te univarijantnim statističkim testovima odredili njihovu povezanost. Bolesnici su praćeni do travnja 2021. putem redovnih kontrolnih pregleda i bolničke dokumentacije. Rezultati: Prosječna dob bolesnika bila je 36 godina, a 28% ispitanika bili su muškarci. Najčešće mjesto metastaziranja bila je regija III, a zatim redom regije IV, II i V. Primarni tumori veći od 1 cm te oni s ekstrakapsularnim širenjem imali su veći broj pozitivnih limfnih čvorova u lateralnim regijama vrata. Prosječan period praćenja iznosio je 62 mjeseca. Tijekom perioda praćenja ukupno je 18 (13,3%) bolesnika razvilo lokoregionalni recidiv, a dvoje (1,5%) bolesnika je uz lokoregionalne recidive razvilo i udaljene metastaze. Nijedan bolesnik nije razvio lokalni recidiv bolesti. Prosječno vrijeme pojave recidiva iznosilo je 16,7 mjeseci. Zaključak: Učestalost metastaziranja u pojedine regije vrata pratila je standardne obrasce metastaziranja pa je tako najčešće zahvaćena regija III, a potom regija IV. U dvije trećine bolesnika nalazimo metastaze u više lateralnih regija vrata. Ovo istraživanje ukazalo je na povezanost veličine papilarnog karcinoma štitnjače s brojem pozitivnih limfnih čvorova u lateralnim regijama vrata te povezanost broja pozitivnih limfnih čvorova u lateralnim regijama vrata u bolesnika s prisutnim ekstrakapsularnim širenjem. S obzirom na nisku stopu recidiva možemo zaključiti da je selektivna disekcija regija II–VI optimalan način liječenja ovih bolesnika.
Among the many great physicians who headed the Department for Ear, Nose and Throat Diseases and Head and Neck Surgery at the Zagreb School of Medicine a significant place belongs to profes- sor ...Zvonimir Krajina since his scientific and professional work was through his entire career centred around this department. He was elected Head of the Department in 1971, exactly half a century after its founding. Since then, he sought to enrich it with a series of innovations in professional and scien- tific areas, as well as make organisational changes in its management. Zvonimir Krajina was equally skilful in all areas of head and neck surgery. He developed rhinology and functional nose surgery, head and neck oncology, and especially functional laryngeal surgery. Besides running the Department, Professor Krajina was also the vice dean of the School of Medicine in the period of 1970 – 1974, and dean in 1974 – 1978. At the University of Zagreb, he was Head of the Committee on International Relations from 1978 – 1982, and in the period of 1982 – 1986 he was the rector of the University
of Zagreb. He was a member of many international scientific societies and was a visiting professor at universities in Europe, USA and Japan. Professor Krajina was truly an exceptional person and doctor and we can claim with full conviction that Zvonimir Krajina is one of the representative personalities of Croatian otorhinolaryngology.
Objective. The aim of the study was to analyze clinical characteristics, surgical treatment, complications, and prognosis related to thyroid surgery in children and adolescents in a 10-year study at ...a single institution. Study Design. Retrospective study. Methods. We performed a retrospective analysis of clinical data of children and adolescents who underwent thyroid surgery due to benign thyroid disease and thyroid cancer from January 2011 to May 2020. We presented the clinical characteristics and type of surgical treatment for different thyroid diseases. Results. We present data on surgical procedures and complication rates following surgery, which was comparable to other published data. We emphasize the importance of radioiodine and hormone replacement postoperative therapy in cancer patients and our opinion on total thyroidectomy and neck dissection in thyroid cancer surgery. Conclusion. This study demonstrated that thyroid surgery in children and adolescents is a safe and efficient procedure in the hands of experienced surgeon for adult thyroid surgery. For children and adolescents with thyroid carcinoma, our method of choice is total thyroidectomy with occasionally paratracheal neck dissection, whereas lateral cervical lymph node dissection is only necessary in fine needle aspiration positive lymph nodes. Our results according to postoperative outcomes and complications are comparable to other recently published data. Key words: thyroidectomy, child, adolescent Cilj. Analiza klinickih karakterstika, kirurskog postupka, komplikacija i prognoze kod djece i adolescenata kod kojih je ucinjena operacija stitnjace tijekom 10-godisnjeg razdoblja u jednoj ustanovi. Nacrt studije. Retrospektivno istrazivanje. Metode. Retrospektivna analiza u razdoblju od sijecnja 2011. godine do svibnja 2020. godine kod djece i adolescenata kod kojih je ucinjena operacija stitnjace zbog benigne bolesti ili karcinoma stitnjace. Pokazali smo klinicke karakteristike i vrstu kirurskog zahvata tijekom lijecenja benignih bolesti stitnjace i karcinoma. Rezultati. U rezultatima pokazali smo kirurske postupke tijekom deset godina u nasoj ustanovi u lijecenju dobrocudnih bolesti stitnjace i karcinoma stitnjace u pedijatrijskoj populaciji. Nasi rezultati postoperativnih komplikacija usporedivi su sa rezultatima iz objavljenih clanaka. Naglasili smo vaznost postoperativnog radiojodnog lijecenja i supstitucijskog lijecenja kod bolesnika sa karcinomom stitnjace i nas stav vezan uz indikacije za totalnu tireoidektomiju i disekciju limfnih cvorova vrata u kirurgiji karcinoma stitnjace. Zakljucak. Ova studija potvrduje kirurgiju stitnjace kod djece i adolescenata kao sigurnu i ucinkovitu ukoliko ju izvodi kirurg iskusan u operacijama stitnjace kod odraslih osoba. Za djecu i adolescente s karcinomom stitnjace nasa metoda izbora je totalna tireoidektomija sa eventualnom paratrahealnom disekcijom, dok je selektivna disekcija limfnih cvorova vrata neophodna samo u slucajevima citoloski pozitivnih limfnih cvorova. Kljucne rijeci: tireoidektomija, dijete, adolescent
Mucoepidermoid carcinoma of the larynx is very rare, with only a few individual cases or studies in small patient groups reported in the literature. Treatment modalities for this type of carcinoma ...are not uniform; in addition, errors in the recognition and pathologic diagnosis are not uncommon. During the period 1991-2000, 771 cases of malignant laryngeal tumours were recorded and histologically verified at the University Department of Otorhinolaryngology and Cervicofacial Surgery, Zagreb University Hospital Centre, three of them were mucoepidermoid supraglottic carcinomas. The experience acquired in the treatment of these tumours is presented along with a review of the literature.
Renal transplantation is associated with increased incidence of cancer. We reviewed a large series of renal transplant recipients to determine the incidence and outcome of patients with malignant ...changes located at the head and neck. A total of 1232 renal transplant recipients have been followed at Department of Dialysis University Hospital Centre Zagreb from 1972 to 2009. Demographic data, localization and disease outcome were evaluated in patients who developed cancer. Twenty one patients (1.7%) developed 27 head and neck malignancies. The average time from transplantation to development of cancer was 56.8 months. The mean length of follow-up was 9.4+/-4.8 years. Eighteen malignancies were cutaneous in origin and 9 were noncutaneous. Of cutaneous malignancies, 88.9% were basal cell carcinoma; one patient had Merkell-cell carcinoma and one patient developed squamous cell carcinoma. Six cases of basocellular skin cancer were recorded in one fair-skin patient. Noncutaneous malignancies involved the oral cavity (2 cases of Kaposi's sarcoma and one pharyngeal cancer) and the thyroid gland in 3 patients each. Two patients had post-transplant lymphoproliferative disorder occurring at the head and neck. One patient had brain tumor. Radical surgery, radiation, and/or chemotherapy were necessary in 33.3% of patients. Immunosuppression was reduced in all patients, and 12 patients were switched from the calcineurin-based immunosuppression to sirolimus. They all have stable graft function. None of the patients died from cancer. Immunosuppression was ceased in one patient with Kaposi's sarcoma who returned to dialysis and died 10 years later from heart failure. An increased incidence of cancer occurring in the head and neck was recorded. Careful skin examination and oral examination is mandatory for discovering cancer before dissemination. Sirolimus is safe alternative to calcineurin-based immunosuppression in patients who developed head and neck malignancies.
The aim of this study was to compare the functional outcomes of swallowing act detected by videofluoroscopy of two different techniques in the treatment of laryngeal carcinoma.
This study was ...conducted on 41 patients undergoing two supraglottic laryngectomy techniques. The research population was assigned into two groups of open and laser supraglottic laryngectomy, including 21 and 20 patients, respectively.
Food residue was present in most of the patients in the open laryngectomy group. Aspiration of the liquid and solid contrasts was observed in 16 and 4 patients, respectively. In the laser laryngectomy group undergoing a partial supraglottic laryngectomy via carbon dioxide (CO
) laser, aspiration was recorded in only six patients. There was a statistically significant difference between these two groups regarding the presence of aspiration as a marker of a bad functional outcome.
Techniques that include the endoscopic removal of the tumor via CO
laser result in good oncologic and functional outcomes, along with reduced postoperative morbidity and mortality.
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