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Medicina
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Emerging Trends in Head and Neck Surgery
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Emerging Trends in Head and Neck Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: 30 September 2026 | Viewed by 4357

Special Issue Editors

Dr. Filippo Carta

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Guest Editor
Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, 09100 Cagliari, Italy
Interests: head and neck oncology; laryngology; ear surgery
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Roberto Puxeddu

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Guest Editor
Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, 09100 Cagliari, Italy
Interests: head and neck oncology; laryngology; ear surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Cinzia Mariani

E-Mail Website
Guest Editor Assistant
Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, 09100 Cagliari, Italy
Interests: laryngology; audiology; head and neck oncology

Special Issue Information

Dear Colleagues,

Head and neck surgery encompasses a broad range of surgical procedures addressing pathologies in the head and neck region, including benign and malignant tumours, congenital abnormalities, trauma, infections, and functional disorders.

Since the head and neck region contains vital organs responsible for essential functions such as breathing, eating, smelling and hearing, surgical procedures in this complex area present significant challenges.

For this reason, any innovation that can reduce morbidity while improving both functional and aesthetic outcomes is highly valued.

This Special Issue will focus on recent advances in imaging and endoscopic technologies, minimally invasive surgical approaches, personalized therapeutic strategies, innovations in reconstructive techniques, and the application of artificial intelligence in the diagnosis and treatment planning of head and neck pathologies.

All research aiming to improve the diagnosis and clinical management of pathologies involving the thyroid, parathyroid, salivary glands, larynx, pharynx, oral cavity, nasal cavity, and paranasal sinuses will be considered for publication.

We particularly welcome interdisciplinary contributions that reflect the collaborative nature of modern head and neck surgical care, involving otolaryngologists, radiologists, oncologists, and reconstructive surgeons.

We invite authors to contribute to this Special Issue by sharing their clinical experience with cutting-edge approaches in head and neck surgery.

Authors are welcome to submit original articles, reports on novel treatment strategies and advances in decision making, clinical outcome studies, comparative studies, narrative reviews, scoping reviews and systematic reviews and meta-analyses. We look forward to receiving your manuscripts.

Dr. Filippo Carta
Prof. Dr. Roberto Puxeddu
Guest Editors

Dr. Cinzia Mariani
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • head and neck surgery
  • minimally invasive surgical approaches
  • new technologies
  • personalized medicine
  • artificial intelligence

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Published Papers (4 papers)

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14 pages, 1856 KB  
Article
In Vivo Engraftment and Functional Efficacy of a 3D-Bioprinted Human Parathyroid Equivalent
by Sumeyra Guler, Seyda Gokyer, Suleyman Can Oztürk, Ertugrul Çelik, Hamdullah Yanik, Ibrahim Burak Bahcecioglu, Mehmet Ali Gulcelik, Pinar Yilgor and Kerim Bora Yilmaz
Medicina 2026, 62(3), 442; https://doi.org/10.3390/medicina62030442 - 26 Feb 2026
Viewed by 1501
Abstract
Background and Objectives: Hypocalcemia due to hypoparathyroidism (HypoPTH) is the most common complication following thyroid surgery, typically resulting from iatrogenic removal, tissue damage, or compromised vascularization of the parathyroid glands. Patients with persistent HypoPTH are at risk for long-term complications such as [...] Read more.
Background and Objectives: Hypocalcemia due to hypoparathyroidism (HypoPTH) is the most common complication following thyroid surgery, typically resulting from iatrogenic removal, tissue damage, or compromised vascularization of the parathyroid glands. Patients with persistent HypoPTH are at risk for long-term complications such as osteoporosis, cardiac dysfunction, and renal impairment. Lifelong regulation of calcium levels is therefore essential to prevent morbidity and mortality associated with these complications. In this study, we aimed to evaluate the functional engraftment efficacy of 3D bioprinted human parathyroid tissue constructs in a xenograft model in vivo. Materials and Methods: Primary cells obtained from freshly excised human parathyroid tissue specimens were isolated and 3D bioprinted using alginate-based bioink. The bioprinted tissue constructs were implanted into CD1 athymic mice. Histopathological evaluation of the grafted constructs was performed at different time points. In addition, surface calcium-sensing receptor (CaSR) expression was assessed by immunofluorescence as an indicator of functional parathyroid tissue engraftment. Results: The presence of CaSR on parathyroid cells within the 3D-printed scaffolds confirmed the persistence of functional parathyroid cells following implantation. In tissue samples obtained during the first, second, and third weeks after implantation, CaSR positivity was consistently observed in the parathyroid cells. However, at the three-month follow-up, the pores within the scaffolds were found to be filled with calcified material and replaced by fibrotic tissue. At this stage, the absence of parathyroid hormone (PTH) expression indicated a loss of functional activity in the grafted biomaterial. Conclusions: Human primary parathyroid cells were successfully isolated, and a functional, hormone-active parathyroid tissue substitute was developed ex vivo using 3D-bioprinted hydrogel scaffolds combined with autologous cells. Although short-term functional engraftment was achieved, long-term graft viability and hormonal activity were limited due to scaffold degradation and fibrosis. These findings indicate the necessity for further improvement in scaffold biocompatibility to enhance the therapeutic potential of 3D-bioprinted parathyroid tissue constructs for in vivo applications. Full article
(This article belongs to the Special Issue Emerging Trends in Head and Neck Surgery)
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18 pages, 568 KB  
Article
Microcalcification and Irregular Margins as Key Predictors of Thyroid Cancer: Integrated Analysis of EU-TIRADS, Bethesda, and Histopathology
by Şebnem Çimen, Nazif Zeybek, Adile Begüm Bahçecioğlu, Kerim Bora Yılmaz, Neşe Ersöz Gülçelik and Mehmet Ali Gülçelik
Medicina 2025, 61(12), 2217; https://doi.org/10.3390/medicina61122217 - 16 Dec 2025
Cited by 1 | Viewed by 1192
Abstract
Background and Objectives: Thyroid nodules are common, and distinguishing benign from malignant lesions is essential for clinical decision-making. While EU-TIRADS provides ultrasound-based risk stratification, fine-needle aspiration biopsy (FNAB) and the Bethesda System remain central diagnostic tools. This study aimed to compare the diagnostic [...] Read more.
Background and Objectives: Thyroid nodules are common, and distinguishing benign from malignant lesions is essential for clinical decision-making. While EU-TIRADS provides ultrasound-based risk stratification, fine-needle aspiration biopsy (FNAB) and the Bethesda System remain central diagnostic tools. This study aimed to compare the diagnostic performance of EU-TIRADS and Bethesda classifications and to identify ultrasonographic features independently associated with malignancy. Materials and Methods: This retrospective single-center study included 824 patients (1132 nodules) who underwent FNAB between August 2021 and June 2024. All ultrasound examinations and FNAB procedures were performed by the same endocrinologist. Sonographic features, EU-TIRADS categories, Bethesda classes, surgical indications, and histopathology were analyzed. Diagnostic accuracy was assessed using ROC curves, and multivariable logistic regression was applied to determine independent predictors of malignancy. Results: Among all nodules, 51.0% were EU-TIRADS 3, 28.6% were EU-TIRADS 4, and 19.2% were EU-TIRADS 5. Bethesda class II constituted 62.7% of FNAB results. Of the 289 surgically treated nodules, 53.3% were malignant. Malignant nodules were smaller, more often solitary and unilateral, and more frequently located in the upper pole (p < 0.05). Irregular margins (OR = 8.15, p < 0.001) and microcalcifications (OR = 10.01, p = 0.003) were independent predictors of malignancy. Taller-than-wide shape also showed significant association. ROC analyses demonstrated that EU-TIRADS (AUC = 0.808) and Bethesda (AUC = 0.869) were both significant predictors, with Bethesda showing higher specificity. Malignancy rates were 0% in EU-TIRADS II, 4.3% in III, 14.5% in IV, and 37.8% in V. Conclusions: EU-TIRADS is a practical and sensitive non-invasive tool for malignancy risk stratification; however, Bethesda classification remains superior in overall diagnostic accuracy. Microcalcification and irregular margins were the strongest ultrasonographic predictors of malignancy, while macrocalcification, parenchymal heterogeneity, and thyroiditis showed no significant association. These findings support the complementary roles of EU-TIRADS and FNAB and highlight key sonographic markers that enhance malignancy prediction in thyroid nodule evaluation. Full article
(This article belongs to the Special Issue Emerging Trends in Head and Neck Surgery)
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9 pages, 702 KB  
Article
The Use of Microporous Polysaccharide Hemospheres in Thyroid Surgery: A Retrospective Study on Safety and Clinical Outcomes
by Cinzia Mariani, Amina Al Dababsekh, Filippo Carta, Mauro Bontempi, Carmelo Barbaccia and Roberto Puxeddu
Medicina 2025, 61(12), 2209; https://doi.org/10.3390/medicina61122209 - 15 Dec 2025
Viewed by 526
Abstract
Background and Objectives: Hemostasis during thyroid surgery is crucial to avoid postoperative complications, particularly hematoma, which can cause life-threatening airway compromise. Arista™ AH, a plant-based absorbable hemostatic powder, is designed to enhance intraoperative bleeding control. The present study evaluates the efficacy and [...] Read more.
Background and Objectives: Hemostasis during thyroid surgery is crucial to avoid postoperative complications, particularly hematoma, which can cause life-threatening airway compromise. Arista™ AH, a plant-based absorbable hemostatic powder, is designed to enhance intraoperative bleeding control. The present study evaluates the efficacy and safety of Arista™ AH in thyroidectomy. Materials and Methods: This retrospective study included 102 patients who underwent thyroidectomy between January 2020 and February 2024. Of these, 63 patients (61.8%) received Arista™ AH as an adjunctive hemostatic agent, and 39 (38.2%) underwent only conventional hemostasis. Outcomes measured included the incidence of postoperative hematoma and seroma, adverse events related to the use of Arista™ AH, and length of hospital stay. Results: None of the patients in the Arista™ AH group developed a hematoma in the thyroid surgical bed, whereas this complication occurred in 2 patients (5.1%) of the control group (p = 0.07). No patients in the Arista™ AH group developed a postoperative seroma, compared with 2 patients (5.1%) in the control group (p = 0.07). No adverse events related to Arista™ AH were reported. Length of hospital stay was similar between groups, with a median of 2 days (IQR 1) in both the Arista™ AH and control groups (p = 0.8). Conclusions: Arista™ AH was associated with favorable postoperative outcomes in thyroid surgery, supporting its safe and effective use as a hemostatic adjunct. Full article
(This article belongs to the Special Issue Emerging Trends in Head and Neck Surgery)
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24 pages, 629 KB  
Systematic Review
Thyroidectomy-Related Dysphagia: A Systematic Literature Review
by Eleni Litsou, Chrissa Sioka, Konstantinos Mpakogiannis, Labrini Magou, Polyxeni Fakitsa, Alexandros Giannakis, Sakkou Sissy Foteini and Fotios Fousekis
Medicina 2026, 62(3), 440; https://doi.org/10.3390/medicina62030440 - 26 Feb 2026
Cited by 1 | Viewed by 776
Abstract
Background and Objectives: Dysphagia is a frequently reported symptom among patients undergoing thyroidectomy, yet its incidence, underlying mechanisms, and temporal progression remain insufficiently clarified. The aim of the present systematic review was to synthesize the existing literature on the occurrence and evolution [...] Read more.
Background and Objectives: Dysphagia is a frequently reported symptom among patients undergoing thyroidectomy, yet its incidence, underlying mechanisms, and temporal progression remain insufficiently clarified. The aim of the present systematic review was to synthesize the existing literature on the occurrence and evolution of swallowing disorders following thyroidectomy, without restriction regarding the extent of surgery, surgical approach, indication, or concomitant complications. Materials and Methods: A systematic literature review, according to PRISMA guidelines, was conducted in the electronic databases PubMed, MEDLINE, and SciELO, using the terms “dysphagia”, “deglutition disorder”, “swallowing disorder”, “thyroid surgery” and “thyroidectomy” in the appropriate combinations. A narrative synthesis of the results followed. Results: 31 eligible studies encompassing a total of 64,123 patients were included in the systematic review and analyzed concerning their type, sample, follow-up and results regarding thyroidectomy-related dysphagia. Data regarding pre- and postoperative dysphagia were extracted and compared. Both subjective patient-reported outcomes and objective assessments were considered. Reported preoperative dysphagia incidence varied widely (3.3–77.8%), with a pooled mean of approximately 25%. Dysphagia rates increased significantly within the first 1–2 postoperative weeks but generally declined to near preoperative levels by 2–3 months, with further improvement observed up to 4–6 months. Several factors were associated with persistent or more severe dysphagia, including the extent of surgery, older age, surgical techniques, central or lateral lymph node dissection, and the need for adjuvant therapies such as radioactive iodine or external beam radiotherapy. Conclusions: Dysphagia after thyroidectomy appears as a common but typically transient symptom, with the highest incidence occurring in the immediate postoperative period and a progressive return to baseline within three months. Although most patients experience improvement, a subset may report persistent symptoms with measurable impact on quality of life. Methodological heterogeneity, variability in symptom assessment tools, and limited long-term follow-up restrict the strength of available evidence. Standardization of outcome measures and longer follow-up periods are needed to achieve more reliable and generalizable conclusions. Full article
(This article belongs to the Special Issue Emerging Trends in Head and Neck Surgery)
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