Optimizing Outcomes 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 June 2025 | Viewed by 2044

Special Issue Editors


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Guest Editor
1. ENT Department, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
2. Craiova Emergency Clinic Districtual Hospital, Craiova, Romania
Interests: head and neck pathology; rhinology; rhinosinusitis with polyposis; otology; multidisciplinary approach in ENT

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Guest Editor Assistant
1. ENT Department, Carol Davila University of Medicine and Pharmacy, 050472 Bucharest, Romania
2. Bucharest Emergency University Hospital, Bucharest, Romania
Interests: head and neck surgery; oncology; salivary glands; trauma; rhinology; respiratory allergy; artificial intelligence; multidisciplinary approach in ENT

Special Issue Information

Dear Colleagues,

In otolaryngology and head and neck surgery, the goal of the diagnostic and therapeutic approach is to achieve a good physical and functional outcome. Functional surgery in ENT pathology aims, as appropriate, to restore hearing, nasal permeability, and smell. Cochlear implants in children and adults made huge progress in restoring hearing. Oncological surgery of the head and neck through the ablative time aims at a resection with negative margins of tumors of the pharynx, larynx, or cervical tumors. Alternatively, through reconstructive time, the aim is to restore some fundamental functional elements, such as anatomical breathing, swallowing, and phonation. Improving functional prognosis in head and neck surgery is an essential goal of clinical and research activity.

New techniques and technologies allow for less invasive approaches, an exploration of hidden areas (e.g., infratemporal fossa, anterior base of the skull), and more precise control of safety margins, enabling for the functional result of the surgical intervention to be as close as possible in appearance before the onset of the disease.

In head and neck cancers, new molecular biology diagnostic techniques allow for the refinement of diagnosis with the de-escalation of adjuvant oncological treatment and improved functional prognosis in terms of sequelae at the end of treatment. It should be remembered that in head and neck oncology, outcomes are measured by two major parameters: survival and quality of life. Neoadjuvant therapies, which include immunotherapy, allow less aggressive oncological surgery and, implicitly, a better functional outcome. Immunotherapy represents an exponentially developed alternative in the recent decade, offering high survival rates in unresectable recurrent and metastatic disease.

Biological therapies represent a horizon of significant improvement of the outcome in chronic rhinosinusitis with nasal polyposis, significantly improving the results obtained with endoscopic rhinosinusal surgery and corticosteroids. In recent years, artificial intelligence systems have been applied in the early diagnosis of head and neck cancer, as well as in personalized therapies.

We are pleased to invite you to contribute to this new Special Issue with manuscripts reflecting new directions in optimizing outcomes in otorhinolaryngology and head and neck surgery. We welcome original articles, but also reviews and selected rare case series, with the goal of updating our knowledge on this topic. We invite senior researchers to submit manuscripts, as well as young doctoral students with perspective research in head and neck surgery. Lastly, the Special Issue Mentor Program is designed to support early career researchers, including postdocs and new faculty members, by offering them the opportunity to propose innovative ideas for this Special Issue, titled “Optimizing Outcomes in Head and Neck Surgery”.

Dr. Carmen Aurelia Mogoantă
Guest Editor

Dr. Daniela Vrinceanu
Guest Editor Assistant

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Keywords

  • head and neck
  • surgery
  • oncology
  • outcomes
  • artificial intelligence
  • otology
  • biologics
  • immunotherapy
  • multidisciplinary approach

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Published Papers (2 papers)

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Research

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10 pages, 4275 KiB  
Article
Challenges in the Management of Giant Carcinoma Ex-Pleiomorphic Adenoma of the Parotid Gland in a Single Tertiary Center
by Miruna Bratiloveanu, Mihai Dumitru, Andreea Nicoleta Marinescu, Crenguta Serboiu, Oana Maria Patrascu, Adrian Costache and Daniela Vrinceanu
Medicina 2025, 61(1), 37; https://doi.org/10.3390/medicina61010037 - 29 Dec 2024
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Abstract
Background and Objectives: Carcinoma ex-pleiomorphic adenoma (CXPA) is a carcinoma derived from a primary or recurrent pleiomorphic adenoma. Microscopically, non-invasive CXPA (intracapsular and carcinoma in situ), minimally invasive CXPA (extracapsular invasion less than 1.5 mm), and invasive CXPA (extracapsular invasion more than [...] Read more.
Background and Objectives: Carcinoma ex-pleiomorphic adenoma (CXPA) is a carcinoma derived from a primary or recurrent pleiomorphic adenoma. Microscopically, non-invasive CXPA (intracapsular and carcinoma in situ), minimally invasive CXPA (extracapsular invasion less than 1.5 mm), and invasive CXPA (extracapsular invasion more than 1.5 mm) are described. Materials and Methods: We performed a retrospective clinical study over the period of 2009–2023 in patients admitted to the ENT Department of the Bucharest University Emergency Hospital. Results: In the studied group, there was a net male predominance of 2.5:1. The tumor evolution until presentation was 6.64 years on average, with values between 2 and 20 years. The reasons for presenting to our department included a sudden increase in size in eleven cases (78.57%), pain in nine cases (64.29%), peripheral facial paralysis in eight cases (57.14%), skin invasion/ulceration in five cases (35.71%), and massive tumor hemorrhage in one case (7.14%). There were histopathological results on paraffin of myoepithelial CXPA in four cases (28.57%), of high-grade CXPA (salivary duct, secretory) in eight cases (57.14%), and of squamous CXPA in two cases (14.29%). The patients with unfavorable evolution showed the following characteristics: a tumor diameter over 11 cm (four cases), integument invasion (four cases), perivascular invasion at HP exam (six cases), perineural invasion at HP exam (six cases), and invasion of the ganglion (three N3b cases and two N1 cases). Conclusions: CXPA is a neoplasia that, when associated with large tumor volumes or peripheral facial paralysis in particular, is a challenge for both the doctor and patient. Full article
(This article belongs to the Special Issue Optimizing Outcomes in Head and Neck Surgery)
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Review

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13 pages, 419 KiB  
Review
Inferior Vestibular Neuritis: Diagnostic Criteria, Clinical Features, and Prognosis—A Focused Review
by Gabriela Cornelia Musat, Mihai Alexandru Preda, Ionut Tanase, Adina Zamfir Chiru Anton, George G. Mitroi, Ovidiu Musat, Alina Lavinia Antoaneta Oancea and Mihaela Roxana Mitroi
Medicina 2025, 61(2), 361; https://doi.org/10.3390/medicina61020361 - 19 Feb 2025
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Abstract
Purpose: This review aims to analyze the diagnostic methods used to evaluate inferior vestibular nerve neuritis. Methods: We performed an electronic search on the PubMed database for clinical studies investigating the diagnostic techniques used for inferior vestibular nerve neuritis. Results: [...] Read more.
Purpose: This review aims to analyze the diagnostic methods used to evaluate inferior vestibular nerve neuritis. Methods: We performed an electronic search on the PubMed database for clinical studies investigating the diagnostic techniques used for inferior vestibular nerve neuritis. Results: We initially identified 114 records in our search. After applying the inclusion and exclusion criteria, we narrowed it down to 12 studies. These studies collectively examined a total of 642 patients diagnosed with vestibular nerve neuritis, 64 of whom had inferior vestibular neuritis. Conclusions: The inferior vestibular neuritis is an unfrequent form of vestibular neuritis, often misdiagnosed. The diagnosis of inferior vestibular neuritis (IVN) is based on clinical history and vestibular testing, specifically reduced posterior canal gain on video head impulse test (vHIT), absent cervical VEMP (cVEMP), normal caloric responses, and preserved ocular VEMP (oVEMP). This review highlights the gaps in current diagnostic strategies and emphasizes the need for integrating advanced vestibular testing methods to enhance diagnostic accuracy for inferior vestibular nerve neuritis. Future studies should address the standardization of diagnostic protocols to facilitate broader clinical application. Full article
(This article belongs to the Special Issue Optimizing Outcomes in Head and Neck Surgery)
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