Head & neck
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Randomized Controlled Trial Comparative Study
Incidence and circumstances of cervical hematoma complicating thyroidectomy and its relationship to postoperative vomiting.
Cervical hematoma is hardly a predictable complication of thyroid surgery. Postoperative vomiting has been reported as a likely risk factor. ⋯ Careful hemostasis remains of prime importance in preventing cervical hematoma. Postoperative vomiting has not been confirmed by this study as a risk factor for the development of hematoma. Ambulatory thyroid surgery is not advisable.
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Randomized Controlled Trial
Superficial selective cervical plexus block following total thyroidectomy: a randomized trial.
Pain after thyroid surgery is of moderate intensity and short duration. Bilaterally superficial cervical plexus block (BSCPB) may reduce analgesic requirements. However, its effectiveness in decreasing pain after thyroidectomy is debated. ⋯ Two-point bilateral BSCPB has a major analgesic effect on patients after total thyroidectomy, with a statistically significant reduction in postoperative pain scores. However, no significant difference was noted in the proportion of patients that required additional analgesics.
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Impact of comorbidity on short-term mortality and overall survival of head and neck cancer patients.
In 2001, we presented a Cox regression model that is able to predict survival of the newly diagnosed patient with head and neck squamous cell carcinoma (HNSCC). This model is based on the TNM classification and other important clinical variables such as age at diagnosis, sex, primary tumor site, and prior malignancies. We aim to improve this model by including comorbidity as an extra prognostic variable. Accurate prediction of the prognosis of the newly diagnosed patient with head and neck cancer can assist the physician in patient counseling, clinical decision-making, and quality maintenance. ⋯ Comorbidity impacts overall survival of the newly diagnosed patient with HNSCC. There is a clear distinction between the impact of the 4 ACE27 severity grades. The impact of an ACE27 grade 3 is comparable to the impact of a T4 tumor or an N2 neck. Comorbidity impacts short-term mortality as well. Especially cardiovascular comorbidity, respiratory comorbidity, gastrointestinal comorbidity, and diabetes show a strong relationship.
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This retrospective study evaluates the efficacy of gabapentin for the treatment of pain syndrome related to radiation-induced mucositis in patients with head and neck tumors. ⋯ Gabapentin appears promising in reducing the need for narcotic pain medication for patients with head and neck malignancies treated with IMRT and should be further evaluated prospectively in controlled clinical trials.