Browsing by Author "Shaha, Ashok R."
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Item Current philosophy in the surgical management of neck metastases for head and neck squamous cell carcinoma(Wiley, 2015-06) Medina, Jesus E.; Robbins, K. Thomas; Silver, Carl E.; Strojan, Primoz; Teymoortash, Afshin; Pellitteri, Phillip K.; Rodrigo, Juan P.; Stoeckli, Sandro J.; Shaha, Ashok R.; Suarez, Carlos; Hartl, Dana M.; De Bree, Remco; Takes, Robert P.; Hamoir, Marc; Pitman, Karen T.; Rinaldo, Alessandra; Ferlito, Alfio; Çoşkun, Hakan H.; Uludağ Üniversitesi/Tıp Fakültesi/Kulak Burun Boğaz-Baş Boyun Cerrahisi Anabilim Dalı.; 13610800100Neck dissection is an important treatment for metastases from upper aerodigestive carcinoma; an event that markedly reduces survival. Since its inception, the philosophy of the procedure has undergone significant change from one of radicalism to the current conservative approach. Furthermore, nonsurgical modalities have been introduced, and, in many situations, have supplanted neck surgery. The refinements of imaging the neck based on the concept of neck level involvement has encouraged new philosophies to evolve that seem to benefit patient outcomes particularly as this relates to diminished morbidity. The purpose of this review was to highlight the new paradigms for surgical removal of neck metastases using an evidence-based approach.Item Do pathologic and molecular analyses of neck dissection specimens justify the preservation of level IV for laryngeal squamous carcinoma with clinically negative neck?(Elsevier, 2006-02) Elsheikh, Mohamed Nasser; Ferlito, Alfio; Rinaldo, Alessandra; Shaha, Ashok R.; Khafif, Avi; Kowalski, Luiz P.; Medina, Jesus E.; Coşkun, H. Hakan; Uludağ Üniversitesi/Tıp Fakültesi/Kulak Burun Boğaz-Baş Boyun Cerrahisi Anabilim Dalı.; 13610800100Since the first detailed description by Franciszek Jaw-dyn ́ski in 1888,1-4there have been many variations andmodifications of the radical neck dissection procedure.These include modified radical neck dissection (alsocalled functional neck dissection) and various selectiveneck dissections.5-6Analysis of the distribution of lymph node metastasesin patients with squamous carcinoma of the larynx re-veals a marked preference for levels II, III, and IV; levelsI and V are rarely involved.7-9Based on these observa-tions, lateral neck dissection has been recommended inpatients with necks staged as N0 or N1.10This meansremoving the upper jugular lymph nodes (level II), mid-dle jugular lymph nodes (level III), and lower jugularlymph nodes (level IV). Lateral neck dissection is alsodescribed as jugular node dissection by many surgeons.The need for routine dissection at level IV has re-cently been questioned.11This article discusses whethersparing level IV lymph nodes is justified on the strengthof pathologic and molecular studies on the pattern ofnodal metastasis in patients with squamous carcinomaof the larynx. In other words, dare we perform a selectiveneck dissection involving levels IIA and III for N0 necklaryngeal cancer to avoid potential complications such aschylous fistula or phrenic nerve injury?Item Prognosis of subglottic carcinoma: Is it really worse?(Wiley, 2019-02) Mendenhall, William M.; Rinaldo, Alessandra; Rodrigo, Juan P.; Suarez, Carlos; Strojan, Primoz; Lopez, Fernando; Mondin, Vanni; Saba, Nabil F.; Shaha, Ashok R.; Smee, Robert; Takes, Robert P.; Ferlito, Alfio; Coşkun, Hakan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Tıp Bilimleri/Kulak, Burun ve Boğaz Hastalıkları Bölümü.; 13610800100It is traditionally accepted that subglottic carcinoma has a worse prognosis than tumors arising in other subsites of the larynx, owing to its tendency to present in advanced stages, with a high incidence of cartilage invasion and extralaryngeal spread. The incidence of subglottic carcinoma varies among series, mainly because there is no uniform definition of the upper boundary of the subglottis. The extent of the tumor may be difficult to define because subglottic carcinoma may spread through the submucosa without visible mucosal changes. There is also a rich lymphatic network in the subglottis draining to the prelaryngeal and paratracheal lymph nodes, which are usually not involved by cancers arising in other laryngeal subsites. Current literature data indicates that early-stage subglottic carcinoma can be treated using radiotherapy or chemoradiotherapy with high locoregional control and survival rates. In advanced stage subglottic carcinoma, combination of surgery followed by radiotherapy or chemoradiotherapy resulted in comparable outcomes, as in advanced carcinomas from the rest of the larynx. Stage for stage, it is likely that the prognosis for subglottic carcinoma and of glottic and supraglottic cancers is similar.Item Proposal for a rational classification of neck dissections(Wiley, 2011-03) Ferlito, Alfio; Robbins, K. Thomas; Shah, Jatin P.; Medina, Jesus E.; Silver, Carl E.; Al-Tamimi, Shawkat; Fagan, Johannes J.; Paleri, Vinidh; Takes, Robert P.; Bradford, Carol R.; Devaney, Kenneth O.; Stoeckli, Sandro J.; Weber, Randal S.; Bradley, Patrick J.; Suarez, Carlos; Leemans, C. Rene; Pitman, Karen T.; Shaha, Ashok R.; de Bree, Remco; Hartl, Dana M.; Haigentz, Missak, Jr.; Rodrigo, Juan P.; Hamoir, Marc; Khafif, Avi; Langendijk, Johannes A.; Owen, Randall P.; Sanabria, Alvaro; Strojan, Primoz; Poorten, Vincent Vander; Werner, Jochen A.; Bien, Stanislaw; Woolgar, Julia A.; Zbaeren, Peter; Betka, Jan; Folz, Benedikt J.; Genden, Eric M.; Talmi, Yoav P.; Strome, Marshall; Botas, Jesus Herranz Gonzalez; Olofsson, Jan; Kowalski, Luiz P.; Holmes, Jon D.; Hisa, Yasuo; Rinaldo, Alessandra; Coşkun, H. Hakan; Uludağ Üniversitesi/Tıp Fakültesi/Kulak Burun Boğaz Anabilim Dalı.; 13610800100Item Retropharyngeal lymph node metastases in head and neck malignancies(Wiley, 2011-10) Ferlito, Alfio; Medina, Jesus E.; Robbins, K. Thomas; Rodrigo, Juan P.; Strojan, Primoz; Suarez, Carlos; Takes, Robert P.; Woolgar, Julia A.; Shaha, Ashok R.; de Bree, Remco; Rinaldo, Alessandra; Silver, Carl E.; Coşkun, Hakan H.; Uludağ Üniversitesi/Tıp Fakültesi/Kulak Burun Boğaz Anabilim Dalı.; 13610800100Retropharyngeal lymph node (RPLN) metastasis of primary head and neck cancer often receives less consideration than lymph node metastasis in the neck. With improvements in imaging techniques and reports of surgical pathology, there is an improved understanding of the risk and subsequently the need for treatment of RPLNs. The rates of RPLN metastasis from carcinomas of the nasopharynx, oropharynx, hypopharynx, postcricoid region, maxillary sinus, and cervical esophagus are sufficiently high to warrant routine treatment, either electively or therapeutically, of this region. Through improved diagnostic techniques and heightened awareness of RPLN metastasis, patients at risk of having these metastases can be treated more effectively.Item When is reoperative surgery not indicated for recurrent head and neck squamous cell carcinoma?(Springer, 2015-02-01) Rodrigo, Juan P.; Kowalski, Luiz P.; Silver, Carl E.; de Bree, Remco; Rinaldo, Alessandra; Shaha, Ashok R.; Strojan, Primoz; Elsheikh, Mohamed N.; Haigentz, Missak, Jr.; Sanabria, Alvaro; Takes, Robert P.; Ferlito, Alfio; Coşkun, H. Hakan; Uludağ Üniversitesi/Tıp Fakültesi/Kulak Burun ve Boğaz Hastalıkları Anabilim Dalı.; EQK-3127-2022; 13610800100