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Clinics and Practice
Special Issues
Clinical Outcome Research in the Head and Neck
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Clinical Outcome Research in the Head and Neck

A special issue of Clinics and Practice (ISSN 2039-7283).

Deadline for manuscript submissions: 24 December 2024 | Viewed by 6453

Special Issue Editors

Dr. Ioannis Tilaveridis

E-Mail Website
Guest Editor
Department of Oral & Maxillofacial Surgery, School of Dentistry, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
Interests: oral maxillofacial surgery; head and neck surgery; reconstructive surgery; free flap surgery; head and neck oncology; quality of life research; outcome research
Dr. Athanassios A. Kyrgidis

E-Mail Website
Guest Editor
Department of Oral & Maxillofacial Surgery, Aristotle University of Thessaloniki, R.G.H. "George Papanikolaou", Exohi, Thessaloniki, Greece
Interests: skin cancer; head and neck cancer; melanoma; clinical pharmacology; patient-reported-outcome-measures; clinical biomarkers; prognostic factors; epidemiology; oral and maxillofacial surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Head and neck diseases have a profound impact on quality of life, healthcare worker burnout, and the healthcare burden. Patients grappling with head and neck diseases often experience a multitude of physical and psychological challenges, including pain, difficulty in swallowing and speaking, disfigurement, and impaired social interactions. These struggles can lead to diminished quality of life, affecting their emotional well-being and overall satisfaction. Additionally, healthcare professionals involved in the care of these patients face unique challenges that contribute to burnout. The complex nature of head and neck diseases requires extensive expertise and coordination among various specialists, resulting in heavy workloads, high stress levels, and emotional strain. Moreover, the healthcare burden associated with these diseases is substantial, encompassing diagnosis, treatment, and long-term management. It places a significant strain on healthcare resources, including hospital facilities, medical equipment, and financial resources. Addressing the quality of life, healthcare worker burnout, and healthcare burden related to head and neck diseases necessitates a holistic approach that emphasizes patient support, caregiver well-being, and investment in healthcare infrastructure and resources. Efforts to improve patient outcomes and alleviate the burden on healthcare workers should focus on education, early intervention, multidisciplinary care, and the development of sustainable healthcare systems.

A Special Issue called “Outcome Research in the Head and Neck” is announced. This Special Issue is calling for original research and systematic reviews that investigate quality of life measures in the head and neck region, healthcare costs and demands, burnout of involved professionals. Studies examining clinical, prognostic, diagnostic and therapeutic predictors and related outcomes will also be considered.

Dr. Ioannis Tilaveridis
Dr. Athanassios A. Kyrgidis
Guest Editors

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 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
  • head and neck cancer
  • professional burnout
  • healthcare cost
  • biomarkers
  • predictors
  • quality of life

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Published Papers (7 papers)

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Research

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15 pages, 1316 KiB  
Article
Time-to-Treatment Delays and Their Prognostic Implications in Pharyngeal Cancer—An Exploratory Analysis in Western Romania
by Andreea Mihaela Kiș, Roxana Buzatu, Lazar Chisavu, Marioara Poenaru, Claudia Borza, Andrada Iftode, Oana Silvana Sarau, Cristina Adriana Dehelean and Simona Ardelean
Clin. Pract. 2024, 14(4), 1270-1284; https://doi.org/10.3390/clinpract14040103 - 29 Jun 2024
Viewed by 607
Abstract
Background: Diagnosis and treatment for pharyngeal cancer are decisive in determining prognosis. Diagnosis delays are frequent, representing a significant cause of avoidable mortality, and an important factor in subpar survival across the continuous HNC care delivery. Methods: The present study represents a retrospective [...] Read more.
Background: Diagnosis and treatment for pharyngeal cancer are decisive in determining prognosis. Diagnosis delays are frequent, representing a significant cause of avoidable mortality, and an important factor in subpar survival across the continuous HNC care delivery. Methods: The present study represents a retrospective analysis of medical records from Western Romania, which included 180 patients, to evaluate the impact of time-to-treatment delay on patients diagnosed with pharyngeal cancer. The data analyses were performed using the Kaplan–Meier method R (version 3.6.3) packages, including tidyverse, final-fit, mcgv, survival, stringdist, janitor, and Hmisc. Results: The mean days from diagnosis until the end of treatment were higher for the nasopharynx group. Cox regression analysis regarding diagnosis to treatment duration categories showed an increased risk mortality by 3.11 times (95%CI: 1.51–6.41, p = 0.0021) with a Harrell’s C-index of 0.638 (95%CI: 0.552–0.723). The hypopharynx and oropharynx locations increased risk mortality by 4.59 (95%CI: 1.55–13.55) and 5.49 times (95%CI: 1.79–16.81) compared to the nasopharynx location. Conclusions: The findings of this study led to the conclusion that it seems there is a trend of mortality risk for oropharynx and hypopharynx cancers due to delays in the time to treatment over 70 days, standing as a basis for further research as there is an imperative need for prospective multicenter studies. Full article
(This article belongs to the Special Issue Clinical Outcome Research in the Head and Neck)
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13 pages, 855 KiB  
Article
The Impact of Thyroidectomy and Lobectomy on Patients’ Health-Related Quality of Life, Eastern Region, Saudi Arabia
by Zainab Ali AlOsaif, Hassan Mohammed Al Bisher, Hend Abdelmonem Elshnawie and Mohammed Taha Al-Hariri
Clin. Pract. 2024, 14(4), 1251-1263; https://doi.org/10.3390/clinpract14040101 - 29 Jun 2024
Viewed by 420
Abstract
Introduction: The thyroid gland is a crucial endocrine organ that can be susceptible to various pathological conditions, often necessitating total thyroidectomy or lobectomy. It is a common surgical procedure in Saudi Arabia. Thus, it is essential to recognize the impact of thyroid surgery [...] Read more.
Introduction: The thyroid gland is a crucial endocrine organ that can be susceptible to various pathological conditions, often necessitating total thyroidectomy or lobectomy. It is a common surgical procedure in Saudi Arabia. Thus, it is essential to recognize the impact of thyroid surgery on patients’ health-related quality of life (HRQoL). Aim: The aim of this study was to evaluate HRQoL among patients with benign and malignant thyroid diseases who underwent thyroidectomy in the eastern region of Saudi Arabia. Methods: This cross-sectional study was conducted at King Fahad Hospital of University in Khobar, Kingdom of Saudi Arabia from January 2018 to May 2018. The data collection method used was divided into two parts. Part I included the patients’ socio-demographic characteristics and the clinical characteristics of their thyroid surgery. Part II was a HRQoL questionnaire (SF-36, version 1.0). Results: The sample included 100 thyroidectomy patients ≥18 years. The study findings revealed that the overall scores for post-thyroidectomy patients showed a significant improvement in HRQoL, and HRQoL was not significantly associated with benign or malignant thyroid diseases. Conclusion: Especially when the surgery is performed by a high-volume endocrine surgeon, thyroidectomy may lead to significant improvements in HRQoL among patients, including the elderly and younger adults, with benign and malignant thyroid disorders. There was no difference in HRQoL between patients who underwent total thyroidectomy or thyroid lobectomy. Also, HRQol among thyroidectomy patients is associated with their educational and occupational statuses. Full article
(This article belongs to the Special Issue Clinical Outcome Research in the Head and Neck)
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15 pages, 1249 KiB  
Article
Unravelling Quality of Life for Head and Neck Cancer Patients after VMAT Radiation Therapy: Insights from Toxicity, Dosimetry and Symptoms Correlation
by Panagiota Kiafi, Maria Anthi Kouri, Georgios Patatoukas, Andromachi Kougioumtzopoulou, Marina Chalkia, Ourania Nicolatou-Galitis, Vassilis Kouloulias, Efthimios Kyrodimos and Kalliopi Platoni
Clin. Pract. 2024, 14(3), 1085-1099; https://doi.org/10.3390/clinpract14030086 - 6 Jun 2024
Viewed by 968
Abstract
(1) Background: Head and neck cancer treatment, including advanced techniques like Volumetric Modulated Arc Therapy (VMAT), presents challenges for maintaining patient quality of life (QoL). Thus, thoroughly investigating how radiation therapy (RT) affects patients has been proved essential. Derived by that, this study [...] Read more.
(1) Background: Head and neck cancer treatment, including advanced techniques like Volumetric Modulated Arc Therapy (VMAT), presents challenges for maintaining patient quality of life (QoL). Thus, thoroughly investigating how radiation therapy (RT) affects patients has been proved essential. Derived by that, this study aims to understand the complex interactions between not only RT and QoL but also symptom severity, and treatment-related toxicities in three distinct time points of patient’s treatment; (2) Methods: To achieve that, EORTC-QLQ-C30 and EORTC QLQ-H&N35 questionnaires were used in combination with EORTC_RTOG scoring criteria and Spearman’s rho statistical analysis for 74 patients with cancer undergoing VMAT radiation therapy; (3) Results: The results revealed a significant improvement in the Overall Health Index post-treatment, indicating a temporary decline during therapy followed by subsequent recovery, often surpassing pre-treatment QoL levels. Concurrently a reduction in symptomatology was observed, notably in pain, swallowing difficulties, and dry mouth, aligning with prior research indicating decreased symptom burden post-treatment. However, Spearman’s correlation coefficient analysis at two distinct time points during therapy uncovered varying degrees of correlation between dosimetric data at Organs at Risk (OARs) and reported symptoms, highlighting potential limitations in using QoL questionnaires as sole indicators of treatment efficacy. Our investigation into the correlation between dosimetric data, toxicity, and symptoms focused on the relationship between radiation doses and oral mucositis levels, a common toxicity in head and neck cancer patients. Significant associations were identified between toxicity levels and dosimetric parameters, particularly with OARs such as the parotid glands, oral cavity, and swallowing muscles, underlining the utility of the EORTC method as a reliable toxicity assessment tool; (4) Conclusions: To summarize, current research attempts to underscore the importance of refining QoL assessments for enhanced patient care. The integration of dosimetric data, symptom severity, and treatment-related toxicities in the QoL outcomes of head and neck cancer patients undergoing VMAT radiation therapy, can lead towards the optimization of treatment strategies and the improvement of patient outcomes in future patient-centered radiation therapy practices. Full article
(This article belongs to the Special Issue Clinical Outcome Research in the Head and Neck)
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8 pages, 228 KiB  
Article
Cross-Cultural Adaptation, Reliability, and Validity of the Polish Version of the Neck Outcome Score
by Nicola Dyrek, Łukasz Pulik, Aleksandra Piwowarczyk, Wiktoria Skała, Nina Grabowska-Mycko and Paweł Łęgosz
Clin. Pract. 2023, 13(6), 1352-1359; https://doi.org/10.3390/clinpract13060121 - 30 Oct 2023
Viewed by 1113
Abstract
This study aimed to translate and psychometrically validate the Neck Outcome Score (NOOS) in the Polish population according to the recommendations of the American Academy of Orthopedic Surgeons Participants completed online version of the NOOS, Neck Disability Index (NDI), and Visual Analogue Scale [...] Read more.
This study aimed to translate and psychometrically validate the Neck Outcome Score (NOOS) in the Polish population according to the recommendations of the American Academy of Orthopedic Surgeons Participants completed online version of the NOOS, Neck Disability Index (NDI), and Visual Analogue Scale (VAS) for pain assessment (23 November 2021–9 April 2022). The questionnaires were completed by 57 women and 32 men with cervical spine ailments. A retest was performed after 48 h. The analysis confirmed the high internal consistency (Cronbach’s alpha of 0.95) of the Polish NOOS. No floor/ceiling effects were observed. The Polish NOOS showed a significant Spearman’s coefficient correlation with NDI (0.87; p < 0.001) and VAS (0.79; p < 0.001). The intraclass correlation coefficient (ICC) for the test–retest was found to be high (0.97). The Polish NOOS can be used for clinical and research purposes as an equivalent to the original version. Full article
(This article belongs to the Special Issue Clinical Outcome Research in the Head and Neck)

Review

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18 pages, 530 KiB  
Review
How to Evaluate the Efficacy of Manipulations in Spine Disorders—A Comprehensive Review of New and Traditional Outcome Measures
by Giacomo Farì, Carlo Mariconda, Laura Dell’Anna, Francesco Quarta, Danilo Donati, Cristiano Sconza, Vincenzo Ricci, Giustino Varrassi, Valeria Coco, Alessandro Manelli, Ennio Spadini, Maria Teresa Giglio and Andrea Bernetti
Clin. Pract. 2024, 14(4), 1478-1495; https://doi.org/10.3390/clinpract14040119 - 29 Jul 2024
Viewed by 256
Abstract
Spine pain (SP) is the most common musculoskeletal disorder that causes transitional forms of motor disability. Considering its affordability and safety, manipulative therapy (MT) stands as one of the primary therapeutic approaches for SP and the related dysfunctional consequences. However, it is still [...] Read more.
Spine pain (SP) is the most common musculoskeletal disorder that causes transitional forms of motor disability. Considering its affordability and safety, manipulative therapy (MT) stands as one of the primary therapeutic approaches for SP and the related dysfunctional consequences. However, it is still difficult to assess and quantify the results of this treatment since there is a lack of objective evaluation tools in the available scientific literature. Thus, the purpose of this comprehensive review is to summarize the main outcomes used to evaluate the effectiveness of spine manipulations, focusing on their strengths and weaknesses. An extensive review of the PubMed, Cochrane, and Embase databases was performed to identify the literature of the last ten years regarding MT and the related assessment tools. A total of 12 studies met the inclusion criteria. The analyzed literature indicates that a wide range of outcome measures have been used to assess the effectiveness of spine MT. Pain is the main aspect to be investigated but it remains difficult to elucidate since it is strongly linked to various dimensions such as self-perception and psychological aspects. Therefore, it seems necessary to include new tools for evaluating the effects of spine MT, with the aim of exploiting new technologies and taking into consideration the SP biomechanical and biopsychosocial aspects. Full article
(This article belongs to the Special Issue Clinical Outcome Research in the Head and Neck)
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12 pages, 754 KiB  
Review
Autophagy Genes and Otitis Media Outcomes
by Yong Jun Kim, Hwa Sung Rim, Jeong Hee Kim, Sung Soo Kim, Joon Hyung Yeo and Seung Geun Yeo
Clin. Pract. 2024, 14(1), 293-304; https://doi.org/10.3390/clinpract14010023 - 6 Feb 2024
Viewed by 1038
Abstract
Otitis media (OM) is a common cause of hearing loss in children that requires corrective surgery. Various studies have investigated the pathomechanisms and treatment of OM. Autophagy, an essential cellular recycling and elimination mechanism implicated in various diseases, is known to play an [...] Read more.
Otitis media (OM) is a common cause of hearing loss in children that requires corrective surgery. Various studies have investigated the pathomechanisms and treatment of OM. Autophagy, an essential cellular recycling and elimination mechanism implicated in various diseases, is known to play an important role in the pathogenesis of OM. Here, we conducted a literature review on autophagy in OM, highlighting the relationship between expression patterns of autophagy-related factors and pathophysiological and clinical aspects of OM. We summarized the existing research results on the expression of autophagy-related factors in acute OM (AOM), OM with effusion (OME), chronic OM (COM) with cholesteatoma, and COM without cholesteatoma (CholeOM) in animals and humans. Autophagy-related factors are expressed in the middle ear mucosa or fluid of AOM, effusion of OME, granulation tissue of COM, and cholesteatoma of CholeOM. Among ATGs and other autophagy-related factors, the most extensively studied in relation to the pathogenesis of OM are mTOR, LC3II/I, PI3K, Beclin-1, FLIP, Akt, and Rubicon. Expression of autophagy-related factors is associated with AOM, OME, COM, and CholeOM. Inadequate expression of these factors or a decrease/increase in autophagy responses can result in OM, underscoring the critical role of ATGs and related factors in the pathogenesis of OM. Full article
(This article belongs to the Special Issue Clinical Outcome Research in the Head and Neck)
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Other

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9 pages, 346 KiB  
Study Protocol
Individualized Cognitive Functional Therapy Compared with Conservative Treatment for Patients with Chronic Neck Pain—Study Protocol for a Single Blind Pragmatic Randomized Controlled Trial
by George Ploutarchou, Vasileios Korakakis, Evi Lazoura, Christos Savva, Kyriakos Pavlou, Iacovos Christofi, Katerina Sotiriou, Chara Savvidou, Andreas Panteli, Christos Karagiannis and Ioannis Mamais
Clin. Pract. 2024, 14(4), 1225-1233; https://doi.org/10.3390/clinpract14040098 - 21 Jun 2024
Viewed by 1277
Abstract
Chronic neck pain (CNP) is one of the most common musculoskeletal conditions, is considered the second leading cause of pain, and is among the leading causes of disability. Cognitive Functional Therapy (CFT) is a novel behavioral therapy for individualizing the management of spinal [...] Read more.
Chronic neck pain (CNP) is one of the most common musculoskeletal conditions, is considered the second leading cause of pain, and is among the leading causes of disability. Cognitive Functional Therapy (CFT) is a novel behavioral therapy for individualizing the management of spinal pain targeting the multidimensional aspect of musculoskeletal pain. This study outlines the protocol for an assessor-blind randomized controlled trial (RCT) designed to compare an individualized Cognitive Functional Therapy (CFT) intervention with usual care in terms of pain and disability. Aiming for a pragmatic intervention, the CFT group will receive 16 sessions based on patient’s condition characteristics, and clinical presentation and progression. The control group will receive 16 sessions of standardized usual care (electrotherapy, massage, posture exercise, and educations). Both groups will have the same intervention duration. Patients will be randomly allocated into groups and will be assessed at baseline, at the 8th session, at the 16th session, and 3 months after randomization. Primary outcomes will be pain, disability, cervical range of motion, and neck muscle isometric strength. To our knowledge, this study will be the first RCT to compare the clinical effectiveness of CFT compared to UC for adults with CNP. The study results will provide information about the use of CFT in clinical practice. Full article
(This article belongs to the Special Issue Clinical Outcome Research in the Head and Neck)
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