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New Insights into Head and Neck Surgery
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New Insights into Head and Neck Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: 20 June 2025 | Viewed by 7760

Special Issue Editor

Dr. Gábor Répássy

E-Mail Website
Guest Editor
Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, 1083 Budapest, Hungary
Interests: otorhinolaryngology; head and neck surgery; laryngeal surgery; thyroid gland surgery; salivary gland surgery; endoscopic sinus surgery

Special Issue Information

Dear Colleagues,

Over the past few years, head and neck surgery has evolved and undergone a great development. New surgical procedures and technological innovations have been presented in the fields of ear surgery, sinonasal surgery, skull base surgery, head and neck tumor surgery, salivary gland surgery and thyroid gland surgery. Alongside these, reconstructive surgical procedures have evolved, improving patients' functional and aesthetic outcomes. Moreover, the head and neck surgery field has experienced a strong and broad collaboration with other specialties, such as with orbital and maxillofacial/dentoalveolar surgeons or neurosurgeons, which aims for a better outcome. The objectives of these innovations and collaborations are to treat lesions that previously were seemingly impossible, to reduce surgical complications and to advance the prognosis of head and neck tumor patients.

The aim of this Special Issue is to explore and describe the latest surgical and/or technological innovations and collaborations in these surgical areas. I ask you to send in your latest research and findings on this topic and am looking forward to receiving your manuscripts.

Dr. Gábor Dénes Répássy
Guest Editor

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 100 words) can be sent to the Editorial Office for announcement on this website.

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. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly 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 2600 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

  • otorhinolaryngology
  • head and neck surgery
  • ear surgery
  • sinonasal surgery
  • skull base surgery
  • salivary gland surgery
  • thyroid gland surgery
  • head and neck cancer surgery

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Published Papers (7 papers)

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Research

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10 pages, 2976 KiB  
Article
Inferior-to-Superior Dissection for Recurrent Laryngeal Nerve Identification in Redo Thyroid Surgery: Enhanced Safety and Reduced Injuries
by Serdar Gumus, Cemil Yuksel, Huseyin Pulat, Cuneyt Akyuz and Mehmet Onur Gul
J. Clin. Med. 2024, 13(23), 7364; https://doi.org/10.3390/jcm13237364 - 3 Dec 2024
Viewed by 555
Abstract
Background: Hoarseness due to recurrent laryngeal nerve (RLN) injury is the most feared complication of thyroid surgery. Scars and anatomical changes caused by previous surgeries make finding the RLN during redo thyroid surgeries difficult. We aimed to analyze the results of the inferior-to-superior [...] Read more.
Background: Hoarseness due to recurrent laryngeal nerve (RLN) injury is the most feared complication of thyroid surgery. Scars and anatomical changes caused by previous surgeries make finding the RLN during redo thyroid surgeries difficult. We aimed to analyze the results of the inferior-to-superior dissection technique that we applied to find the RLN in redo surgeries. Methods: We analyzed the results of 40 consecutive redo thyroidectomy cases in which the inferior-to-superior nerve dissection technique was used to identify the RLN. We compared this cohort with primary thyroidectomies using a lateral-to-medial approach to determine the reliability of this technique. Results: Most patients were women (80%), and the mean age was 48.1 years. The ASA score was mostly 2. In total, 25% of the patients had a preoperative diagnosis of malignancy. A total of 8 of the patients underwent unilateral surgery and 32 underwent bilateral surgeries. Two patients had previous recurrent laryngeal nerve paralysis (RLNP), but one of them underwent contralateral surgery. Permanent recurrent laryngeal nerve paralysis developed in only 2 of 71 RLNs at risk (2.8%). Complications classified as Clavien-Dindo 3 and above were observed in 12.5% of our patients during the early postoperative period. The transient hypocalcemia rate was 7.5%, and the permanent hypocalcemia rate was 5%. A 2.8% unilateral RLPN rate was detected, but bilateral RLNP was not observed. All of the complications were not observed to be statistically different among those who underwent primary thyroidectomy. Conclusions: The inferior-to-superior nerve dissection approach is a beneficial technique in redo thyroidectomy for preserving RLNP. Surgeons should keep this technique in mind to prevent hoarseness. Full article
(This article belongs to the Special Issue New Insights into Head and Neck Surgery)
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12 pages, 1274 KiB  
Article
Epidemiology and Management Paradigm of Head and Neck Infections, Including COVID-19 Pandemic Period: A 10-Year Retrospective Study in a Maxillofacial Center of Cluj-Napoca
by Cosmin Ioan Faur, Mădălina Anca Moldovan, Tino Paraschivescu, Sergiu Megieșan and Rareș Călin Roman
J. Clin. Med. 2024, 13(14), 4046; https://doi.org/10.3390/jcm13144046 - 10 Jul 2024
Viewed by 1197
Abstract
Background. The management of odontogenic infections varies across the globe. To shed light on the subject, this study delves into the practices of the Oral and Maxillofacial Department at Cluj-Napoca County Hospital. Material and Methods. This comprehensive retrospective analysis of 10 years of [...] Read more.
Background. The management of odontogenic infections varies across the globe. To shed light on the subject, this study delves into the practices of the Oral and Maxillofacial Department at Cluj-Napoca County Hospital. Material and Methods. This comprehensive retrospective analysis of 10 years of clinical experience covered a range of factors, including demographics, clinical and investigations factors, medical and surgical treatment approaches, and follow-up. Additionally, the study examined the change in trends over the course of the COVID-19 pandemic. Results. While head and neck infection occurrence had a decreasing trend before the COVID-19 pandemic, during the pandemic era the number of patients almost doubled. The infections were prevalent in the submandibular space, teeth being the prevalent cause. Young adults are prone to suffer from odontogenic infections. High levels of C reactive protein, ASA II-IV risk, and hepatic dysfunction indicated a longer time of hospitalization. The majority of antibiograms were negative, and the positive ones indicated Streptococcus and Staphylococcus species as prevalent pathogens. Extra- or intraoral surgical drainage and wide-spectrum antibiotics proved to be the workhorse for odontogenic infections. Conclusion. This study advances our understanding of oral and maxillofacial surgery and offers actionable strategies for improving patient outcomes in similar healthcare institutions worldwide. Full article
(This article belongs to the Special Issue New Insights into Head and Neck Surgery)
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10 pages, 544 KiB  
Article
Impact of the COVID-19 Pandemic on the Surgical Management of Head and Neck Non-Melanoma Skin Cancers in a Maxillofacial Center of Cluj-Napoca
by Rareș Călin Roman, Cosmin Ioan Faur, Edina Gordan, Mădălina Văleanu and Mădălina Anca Moldovan
J. Clin. Med. 2024, 13(13), 3934; https://doi.org/10.3390/jcm13133934 - 4 Jul 2024
Cited by 1 | Viewed by 1034
Abstract
Background: The COVID-19 era has been a bleak period for both cancer and non-cancer patients, with delayed non-emergency treatments, such as for non-melanoma skin cancer (NMSC). This study aimed to evaluate how the treatment of NMSC patients was influenced by the management [...] Read more.
Background: The COVID-19 era has been a bleak period for both cancer and non-cancer patients, with delayed non-emergency treatments, such as for non-melanoma skin cancer (NMSC). This study aimed to evaluate how the treatment of NMSC patients was influenced by the management of the COVID-19 pandemic in an Eastern European Maxillofacial Surgery center. Materials and Methods: A total of 176 patients with a histopathological diagnosis of head and neck NMSC who were surgically treated in Cluj-Napoca Emergency County Hospital between 2016 and 2022 were included in this study, and divided into two samples, pre-pandemic (2016–2019) and COVID-19 (2020–2022) periods. Results: The pandemic presented with a decrease of 46.15% in patients’ hospitalization, with wealthy and educated patients being prevalent. Even if the waiting time for surgery was increased, the stage of cancer and preference method for reconstruction did not differ. Despite the lower addressability of NMSC patients during the pandemic, there were no changes in surgical treatment. Conclusions: During COVID-19, the number of patients was reduced, with a longer waiting time for surgery, but without any changes in tumor stage and treatment preferences. However, the benefit of removing a cancer tumor is higher compared to the risk of developing COVID-19 infection during hospitalization Full article
(This article belongs to the Special Issue New Insights into Head and Neck Surgery)
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13 pages, 812 KiB  
Article
Influencing Factors of Survival in Hypopharyngeal Squamous Cell Cancer
by Gábor Dénes Répássy, Dóra Hargas, András Molnár, Stefani Maihoub and László Tamás
J. Clin. Med. 2024, 13(13), 3853; https://doi.org/10.3390/jcm13133853 - 30 Jun 2024
Viewed by 929
Abstract
Objectives: This study examined the effects of various factors on survival in hypopharyngeal cancer, involving a total of 100 patients. Methods: Comorbidities, treatment modalities, survival times, and potential factors affecting survival were retrospectively analysed. The expression of p16 was also examined. A statistical [...] Read more.
Objectives: This study examined the effects of various factors on survival in hypopharyngeal cancer, involving a total of 100 patients. Methods: Comorbidities, treatment modalities, survival times, and potential factors affecting survival were retrospectively analysed. The expression of p16 was also examined. A statistical analysis was conducted using IBM SPSS V25 software. Results: The mean overall survival time was determined to be 30.8 months. Smoking was observed in 95%, and regular alcohol consumption was reported in 75% of the cases. The expression of p16 did not significantly affect survival (p = 0.74) or the maximum tumour size (p = 0.21). The Kaplan–Meier method demonstrated significantly longer survival times (p = 0.047 *) in the group that underwent partial pharyngolaryngectomy with or without adjuvant therapy (median: 75.25 months, 95% CI: 31.57–118.93), compared to the other four treatment groups (i.e., total laryngectomy with pharyngectomy with or without adjuvant therapy, chemoradiation, chemotherapy, and radiotherapy). Conclusions: The study found that factors such as sex, comorbidities (e.g., type 2 diabetes and chronic obstructive pulmonary disease), TNM and stage, weight loss, smoking, and alcohol consumption did not have a significant effect on survival. In conclusion, the longest survival was observed after partial pharyngolaryngectomy with or without adjuvant therapy. Risk factors and comorbidities did not show a significant effect on survival. p16 expression was not a factor that affected either survival or tumour size. Full article
(This article belongs to the Special Issue New Insights into Head and Neck Surgery)
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10 pages, 1078 KiB  
Article
Is Oral Microflora Related to Development of Malfunction in Patients Using Voice Prosthesis?
by Angelo Immordino, Francesco Dispenza, Federico Sireci, Riccardo Anzalone, Palmira Immordino, Cinzia Calà, Salvatore Gallina and Francesco Lorusso
J. Clin. Med. 2024, 13(12), 3492; https://doi.org/10.3390/jcm13123492 - 14 Jun 2024
Viewed by 896
Abstract
Background: this prospective study investigated the correlation between the oral bacterial microflora and the microflora found in voice prostheses (VPs) among 20 patients who had undergone laryngectomy. The aim was to explore the associations between the microflora’s presence and the malfunction of [...] Read more.
Background: this prospective study investigated the correlation between the oral bacterial microflora and the microflora found in voice prostheses (VPs) among 20 patients who had undergone laryngectomy. The aim was to explore the associations between the microflora’s presence and the malfunction of VPs, along with the association between the predominant microorganism and the longevity of VPs. Methods: the research process included gathering medical histories, conducting ENT examinations, replacing VPs, and performing check-ups every four months for a period of 15.5 months. Additionally, microbiological examinations, blood tests, and voice change surveys were conducted. Results: a correlation between the microflora isolated from VPs and that from oral rinses was demonstrated in a large percentage of patients who experienced a loss of prosthetic functional efficiency. The correlation analysis between the type of microorganism and the lifespan of VPs showed a non-significant Pearson correlation coefficient (r = 0.043, p = 0.678). Conclusions: there is no significant linear correlation between the predominant microorganism and the average lifespan of VPs. Full article
(This article belongs to the Special Issue New Insights into Head and Neck Surgery)
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12 pages, 264 KiB  
Article
Platelet-Rich Fibrin Treatment Evaluation in Patients with Medication-Related Osteonecrosis of the Jaw and Osteoradionecrosis
by Rareș Călin Roman, Mădălina Anca Moldovan, Loredana Sabrina Pop, Sergiu Megieșan and Cosmin Ioan Faur
J. Clin. Med. 2024, 13(12), 3473; https://doi.org/10.3390/jcm13123473 - 14 Jun 2024
Viewed by 1278
Abstract
Background. Medication-related osteonecrosis of the jaw (MRONJ) and osteoradionecrosis (ORN) are associated with severe disability and continuous pain, both of which are very difficult to control. This study aims to evaluate the outcome of platelet-rich fibrin (PRF) treatment compared to iodoform gauze packing [...] Read more.
Background. Medication-related osteonecrosis of the jaw (MRONJ) and osteoradionecrosis (ORN) are associated with severe disability and continuous pain, both of which are very difficult to control. This study aims to evaluate the outcome of platelet-rich fibrin (PRF) treatment compared to iodoform gauze packing and the primary suture of oral mucosa in patients with both MRONJ and ORN. Methods. Patients suffering from MRONJ and ORN who were treated in the Oral and Maxillofacial Surgery Clinic of Cluj-Napoca in the last 10 years were selected for this study from the hospital database. Results. PRF treatment proved to be a reliable method to help heal the necrotic bone sites. High-ASA risk patients and immunosuppressed patients are more prone to recurrence and persistent signs and symptoms. Intravenous bisphosphonates produce more intense symptomatology compared to oral administration. The posterior mandible is more difficult to treat compared to other sites. Conclusions. The quality of life of MRONJ and ORN patients may be improved by a protocol that reduces pain and hospitalization. Full article
(This article belongs to the Special Issue New Insights into Head and Neck Surgery)

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19 pages, 10519 KiB  
Review
New Insights into Cervicofacial Vascular Anomalies
by Daniela Vrinceanu, Mihai Dumitru, Andreea Marinescu, Bogdan Dorobat, Octavian Dragos Palade, Felicia Manole, Horia Muresian, Matei Popa-Cherecheanu and Cătălina Mariana Ciornei
J. Clin. Med. 2024, 13(12), 3515; https://doi.org/10.3390/jcm13123515 - 15 Jun 2024
Cited by 4 | Viewed by 1309
Abstract
Congenital cervicofacial vascular anomalies are extremely rare and present many difficulties in diagnosis and treatment requiring a multidisciplinary approach. Firstly, there is little consensus on this subject among head and neck specialists. There are two main types of vascular anomalies: vascular tumors and [...] Read more.
Congenital cervicofacial vascular anomalies are extremely rare and present many difficulties in diagnosis and treatment requiring a multidisciplinary approach. Firstly, there is little consensus on this subject among head and neck specialists. There are two main types of vascular anomalies: vascular tumors and vascular malformations. Vascular malformations are also divided into malformations with slow blood flow (veins, lymphatics, capillaries or combined) and malformations with a fast blood flow (arteriovenous malformations and fistula). Vascular tumors like hemangiomas are known for their spontaneous involution with aging, while vascular malformations grow in dimensions with age. It is very important to choose the correct differential diagnosis between cervicofacial hemangiomas and vascular malformations for proper therapy management. Anamnesis and clinical exams help in raising suspicions about the real nature of a cervico-vascular anomaly. Furthermore, imaging brings in-depth details of the anomaly, ranging from ultrasound and contrast CT to MRI scanning and minimally invasive angiography. Angiography with selective embolization is rarely a curative procedure for arteriovenous malformations, being more suitable as a preliminary step before attempted surgical removal. Surgery is clearly necessary when there are aesthetic and functional deficits. Slow-flow vascular malformations present a reduced morbidity, and in cases without involution, the surgical ablation is reserved for the cases with aesthetic dysfunctions or psychological trauma. Lymphatic malformations must undergo surgical ablation when they are associated with mass effects and compression of great vessels or aerial viscera. The prognosis after surgical removal is good, with a low rate of recurrence or morbidity. Fast-flow vascular malformations require a combined approach, with embolization and excision in the next 48 h for safety reasons. Removal may be followed by reconstructive surgery depending on the location and dimensions of the malformation, with a possible secondary recovery of the normal microscopic vessels. Some of the masses may hinder the normal airflow and swallowing. Pathology is the gold standard for confirming the clinical and imaging diagnosis. Full article
(This article belongs to the Special Issue New Insights into Head and Neck Surgery)
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