Quality of life in patients older than 75 years following major head and neck surgery

Head & Neck ◽  
2007 ◽  
Vol 29 (10) ◽  
pp. 932-939 ◽  
Author(s):  
Avi Khafif ◽  
Jennie Posen ◽  
Yaron Yagil ◽  
Michael Beiser ◽  
Ziv Gil ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck ◽  
Neck Surgery ◽  
Head And Neck Surgery

Predictors of Quality‐of‐Life Improvements Following Global Head and Neck Surgery Trips to Underserved Regions

2021 ◽  
Author(s):  
Bharat A. Panuganti ◽  
Aria Jafari ◽  
Sarek Shen ◽  
Jesse R. Qualliotine ◽  
Elizabeth A. Schueth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck ◽  
Neck Surgery ◽  
Head And Neck Surgery

Quality of Life Assessment in Patients Undergoing Head and Neck Surgery As Evaluated by Lay Caregivers

1999 ◽  
Vol 109 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Daniel G. Deschler ◽  
Kathleen A. Walsh ◽  
Stephanie Friedman ◽  
Richard E. Hayden
Keyword(s):  
Quality Of Life ◽  
Head And Neck ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Life Assessment ◽  
Quality Of Life Assessment

Longitudinal Assessment of Frailty and Quality of Life in Patients Undergoing Head and Neck Surgery

2021 ◽  
Author(s):  
Carissa M. Thomas ◽  
Michael C. Sklar ◽  
Jie Su ◽  
Wei Xu ◽  
John R. Almeida ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Longitudinal Assessment

Palliation in Head and Neck Surgery

2019 ◽  
pp. 203-212
Author(s):  
Susan D. McCammon
Keyword(s):  
Quality Of Life ◽  
Supportive Care ◽  
Head And Neck ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Survival Outcomes ◽  
Medical Decisions ◽  
Thoracic Inlet ◽  
The Face

Head and neck surgery treats lesions from the skull base to the thoracic inlet. While most of these are malignant and require multimodal oncologic management, many are benign, but their treatment can be quite morbid due to their location. This anatomic area encompasses the special sense organs of sight, smell, taste, and hearing as well as the essential social function of speech and the vital processes of breathing and swallowing. The appearance of the face is often affected, and this can affect personal identity. In many clinical situations, survival outcomes are equal between radically different treatment paradigms, and medical decisions are predicated on anticipated survival and quality of life. Thus, it is critical to elicit accurate values and goals of care from patients and families facing these decisions. Narrative competence in describing and quantifying likely outcomes is an important skill for clinicians to cultivate, as is awareness of unconscious biases and the use of directive counsel. Even successful head and neck surgery has symptomatic sequelae that can be minimized with prehabilitation and managed with ongoing supportive care.

scholarly journals Clinical Practice Guideline: Hoarseness (Dysphonia) (Update) Executive Summary

2018 ◽  
Vol 158 (3) ◽  
pp. 409-426 ◽  
Author(s):  
Robert J. Stachler ◽  
David O. Francis ◽  
Seth R. Schwartz ◽  
Cecelia C. Damask ◽  
German P. Digoy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Examination ◽  
Head And Neck ◽  
Geriatric Medicine ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Voice Therapy ◽  
Vocal Effort ◽  
Professional Voice

Objective This guideline provides evidence-based recommendations on treating patients presenting with dysphonia, which is characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication and/or quality of life. Dysphonia affects nearly one-third of the population at some point in its life. This guideline applies to all age groups evaluated in a setting where dysphonia would be identified or managed. It is intended for all clinicians who are likely to diagnose and treat patients with dysphonia. Purpose The primary purpose of this guideline is to improve the quality of care for patients with dysphonia, based on current best evidence. Expert consensus to fill evidence gaps, when used, is explicitly stated and supported with a detailed evidence profile for transparency. Specific objectives of the guideline are to reduce inappropriate variations in care, produce optimal health outcomes, and minimize harm. For this guideline update, the American Academy of Otolaryngology—Head and Neck Surgery Foundation selected a panel representing the fields of advanced practice nursing, bronchoesophagology, consumer advocacy, family medicine, geriatric medicine, internal medicine, laryngology, neurology, otolaryngology–head and neck surgery, pediatrics, professional voice, pulmonology, and speech-language pathology. Action Statements The guideline update group made strong recommendations for the following key action statements (KASs): (1) Clinicians should assess the patient with dysphonia by history and physical examination to identify factors where expedited laryngeal evaluation is indicated. These include but are not limited to recent surgical procedures involving the head, neck, or chest; recent endotracheal intubation; presence of concomitant neck mass; respiratory distress or stridor; history of tobacco abuse; and whether the patient is a professional voice user. (2) Clinicians should advocate voice therapy for patients with dysphonia from a cause amenable to voice therapy. The guideline update group made recommendations for the following KASs: (1) Clinicians should identify dysphonia in a patient with altered voice quality, pitch, loudness, or vocal effort that impairs communication or reduces quality of life (QOL). (2) Clinicians should assess the patient with dysphonia by history and physical examination for underlying causes of dysphonia and factors that modify management. (3) Clinicians should perform laryngoscopy, or refer to a clinician who can perform laryngoscopy, when dysphonia fails to resolve or improve within 4 weeks or irrespective of duration if a serious underlying cause is suspected. (4) Clinicians should perform diagnostic laryngoscopy, or refer to a clinician who can perform diagnostic laryngoscopy, before prescribing voice therapy and document/communicate the results to the speech-language pathologist (SLP). (5) Clinicians should advocate for surgery as a therapeutic option for patients with dysphonia with conditions amenable to surgical intervention, such as suspected malignancy, symptomatic benign vocal fold lesions that do not respond to conservative management, or glottic insufficiency. (6) Clinicians should offer, or refer to a clinician who can offer, botulinum toxin injections for the treatment of dysphonia caused by spasmodic dysphonia and other types of laryngeal dystonia. (7) Clinicians should inform patients with dysphonia about control/preventive measures. (8) Clinicians should document resolution, improvement or worsened symptoms of dysphonia, or change in QOL of patients with dysphonia after treatment or observation. The guideline update group made a strong recommendation against 1 action: (1) Clinicians should not routinely prescribe antibiotics to treat dysphonia. The guideline update group made recommendations against other actions: (1) Clinicians should not obtain computed tomography (CT) or magnetic resonance imaging (MRI) for patients with a primary voice complaint prior to visualization of the larynx. (2) Clinicians should not prescribe antireflux medications to treat isolated dysphonia, based on symptoms alone attributed to suspected gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR), without visualization of the larynx. (3) Clinicians should not routinely prescribe corticosteroids in patients with dysphonia prior to visualization of the larynx. The policy level for the following recommendation about laryngoscopy at any time was an option: (1) Clinicians may perform diagnostic laryngoscopy at any time in a patient with dysphonia. Differences from Prior Guideline (1) Incorporating new evidence profiles to include the role of patient preferences, confidence in the evidence, differences of opinion, quality improvement opportunities, and any exclusion to which the action statement does not apply (2) Inclusion of 3 new guidelines, 16 new systematic reviews, and 4 new randomized controlled trials (3) Inclusion of a consumer advocate on the guideline update group (4) Changes to 9 KASs from the original guideline (5) New KAS 3 (escalation of care) and KAS 13 (outcomes) (6) Addition of an algorithm outlining KASs for patients with dysphonia

Advances in regenerative medicine for otolaryngology/head and neck surgery

BMJ ◽  
2020 ◽  
pp. m718
Author(s):  
Michael J McPhail ◽  
Jeffrey R Janus ◽  
David G Lott
Keyword(s):  
Regenerative Medicine ◽  
Head And Neck ◽  
Vocal Communication ◽  
Sense Of Self ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Current Standard ◽  
Vital Functions ◽  
Neck Disorders

ABSTRACT Head and neck structures govern the vital functions of breathing and swallowing. Additionally, these structures facilitate our sense of self through vocal communication, hearing, facial animation, and physical appearance. Loss of these functions can lead to loss of life or greatly affect quality of life. Regenerative medicine is a rapidly developing field that aims to repair or replace damaged cells, tissues, and organs. Although the field is largely in its nascence, regenerative medicine holds promise for improving on conventional treatments for head and neck disorders or providing therapies where no current standard exists. This review presents milestones in the research of regenerative medicine in head and neck surgery.

Self-retaining retractors in head and neck surgery

2005 ◽  
Vol 119 (10) ◽  
pp. 813-815 ◽  
Author(s):  
A S Banerjee ◽  
F W Stafford
Keyword(s):  
Head And Neck ◽  
Thyroid Surgery ◽  
Learning Experience ◽  
Neck Surgery ◽  
Skin Incision ◽  
Head And Neck Surgery ◽  
Carotid Sheath ◽  
Wine Glass ◽  
Good Exposure

The Norfolk and Norwich retractor is a vital tool in head and neck surgery. It is of great aid in training junior surgeons and has become an integral part of the standard neck dissection instrument set in our unit. This retractor enables good exposure of the carotid sheath, its atraumatic blunt tip retracting the carotid sheath without damage. It makes a single skin incision for neck exposure possible, rather than a Y, T or wine glass incision, avoiding a three-point junction, especially in the post-irradiated neck. In thyroid surgery it reduces the need for manual retraction thereby relieving the assistant surgeon and enhancing the quality of the learning experience.

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