Informing patient choice and service planning in surgical voice restoration: valve usage over three years in a UK head and neck cancer unit

Author(s):  
K McLachlan ◽  
A Hurren ◽  
S Owen ◽  
N Miller
2016 ◽  
Vol 130 (S2) ◽  
pp. S104-S110 ◽  
Author(s):  
P Pracy ◽  
S Loughran ◽  
J Good ◽  
S Parmar ◽  
R Goranova

AbstractThis is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. With an age standardised incidence rate of 0.63 per 100 000 population, hypopharynx cancers account for a small proportion of the head and neck cancer workload in the UK, and thus suffer from the lack of high level evidence. This paper discusses the evidence base pertaining to the management of hypopharyngeal cancer and provides recommendations on management for this group of patients receiving cancer care.Recommendations• Cross-sectional imaging with computed tomography of the head, neck and chest is necessary for all patients; magnetic resonance imaging of the primary site is useful particularly in advanced disease; and computed tomography and positron emission tomography to look for distant disease. (R)• Careful evaluation of the upper and lower extents of the disease is necessary, which may require contrast swallow or computed tomography and positron emission tomography imaging. (R)• Formal rigid endoscopic assessment under general anaesthetic should be performed. (R)• Nutritional status should be proactively managed. (R)• Full and unbiased discussion of treatment options should take place to allow informed patient choice. (G)• Early stage disease can be treated equally effectively with surgery or radiotherapy. (R)• Endoscopic resection can be considered for early well localised lesions. (R)• Bulky advanced tumours require circumferential or non-circumferential resection with wide margins to account for submucosal spread. (R)• Offer primary surgical treatment in the setting of a compromised larynx or significant dysphagia. (R)• Midline lesions require bilateral neck dissections. (R)• Consider management of silent nodal areas usually not addressed for other primary sites. (G)• Reconstruction needs to be individualised to the patients’ needs and based on the experience of the unit with different reconstructive techniques. (G)• Consider tumour bulk reduction with induction chemotherapy prior to definitive radiotherapy. (R)• Consider intensity modulated radiation therapy where possible to limit the consequences of wide field irradiation to a large volume. (R)• Use concomitant chemotherapy in patients who are fit enough and consider epidermal growth factor receptor blockers for those who are less fit. (R)


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Suresh ◽  
A Goel ◽  
N Khan ◽  
P Promod ◽  
R Pabla ◽  
...  

Abstract Introduction Pandemic COVID-19 necessitated a transformation in the delivery of healthcare. Telephone consultations were introduced to protect and progressively manage patients with minimal delay. This is a review of the effectiveness of these remote consultations for suspected 2-week wait (2ww) head and neck cancer referrals to a north London NHS teaching hospital Oral and Maxillofacial unit during the first official UK government lockdown from March - July 2020. Method Prospective electronic records of 176 consecutive 2ww referrals between March – July 2020 was assessed. Data analysed included initial telephone consultations, subsequent face-to-face (F2F) appointments, if required, the interval from telephone to F2F appointments and histopathological diagnoses. Results 157 patients (n = 176) received an initial telephone call, of which 127 (80.9%) required a F2F consultation. The number of days between the initial telephone consultation and subsequent F2F assessment ranged from 0 to 141, with a mean of 11 and a median of 1. Notably, 31 patients (24.4%) were seen in person on the same day as their telephone consultation. Biopsies were indicated for 69 patients (54.3%) of which 9 (13.0%) were diagnosed as malignancies. Conclusions Whilst protecting patients from a pandemic is utmost, continuing care for non-pandemic conditions must be considered. It is even more important to manage 2ww referrals efficiently. These results indicate the majority of suspected cancer referrals warrant F2F assessment for a confident outcome. Despite reinstated, ongoing social restrictions, 2ww referrals are now being seen exclusively F2F, subject to patient choice. This information is useful for planning and strategizing services in a head and neck OMFS unit.


2017 ◽  
Vol 2 (13) ◽  
pp. 139-146
Author(s):  
Clare L. Burns ◽  
Laurelie R. Wall

With the rise of technology-enhanced health services, there is a growing opportunity to use telepractice to address the challenges associated with accessing and delivering speech-language pathology head and neck cancer (HNC) services. With an emerging body of research reporting clinical, patient and service benefits, careful planning and coordination of a range of factors are required to integrate these new models into routine speech-language pathology practice. This paper provides a review of current evidence and key professional policy documents to assist clinicians in the development of speech-language pathology HNC telepractice services. Important aspects of service design such as mode and configuration of technology, patient suitability, staff support, and training, as well as strategies for service establishment and evaluation are discussed. Consideration of these aspects is important to ensure that future speech-language pathology HNC telepractice services meet clinical, technical, and operational requirements to support successful service implementation and long-term sustainability.


2018 ◽  
Vol 7 (10) ◽  
pp. 4964-4979 ◽  
Author(s):  
Arash O. Naghavi ◽  
Michelle I. Echevarria ◽  
Tobin J. Strom ◽  
Yazan A. Abuodeh ◽  
Puja S. Venkat ◽  
...  

1998 ◽  
Vol 23 (4) ◽  
pp. 376-376
Author(s):  
Quak ◽  
Van Bokhorst ◽  
Klop ◽  
Van Leeuwen ◽  
Snow

1969 ◽  
Vol 2 (3) ◽  
pp. 533-541
Author(s):  
William E. Powers ◽  
Joseph H. Ogura

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