Surgery is the major treatment option for malignant tumors and some benign neoplasms of the thyroid, most of which are differentiated thyroid carcinoma. Despite the progresses that have been made in surgical techniques, iatrogenic injuries of the parathy-roid and laryngeal nerves, including superior and recurrent laryngeal nerves, could not be completely avoided in the surgical manage-ment of thyroid tumors. In this review, the causes of intraoperative injuries of parathyroid and laryngeal nerves are systematically ana-lyzed with respect to types and extents of surgical operations, changes in topical anatomy, and secondary thyroid surgeries. The princi-ples and strategies for protecting and restoring injuries of the parathyroid and laryngeal nerves are also elucidated for the effective prevention and adequate treatment of these major complications in the thyroid surgery.

Overexpression of the epidermal growth factor receptor (EGFR) is a common characteristic of head and neck squamous cell carcinomas (HNSCC) , and initiates important signal transduction pathways in carcinogenesis. Now the EGFR is a validated target for cancer therapies in HNSCC. However, the effect of EGFR-targeted therapies is only modest because of primary and/or acquired resistance. Therefore, an improved understanding of the molecular mechanisms of resistance to EGFR inhibitors may establish new treatment options to overcome resistance. In this review, the molecular mechanisms of resistance and the strategies to overcome it were summarized.
Antineoplastic Agents ; Carcinoma, Squamous Cell ; drug therapy ; Drug Resistance, Neoplasm ; ErbB Receptors ; Head and Neck Neoplasms ; drug therapy ; Humans ; Signal Transduction ; Squamous Cell Carcinoma of Head and Neck

Head and Neck Neoplasms ; surgery ; Humans ; Palliative Care

Head and Neck Neoplasms ; surgery ; Humans ; Reconstructive Surgical Procedures

OBJECTIVE: To-evaluate the role and clinical value of cetuximab in the treatment of head and neck squamous cell carcinoma (HNSCC), and figure out its effectiveness and application, so as to develop evidence-based recommendations for treatment. METHOD: We comprehensively searched the CBM, Pubmed, EMBASE, and the Cochrane databases to identify published studies on the effect of cetuximab in HNSCC patients. Primary outcomes included overall survival (OS), progression-free survival(PFS) and overall response rate(ORR). Secondary outcomes included serious adverse events, such as neutropenia, anemia, thrombocytopenia, skin reactions, hypokalemia, vomiting, asthenia, hypomagnesemia, dyspnea and sepsis. Results were dispalyed as risk ratio (RR), odds ratio (OR), mean difference (MD) and 95% CI. RESULT: A Meta-analysis was conducted on 4 randomized controlled trials, including 2 trials comprising 1,319 patients with locally advanced HNSCC and 2 trails comprising 559 patients with recurrent or metastatic HNSCC. For locally advanced HNSCC, the 2 year PFS and OS showed no significant differences in patients received cetuximab or not (PFS fixed effect: RR=1.02, 95%CI 0.92-1.12, P>0.05; OS fixed effect: RR=1.06, 95%CI 1.00-1.13, P>0.05, respectively). Grade 3-4 dysphagia was also similar in patients treated with cetuximab or no cetuximab (dysphagia: fixed effect: RR = 0.92; 95% CI 0.84-1.02, P>0. 05). Only grade 3-4 mucositis and skin reaction showed statistical significance between patients treated with cetuximab and patients with no cetuximab (mucositis: fixed effect: RR=1.21; 95%CI 1.07-1. 36, P<0. 05; skin reaction: fixed effect: RR=1.99; 95%CI 1.39-2.85, P<0.05, respectively). For recurrent or metastatic HNSCC, the OS overall mean difference was 2.41 (95% CI 0.96-3.86, P<0.05), the PFS overall mean difference was 2. 06 (95% CI 1.34 - 2.77, P<0.05), and the ORR overall Odds ratio was 2.38 (95% CI 1.60-3.54,P<0.05), suggesting significant effect of cetuximab in improving the prognosis of R/M HNSCC. Owing to small number of trials it was not possible to assess the presence of publication bias. Of note, the 1 year survival overall Odds ratio was 1.39 (95% CI 0.98-1.97, P>0.05). The grade 3 or 4 adverse effects were described in 83. 4% of patients in cetuximab group and 75. 5% of patients in no cetuximab group. The overall side effects risk ratio suggested statistically significant difference between patients treated with cetuximab and pa- tients with no cetuximab (RR=1.11, 95% CI 1.01-1.20, P<0.05, P =47%). CONCLUSION The 2 year progression-free survival and overall survival were similar between cetuximab group and no cetuximab group in patients with locally advanced head and neck squamous cell cancer. Data are limited and the benefits of cetuximab on this outcome remain uncertain. Impact of grade 3-4 dysphagia was similar in both groups, however, the incidence of grade 3-4 mucositis and skin reaction were lower in patients treated with cetuximab. Existing randomized controlled trials provided a scientific evidence for the use of cetuximab in R/M HNSCC. The conclusion of the study is based on limited number of RCT, so further investigation is still needed before firm recommendations of cetuximab can be made in the treatment of HNSCC.
Antibodies, Monoclonal, Humanized ; therapeutic use ; Antineoplastic Agents ; therapeutic use ; Carcinoma, Squamous Cell ; drug therapy ; Cetuximab ; Disease-Free Survival ; Head and Neck Neoplasms ; drug therapy ; Humans ; Squamous Cell Carcinoma of Head and Neck

Head and Neck Neoplasms ; therapy ; Humans ; Palliative Care

Genetic Therapy ; Head and Neck Neoplasms ; therapy ; Humans

Humans ; Thyroid Diseases ; diagnosis ; surgery

Carcinoma, Squamous Cell ; surgery ; Head and Neck Neoplasms ; surgery ; Humans ; Nose Neoplasms ; surgery ; Paranasal Sinus Neoplasms ; surgery ; Reconstructive Surgical Procedures

Objective: To study the expression of laminin (L N) and it’s receptor(LN-R)in adenoid cystic carcinoma (ACC) of salivary glan d.Methods: The expression of LN and LN-R in 34 cases of ACC was studied by immunohistochemical ultrasensitive S-P methods.Results:Positive expression of LN was observed in 15 of 19 cases with adeno-tubular ACC and in 3 of 15 with parenchymal ACC (P0 05). Positive expression o f LN-R was observed in 7 of 19 cases with adeno-tubular ACC and in 11 of 15 with parenchymal ACC (P