Therapeutic Diet for Xerostomia in Head and Neck Cancer Patients: A Narrative Review Xerostomia significantly disrupts nutritional status, increases oral complications, and reduces quality of life in head and neck cancer (HNC) patients. This systematic review aimed to determine the best dietary interventions for the management of xerostomia in HNC patients by examining available therapies and their effects. A search of PubMed, Web of Science, and Scopus was conducted for randomised controlled trials, interventional, and observational studies published between December 2000 and December 2021. English articles involving adult HNC patients undergoing or having completed anti-cancer therapy were included. Non-HNC xerostomia causes and abstracts were excluded. Risk of bias was assessed using the Cochrane and Joanna Briggs Institute (JBI) tools. Fifteen studies were included out of 533 articles. Acidic candy, ginger extract, chewing gum, vitamin C/E supplements, and thyme honey were identified as helpful in reducing xerostomia. Dietary counselling and awareness of diet modifications improved symptoms, nutrition, and quality of life. Acidic candy was particularly effective in stimulating salivary flow but may cause dental enamel erosion, and timing precautions were necessary for thyroid patients’ post-radioactive ablation. Hydration techniques were commonly adopted by patients for symptom alleviation. Dietary modifications show promise in managing xerostomia in HNC patients, although further large-scale, randomised trials are needed to confirm these findings and explore new interventions.

Oral squamous cell carcinoma (OSCC) is the commonest malignant tumour affecting the oral cavity with a poor 5-year disease free survival. We present an octogenarian with a recurrent oral cavity squamous cell carcinoma, treated with salvage mandibulectomy without bony reconstruction. No immediate or intermediate perioperative complications were documented. Subsequent monthly surveillance clinical examination, endoscopy and computed tomography at six months post-operative showed no evidence of residual tumour. Geriatric syndrome, perioperative risk and oncologic stratification are three main cornerstones in evaluating feasibility of oncologic surgery in an elderly patient. A multidisciplinary approach allowed surgical extirpation of OSCC with a good outcome

ABSTRACT Granulomatosis with polyangiitis (GPA) is a rare multisystem disease. Although GPA is rare, it commonly presents in a localised stage where its manifestation involves the upper or lower respiratory tract before progressing to a generalised stage. Therefore, most patients with GPA will visit an oral surgeon or an otolaryngologist to seek treatment. However, the diagnosis of GPA is often delayed as GPA is not frequently considered as a differential diagnosis in common oral and facial diseases. The lack of gold standard investigation for the diagnosis of GPA makes management of this case, a diagnostic conundrum. We herein report a patient who was diagnosed with bilateral acute otitis media and left mastoiditis complicated with facial nerve palsy, and later developed tongue ulceration one month after his initial presentation. The ear, facial and oral symptoms represent a diagnostic red herring to a full-blown generalised stage of GPA.
Facial Paralysis ; Oral Ulcer ; Granulomatosis with Polyangiitis