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Article: Endoscopic Removal of a Displaced Tracheoesophageal Voice Prosthesis.

Li, Suqing / Enepekides, Danny / Cohen, Lawrence

2021 Volume 8, Issue 11, Page(s) e00708

Language	English
Publishing date	2021-11-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2814825-3
ISSN	2326-3253
ISSN	2326-3253
DOI	10.14309/crj.0000000000000708
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Article ; Online: Facial Nerve Paralysis and COVID-19: A Systematic Review.

Namavarian, Amirpouyan / Eid, Anas / Ziai, Hedyeh / Cheng, Emily YiQin / Enepekides, Danny

The Laryngoscope

2022 Volume 133, Issue 5, Page(s) 1007–1013

Abstract: Objective: Several cases of facial nerve paralysis (FNP) post-COVID-19 infection have been reported with varying presentations and management. This study aims to identify FNP clinical characteristics and recovery outcomes among patients acutely infected ...

Abstract	Objective: Several cases of facial nerve paralysis (FNP) post-COVID-19 infection have been reported with varying presentations and management. This study aims to identify FNP clinical characteristics and recovery outcomes among patients acutely infected with COVID-19. We hypothesize that FNP is a potentially unique sequalae associated with COVID-19 infections. Methods: A systematic review of PubMed-Medline, OVID Embase, and Web of Science databases from inception to November 2021 was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: This search identified 630 studies with 53 meeting inclusion criteria. This resulted in 72 patients, of which 30 (42%) were diagnosed with Guillain-Barré Syndrome (GBS). Non-GBS patients were on average younger (36 vs. 53 years) and more likely to present with unilateral FNP (88%) compared to GBS patients who presented predominantly with bilateral FNP (74%). Among non-GBS patients, majority (70%) of FNP presented a median of 8 [IQR 10] days after the onset of initial COVID-19 symptom(s). Treatment for non-GBS patients consisted of steroids (60%), antivirals (29%), antibiotics (21%), and no treatment (21%). Complete FNP recovery in non-GBS patients was achieved in 67% patients within a median of 11 [IQR 24] days. Conclusion: FNP is a possible presentation post COVID-19 infections, associated with both GBS and non-GBS patients. Although no causation can be assumed, the clinical course of isolated FNP associated with COVID-19 raises the possibility of a unique presentation differing from Bell's palsy, seen with higher proportion of patients developing bilateral FNP and a shorter duration to complete recovery. Laryngoscope, 133:1007-1013, 2023.
MeSH term(s)	Humans ; Bell Palsy/drug therapy ; COVID-19/complications ; Facial Nerve ; Facial Paralysis/drug therapy ; Steroids/therapeutic use
Chemical Substances	Steroids
Language	English
Publishing date	2022-08-08
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	80180-x
ISSN	1531-4995 ; 0023-852X
ISSN (online)	1531-4995
ISSN	0023-852X
DOI	10.1002/lary.30333
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Article ; Online: Lymph node yield: Impact on oncologic outcomes in oral cavity cancer.

Khalil, Carlos / Khoury, Mark / Higgins, Kevin / Enepekides, Danny / Karam, Irene / Husain, Zain Ali / Bayley, Andrew / Poon, Ian / Truong, Tra / Chan, Kelvin K W / Smoragiewicz, Martin / Fu, Rui / Eskander, Antoine

Head & neck

2024

Abstract: Background: Lymph node metastases are associated with poor prognosis in oral cavity squamous cell carcinoma (OCSCC). In other cancers, clinical guidelines on the number of lymph nodes removed during primary surgery, lymph node yield (LNY), exist. Here, ... ...

Abstract	Background: Lymph node metastases are associated with poor prognosis in oral cavity squamous cell carcinoma (OCSCC). In other cancers, clinical guidelines on the number of lymph nodes removed during primary surgery, lymph node yield (LNY), exist. Here, we evaluated the prognostic capacity of LNY on regional failure, locoregional recurrence, and disease-free survival (DFS) in patients with OCSCC treated by primary neck surgery. Methods: This retrospective cohort study took place at Sunnybrook Health Sciences Centre in Toronto, Canada and involved a chart review of all adult patients with treatment-naive OCSCC undergoing primary neck dissection. For each outcome, we first used the maximally selected rank statistics and an optimism-corrected concordance to identify an optimal threshold of LNY. We then used a multivariable Cox proportional hazards model to assess the association between high LNY (>threshold) and each outcome. Results: Among the 579 patients with OCSCC receiving primary neck dissection, 61.7% (n = 357) were male with a mean age of 62.9 years (standard deviation: 13.1) at cancer diagnosis. When adjusting for sociodemographic and clinical factors, LNY >15 was significantly associated with improved DFS (adjusted HR [aHR]: 0.73, 95% CI: 0.54-0.98), locoregional recurrence (aHR: 0.68, 95% CI: 0.49-0.95), and regional failure (aHR: 0.61, 95% CI: 0.39-0.93). Conclusions: Our study findings suggested high LNY to be a strong independent predictor of various patient-level quality of surgical care metrics. The optimal LNY we found (15) was lower than the conventionally recommended (18), which calls for further research to establish validity in practice.
Language	English
Publishing date	2024-02-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	645165-2
ISSN	1097-0347 ; 0148-6403 ; 1043-3074
ISSN (online)	1097-0347
ISSN	0148-6403 ; 1043-3074
DOI	10.1002/hed.27656
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Article ; Online: Stereotactic body radiotherapy for distant metastases to the head and neck.

Mutsaers, Adam / Abugharib, Ahmed / Poon, Ian / Loblaw, Joshua / Bayley, Andrew / Zhang, Liying / Chin, Lee / Galapin, Madette / Erler, Darby / Sahgal, Arjun / Higgins, Kevin / Enepekides, Danny / Eskander, Antoine / Karam, Irene

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

2024 Volume 32, Issue 4, Page(s) 230

Abstract: Purpose: To report clinical outcomes for patients with metastatic disease to the head and neck (HN) treated with stereotactic body radiation therapy (SBRT).: Methods: A retrospective review of patients treated with SBRT to HN sites from 2012 to 2020 ... ...

Abstract	Purpose: To report clinical outcomes for patients with metastatic disease to the head and neck (HN) treated with stereotactic body radiation therapy (SBRT). Methods: A retrospective review of patients treated with SBRT to HN sites from 2012 to 2020 was conducted. Treatment indications included the following: oligometastases, oligoprogression, and control a dominant area of progression (DAP). Kaplan-Meier method was used to estimate local control (LC), regional control (RC), overall survival (OS), and progression-free survival (PFS). Univariable (UVA) and multivariable analyses (MVA) were performed. Grade 3-4 acute and late toxicities were reported by the Common Terminology Criteria for Adverse Events v5.0. Results: Fifty-six patients (58 lesions) were analysed with a median follow-up of 16 months. Primary sites included lung (25.0%), kidney (19.6%), breast (19.6%) and other (35.8%). SBRT indications were as follows: oligometastases (42.9%), oligoprogression (19.6%) and local control of a dominant area of progression (37.5%). Most patients received SBRT to a single neck node (n = 47, 81.0%). Median SBRT dose was 40 Gy (range 25-50 Gy) in five fractions, with a median biologically effective dose (BED Conclusion: The use of SBRT for metastatic disease to the HN provided excellent LC rates with low rates of regional failure and an acceptable toxicity profile, highlighting its utility in these patients. Patients with oligometastatic disease had better OS and PFS than others.
MeSH term(s)	Humans ; Radiosurgery/adverse effects ; Radiosurgery/methods ; Lung Neoplasms/pathology ; Progression-Free Survival ; Lung/pathology ; Neck ; Retrospective Studies
Language	English
Publishing date	2024-03-15
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1134446-5
ISSN	1433-7339 ; 0941-4355
ISSN (online)	1433-7339
ISSN	0941-4355
DOI	10.1007/s00520-024-08419-0
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Article ; Online: Patient satisfaction with different types of craniofacial prostheses.

Higgins, Kevin M / Gressmann, Kassandra / Yan, Bernie / Eskander, Antoine / Enepekides, Danny J / Blanas, Nick / Somogyi-Ganss, Eszter

The Journal of prosthetic dentistry

2022

Abstract: Statement of problem: A maxillofacial prosthesis represents an effective method of giving maxillofacial defects a positive esthetic appearance with minimal risk. However, studies of complications among prosthesis wearers are lacking.: Purpose: The ... ...

Abstract	Statement of problem: A maxillofacial prosthesis represents an effective method of giving maxillofacial defects a positive esthetic appearance with minimal risk. However, studies of complications among prosthesis wearers are lacking. Purpose: The purpose of this cross-sectional study was to determine levels of patient satisfaction with various maxillofacial prostheses and retention types, as measured through a survey questionnaire package. Material and methods: Patients treated at the Sunnybrook Health Sciences Center Craniofacial Prosthetics Unit (CPU) since 2015 were included. They had been treated according to a standardized protocol and answered a survey questionnaire package with the following sections: demographics, frequency of prosthesis usage, and the Toronto Outcome Measure for Craniofacial Prosthetics (TOMCP-27) survey addressing patient satisfaction. To be eligible for this study, patients must have been more than 18 years of age, in possession of a maxillofacial prosthesis, and received treatment at the Sunnybrook Health Sciences Center CPU since 2015. Results: A total of 157 patients were eligible and contacted, of whom 51 agreed to participate in the survey. The study population was overall extremely satisfied with their maxillofacial prostheses. In 77.8% of the TOMCP-27 questions, the largest group of patients chose the answer demonstrating the highest level of satisfaction. Of all prosthesis types surveyed, patients with auricular prostheses reported the greatest rates of satisfaction, with the entire group having selected answers corresponding to the highest levels of overall satisfaction. However, patients with orbital prostheses were more likely to experience varying degrees of dissatisfaction, with 72% of the highest reported levels of dissatisfaction being from this prosthesis group. In addition, patients with osseointegrated implant-retained prostheses reported higher satisfaction levels with other retention methods, with the bar clasp group outperforming the magnetic coupling retention group. Conclusions: Patients experienced an excellent overall rate of satisfaction with their maxillofacial prostheses. Future development should focus on the continued development of osseointegrated methods, improved magnetic coupling, and improved prosthesis technology, especially for orbital prostheses.
Language	English
Publishing date	2022-09-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	218157-5
ISSN	1097-6841 ; 0022-3913
ISSN (online)	1097-6841
ISSN	0022-3913
DOI	10.1016/j.prosdent.2022.08.019
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Article ; Online: Length of Stay Prediction Models for Oral Cancer Surgery: Machine Learning, Statistical and ACS-NSQIP.

Namavarian, Amirpouyan / Gabinet-Equihua, Alexander / Deng, Yangqing / Khalid, Shuja / Ziai, Hedyeh / Deutsch, Konrado / Huang, Jingyue / Gilbert, Ralph W / Goldstein, David P / Yao, Christopher M K L / Irish, Jonathan C / Enepekides, Danny J / Higgins, Kevin M / Rudzicz, Frank / Eskander, Antoine / Xu, Wei / de Almeida, John R

The Laryngoscope

2024

Abstract: Objective: Accurate prediction of hospital length of stay (LOS) following surgical management of oral cavity cancer (OCC) may be associated with improved patient counseling, hospital resource utilization and cost. The objective of this study was to ... ...

Abstract	Objective: Accurate prediction of hospital length of stay (LOS) following surgical management of oral cavity cancer (OCC) may be associated with improved patient counseling, hospital resource utilization and cost. The objective of this study was to compare the performance of statistical models, a machine learning (ML) model, and The American College of Surgeons National Surgical Quality Improvement Program's (ACS-NSQIP) calculator in predicting LOS following surgery for OCC. Materials and methods: A retrospective multicenter database study was performed at two major academic head and neck cancer centers. Patients with OCC who underwent major free flap reconstructive surgery between January 2008 and June 2019 surgery were selected. Data were pooled and split into training and validation datasets. Statistical and ML models were developed, and performance was evaluated by comparing predicted and actual LOS using correlation coefficient values and percent accuracy. Results: Totally 837 patients were selected with mean patient age being 62.5 ± 11.7 [SD] years and 67% being male. The ML model demonstrated the best accuracy (validation correlation 0.48, 4-day accuracy 70%), compared with the statistical models: multivariate analysis (0.45, 67%) and least absolute shrinkage and selection operator (0.42, 70%). All were superior to the ACS-NSQIP calculator's performance (0.23, 59%). Conclusion: We developed statistical and ML models that predicted LOS following major free flap reconstructive surgery for OCC. Our models demonstrated superior predictive performance to the ACS-NSQIP calculator. The ML model identified several novel predictors of LOS. These models must be validated in other institutions before being used in clinical practice. Level of evidence: Level 3 Laryngoscope, 2024.
Language	English
Publishing date	2024-04-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	80180-x
ISSN	1531-4995 ; 0023-852X
ISSN (online)	1531-4995
ISSN	0023-852X
DOI	10.1002/lary.31443
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Article ; Online: Innovative insertion of the palmaris major tendon after lower lip reconstruction.

Sahovaler, Axel / Higgins, Kevin / Deutsch, Konrado / Eskander, Antoine / Enepekides, Danny

The Laryngoscope

2019 Volume 129, Issue 11, Page(s) 2479–2481

MeSH term(s)	Aged ; Carcinoma, Squamous Cell/surgery ; Humans ; Lip/surgery ; Lip Neoplasms/surgery ; Male ; Mouth Neoplasms/surgery ; Reconstructive Surgical Procedures/methods ; Tendons/surgery
Language	English
Publishing date	2019-02-06
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80180-x
ISSN	1531-4995 ; 0023-852X
ISSN (online)	1531-4995
ISSN	0023-852X
DOI	10.1002/lary.27825
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Article: [No title information]

Habib, Mahiya / Korman, Melissa B / Aliasi-Sinai, Lital / den Otter-Moore, Sophia / Conn, Lesley Gotlib / Murray, Alva / Jacobson, Marlene Carno / Enepekides, Danny / Higgins, Kevin / Ellis, Janet

Canadian oncology nursing journal = Revue canadienne de nursing oncologique

2023 Volume 33, Issue 1, Page(s) 87–100

Title translation	Étude des soins compatissants du point de vue du patient dans l’optique particulière des soins du cancer de la tête et du cou.
Language	French
Publishing date	2023-01-01
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2033138-1
ISSN	2368-8076 ; 1181-912X
ISSN (online)	2368-8076
ISSN	1181-912X
DOI	10.5737/2368807633187
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Article: Understanding compassionate care from the patient perspective: Highlighting the experience of head and neck cancer care.

Habib, Mahiya / Korman, Melissa B / Aliasi-Sinai, Lital / den Otter-Moore, Sophia / Conn, Lesley Gotlib / Murray, Alva / Jacobson, Marlene Carno / Enepekides, Danny / Higgins, Kevin / Ellis, Janet

Canadian oncology nursing journal = Revue canadienne de nursing oncologique

2023 Volume 33, Issue 1, Page(s) 74–86

Abstract: Objectives: To address the knowledge gap in the practice of compassionate healthcare by elucidating patient perspectives on compassion, empathy, and sympathy.: Methods: Semi-structured telephone interviews were conducted at two time points with ... ...

Abstract	Objectives: To address the knowledge gap in the practice of compassionate healthcare by elucidating patient perspectives on compassion, empathy, and sympathy. Methods: Semi-structured telephone interviews were conducted at two time points with patients undergoing head and neck cancer treatment. Questions explored participants' understanding of compassion, sympathy, and empathy, as they relate to each other and to healthcare. Interviewers manually recorded responses. Qualitative exploratory methods were used to analyze data; inductive line-by-line coding was conducted to develop primary codes. Themes emerged through categorization of codes. Results: Ninety-five interviews conducted with 63 participants across two time points revealed four major themes - Compassion-vs-Empathy-vs-Sympathy, Coping Methods, Showing Care, and Nature of Interaction - encompassing seven categories, with a total of 24 codes. Codes were consistent across time points, except for two new codes, "positivity" and "personalized" emerging during follow-up interviews. Conclusions: Patient narrative from this study supported the concept that compassion is multidimensional and enabled several dimensions to be identified, highlighting the importance of patient perspectives in improving the provision of compassionate healthcare. Findings should be considered in future training and practice.
Language	English
Publishing date	2023-01-01
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2033138-1
ISSN	2368-8076 ; 1181-912X
ISSN (online)	2368-8076
ISSN	1181-912X
DOI	10.5737/2368807633174
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Article ; Online: Cine MRI-based analysis of intrafractional motion in radiation treatment planning of head and neck cancer patients.

Weiss, Yonatan / Chin, Lee / Younus, Eyesha / Guo, Kaiming / Dydula, Christopher / Hupman, Allan / Lau, Angus / Husain, Zain / Bayley, Andrew / Higgins, Kevin / Enepekides, Danny / Eskander, Antoine / Ho, Ling / Poon, Ian / Karam, Irene

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

2023 Volume 186, Page(s) 109790

Abstract: Purpose/objective(s): To investigate intrafraction motion of (HN) target volumes and to determine patient-specific planning target volume (PTV) margins.: Materials/methods: MR-cine imaging was performed for radiation treatment planning in HN cancer ... ...

Abstract	Purpose/objective(s): To investigate intrafraction motion of (HN) target volumes and to determine patient-specific planning target volume (PTV) margins. Materials/methods: MR-cine imaging was performed for radiation treatment planning in HN cancer patients treated with definitive EBRT (n = 62) or SBRT (n = 4) on a 1.5 T MRI between 2017-2019. Dynamic MRI scans (sagittal orientation, 2 × 82 × 7 mm3 resolution), ranging from 3-5 min and 900-1500 images, were acquired. The position of the maximum tumor displacement along each direction in the anterior/posterior (A/P) and superior/inferior (S/I) position was recorded and analyzed to determine average PTV margins. Results: Primary tumor sites (n = 66) were oropharynx (n = 39), larynx (n = 24) and hypopharynx (n = 3). PTV margins for A/P/S/I positions were 4.1/4.4/5.0/6.2 mm and 4.9/4.3/6.7/7.7 mm for oropharyngeal and laryngeal/hypopharyngeal cancers when accounting for all motion. V100 for PTV was calculated and compared to the original plans. The mean drop in PTV coverage was in most cases under 5%. For a subset of patients with 3 mm plans available, V100 for PTV had more substantial decreases in coverage averaging 8.2% - and 14.3% for oropharyngeal and laryngeal/hypopharynx plans, respectively. Conclusion: The use of MR-cine in treatment planning allows for quantification of tumor motion during swallow and resting periods and should be accounted for during treatment planning. With motion considered, the derived margins may exceed the commonly used 3-5 mm PTV margins. Quantification and analysis of tumor and patient-specific PTV margins is a step towards real-time MRI guidance adaptive radiotherapy.
MeSH term(s)	Humans ; Magnetic Resonance Imaging, Cine ; Radiotherapy Planning, Computer-Assisted/methods ; Motion ; Magnetic Resonance Imaging/methods ; Head and Neck Neoplasms/diagnostic imaging ; Head and Neck Neoplasms/radiotherapy ; Laryngeal Neoplasms ; Radiotherapy Dosage
Language	English
Publishing date	2023-07-04
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	605646-5
ISSN	1879-0887 ; 0167-8140
ISSN (online)	1879-0887
ISSN	0167-8140
DOI	10.1016/j.radonc.2023.109790
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