Head and neck squamous cell carcinomas (HNSCCs), a heterogeneous group of cancers that arise from the mucosal epithelia cells in the head and neck areas, present great challenges in diagnosis, treatment and prognosis due to their complex aetiology and various clinical manifestations. Several factors, including smoking, alcohol consumption, oncogenic genes, growth factors, Epstein‑Barr virus and human papillomavirus infections can contribute to HNSCC development. The unpredictable tumour microenvironment adds to the complexity of managing HNSCC. Despite significant advances in therapies, the prediction of outcome after treatment for patients with HNSCC remains poor, and the 5‑year overall survival rate is low due to late diagnosis. Early detection greatly increases the chances of successful treatment. The present review aimed to bring together the latest findings related to the molecular mechanisms of HNSCC carcinogenesis and progression. Comprehensive genomic, transcriptomic, metabolomic, microbiome and proteomic analyses allow researchers to identify important biological markers such as genetic alterations, gene expression signatures and protein markers that drive HNSCC tumours. These biomarkers associated with the stages of initiation, progression and metastasis of cancer are useful in the management of patients with cancer in order to improve their life expectancy and quality of life.

Background and Objectives: Patients with advanced head and neck tumors require salvage surgery as a last resort. These extensive surgeries pose the challenge of complex reconstructions. The head and neck surgeon undertaking such complex cases needs to master different flaps. The team managing these patients needs input from various specialists, along with otorhinolaryngologists, plastic surgeons, maxillofacial surgeons, vascular surgeons, experienced radiologists, dedicated pathologists, oncologists and radiation therapists. We focus on the optimum solution between oncologic resections and the future quality of life of patients and overall survival. Each complex case requires a personalized medicine approach. This scoping review aims to assess the efficacy and outcomes of complex reconstructions using various flaps for head and neck tumors, with a focus on free flaps and emerging techniques. Materials and Methods: A systematic search of the literature was conducted following PRISMA guidelines, resulting in the inclusion of 44 articles that met the predefined criteria in the last 10 years. Results: The included studies encompassed diverse patient populations and evaluated various surgical techniques, outcomes, complications, and advancements in head and neck reconstruction. The review identified a variety of flaps utilized in head and neck tumor reconstruction, including free flaps such as the radial forearm, anterolateral thigh, scapular tip, and myocutaneous flaps, among others. The success rates for free flap reconstructions ranged from 85% to 100%, with notable variations attributed to patient selection, tumor characteristics, and surgical expertise. Conclusions: Complications such as flap necrosis, infection, hematoma, and donor site morbidity were documented across studies, highlighting the importance of meticulous surgical planning and postoperative care. Furthermore, the review revealed emerging techniques such as computer-aided design, virtual surgery, stereolithographic models, customized implants, tissue engineering, and allotransplants, offering promising reconstructive armamentarium. Advances in surgical techniques and emerging technologies hold promise for further enhancing reconstructive outcomes, minimizing morbidity, and improving patient quality of life.

Telomeres play a crucial role in maintaining chromosomal integrity and regulating the number of cell divisions and have been associated with cellular aging. Telomere length (TL) has been widely studied in manifold cancer types; however, the results have been inconsistent. This systematic review and meta-analysis aims to analyze the evidence on the association between TL and head and neck cancer (HNC) risk. We comprehensively searched the literature in PubMed, Cochrane Library, and Scopus and identified nine eligible studies, which yielded 11 datasets. The odds ratios (ORs) and 95% confidence intervals (CIs) were used to ascertain the strength of the association. On the basis of the median TL, we defined two groups, short TL and long TL, with the latter being the reference group. Our analysis found a significant relationship between short TL and increased HNC risk (OR 1.38, 95% CI: 1.10-1.73, p = 0.005), while significant heterogeneity among the studies was noted. The subgroup analysis on HNC subtypes revealed a significant association between short TL and oral cancers (OR 2.08, 95% CI: 1.23-3.53, p = 0.007). Additionally, subgroup analysis indicates that adjustments for age, sex, and smoking did not affect the significance of our findings. In conclusion, our meta-analysis found evidence for an association between short TL and HNC risk, which could indicate that TL might act as a potential biomarker for HNC risk, but high-quality prospective studies are imperative to validate our findings.

ead and neck paraganglioma（HNPGL） often originates from the parasympathetic ganglia and is a highly invasive benign tumor. The diagnosis and treatment of this disease with strong heterogeneity is still a challenge. In the future, deep exploration is needed in genetic typing, grading diagnosis and treatment decisions, protection of cranial nerves and new drug treatments to better treat this disease.
摘要：头颈部副神经节瘤多起源于副交感神经节，是一种侵袭性较强的良性肿瘤。对于这一类异质性较强的疾病的诊治目前仍是挑战。未来需要在遗传学分型、分级诊疗决策、保护颅神经及新型药物治疗等方面深入探索，以期更好的治疗该疾病。.

OBJECTIVE: Alcohol drinking is a major risk factor for head and neck cancer (HNC), and this risk may be modified by alcohol dehydrogenase (ADH) genes. The first systematic review and meta-analysis was designed with more studies and added trial sequential analysis and functional analysis for a better understanding of the role of ADH3 polymorphism in HNC patients.
METHODS: A search was performed across several databases, including PubMed/Medline, Web of Science, Scopus, and Cochrane Library, up to May 5, 2024, without any restrictions to find pertinent studies. The RevMan 5.3 software was used to calculate the effect sizes. These were expressed as the odds ratio (OR) with a 95 % confidence interval.
RESULTS: Twenty-seven articles were included in the meta-analysis. The frequency of *1/*1, *1/*2, and *2/*2 genotypes in cases with HNC was 47.14 %, 41.06 %, and 11.80 %, respectively, and in controls was 50.56 %, 38.29 %, and 11.15 %, respectively. The pooled OR for the allelic model is 1.11 (p = 0.18), for the homozygous model is 0.95 (p = 0.64), for the heterozygous model is 0.99 (p = 0.90), for the dominant model is 1.11 (p = 0.14), and for the recessive model is 0.98 (p = 0.78). In the Asians, the three models showed an increased significant association. In the cancer subtype subgroup, a protective significant association was found in the pharyngeal cancer subtype.
CONCLUSIONS: The current analysis suggests that ADH3 polymorphism may not have a significant impact on the risk of HNC, but the polymorphism had an increased risk in Asians and a protective role in pharyngeal cancers.

Cuproptosis, a copper-dependent programmed cell death process, holds promise for controlling cell death in tumor cells. Autophagy, a fundamental cellular process, has been linked to various aspects of cancer, such as proliferation, migration, and drug resistance. This research is centered on the investigation of autophagy- and cuproptosis-related long noncoding RNAs (lncRNAs) and the establishment of a prognostic model for head and neck squamous cell carcinoma. RNA sequencing data from head and neck squamous cell carcinoma patients in The Cancer Genome Atlas database identified cuproptosis-related lncRNAs via Pearson analysis. Patients were divided into training and testing sets. A prognostic model developed in the training set using univariate-least absolute shrinkage and selection operator (Lasso) and multivariate Cox regression was tested for accuracy. Kaplan-Meier analysis showed high-risk patients had poorer outcomes. Cox regression confirmed the model\'s risk score as an independent prognostic indicator, with receiver operating characteristic and decision curve analyses validating its predictive accuracy. Thirteen lncRNAs associated with autophagy and cuproptosis were identified through bioinformatics analysis. Lasso regression narrowed this to 3 significant prognostic lncRNAs. Based on median risk scores, patients were classified into high-risk and low-risk groups. Kaplan-Meier survival curves revealed significant differences between these groups (P < .01). Through a set of bioinformatics analyses, we identified 13 autophagy- and cuproptosis-related lncRNAs. By Lasso regression, 3 prognostic-related lncRNAs were further selected. We also investigated these 3 lncRNAs in relation to clinicopathologic features. The principal component analysis visually showed differences between the high-risk and low-risk groups.

OBJECTIVE: Radiotherapy to the head and neck region (HN) bears the risk of a rampant development of caries, making intensified prevention necessary. Aim of this systematic review was to summarize the evidence on the efficacy of caries preventive measures in these patients.
METHODS: Clinical studies investigating caries in patients with radiotherapy in the HN with at least 1 caries preventive intervention compared to any control were included. Reports in languages other than English or German were excluded. Records were identified on PubMed, Web of Science, Google Scholar, and Cochrane Library mid-January 2024. Risk of bias was assessed with RoB2. Results were summarized. Planned meta-analyses could not be performed, because of heterogenous data.
RESULTS: Five studies were included, with a total of 355 participants. They were irradiated with up to 70 Gy and received different caries preventive interventions, including sodium fluoride or stannous fluoride gels, remineralizing solutions, an \"Intraoral Fluoride Release System\" and sucrose restricted diet. Caries score increased between 0.48 DMF-S and 9.2 DF-S per year. Largest differences in caries increments were measured between groups with insufficient and with rigorous fluoride application.
CONCLUSIONS: The main limitations were compromised randomization, heterogeneity of patients and small sample sizes. Clinical studies on caries prevention after radiotherapy to the HN are lacking and the existing ones bear extensive limitations. However, the large effect size and broad consensus suggest the use of fluoride to be indispensable in preventing caries in these patients. The study was funded by the Medical Center - University of Freiburg and was not registered.

BACKGROUND: Cervical lipomas accompanied by neurovascular compression are extremely rare and require surgical treatment in case of appropriate symptoms. The preferable method is gross total resection, as otherwise they tend to recur. Invasive growth is not typical for lipomas. However, large tumors can involve adjacent nerves and vessels and significantly complicate resection.
METHODS: We present a 57-year-old patient who underwent resection of giant soft tissue cervical lipoma invading neurovascular bundle and compressing the oropharynx and esophagus with dysphagia and positional asphyxia. The patient was followed-up for previous 5 years. Resection was necessary due to tumor enlargement with appropriate symptoms. Searching for literature data was performed in the Pubmed, Medline, EMBASE, Cochrane Library and eLibrary databases.
CONCLUSIONS: Gross total resection of 7-cm tumor was accompanied by mobilization of hypoglossal and vagus nerves, common, external and internal carotid arteries and jugular vein with repositioning of the oropharynx and esophagus. There was mild Horner\'s syndrome in early postoperative period. The patient was discharged in 4 days after surgery with regression of complaints. We found only 5 reports describing giant cervical lipomas invading neurovascular bundle.
CONCLUSIONS: Giant cervical lipomas are extremely rare, and total resection with preservation of critical structures is possible in a specialized hospital.
Липомы, сопровождающиеся компрессией сосудисто-нервного пучка шеи, встречаются крайне редко и требуют хирургического лечения в случаях появления соответствующей симптоматики. Предпочтительным методом является радикальное удаление, так как в противном случае они склонны рецидивировать. Для липом не характерен инвазивный рост, однако, достигая больших размеров, они могут вовлекать в себя прилежащие нервные и сосудистые структуры, что значительно затрудняет радикальную хирургическую резекцию.
UNASSIGNED: В статье представлено наблюдение пациента 57 лет, которому было произведено удаление гигантской липомы мягких тканей шеи, распространяющейся в сосудисто-нервный пучок и приводящей к компрессии ротоглотки, пищевода, дисфагии и позиционной асфиксии при повороте головы. Пациент наблюдался по поводу образования в течение 5 лет, в связи с увеличением образования в динамике и нарастанием жалоб было принято решение об его удалении. Произведен поиск литературы по ключевым словам в научных базах данных PubMed, Medline, EMBASE, Cochrane Library и eLibrary.
UNASSIGNED: В ходе операции опухоль 7 см в диаметре была полностью удалена, из нее выделены и сохранены подъязычный, блуждающий нервы, общая, наружная и внутренняя сонные артерии и яремная вена, сдавленные ротоглотка и пищевод приняли нормальное положение. В раннем послеоперационном периоде отмечалось появление минимально выраженного синдрома Горнера, пациент был выписан из клиники на 4-е сутки после операции с регрессом жалоб. При поиске литературы было найдено лишь 5 работ, описывающих гигантские липомы шеи с вовлечением сосудисто-нервного пучка.
UNASSIGNED: Гигантские липомы шеи встречаются крайне редко, а их радикальное удаление с сохранением критических структур возможно в условиях специализированного стационара.

Perineural tumour spread in head and neck cancer can be a challenging diagnosis for radiologists; head and neck anatomy is intimidating and perineural tumour spread can be subtle and difficult to detect. It results in significant morbidity for patients, can upstage disease and will frequently result in more prolonged treatment courses. This pictorial review provides a thorough examination of the imaging characteristics of perineural tumour spread in head and neck malignancy. It highlights key imaging features, from initial diagnosis to its post-therapy appearance, emphasising the clinical relevance and role of imaging in post-therapy assessment. Multi-modality imaging examples are included with a focus on magnetic resonance imaging (MRI) and positron-emission tomography (PET)/computed tomography (CT). MRI features of perineural tumour spread include intermediate T2 signal expansion of a nerve, abnormal enhancement extending along a nerve, expansion of a skull or neural foramen and loss of normal fat planes surrounding nerve pathways. 18F-fluorodeoxyglucose (FDG) PET/CT is a useful adjunct to MRI, perineural tumour spread results in abnormal FDG accumulation in a linear fashion anatomically spreading along a nerve pathway. Knowledge of these features and useful check areas will ensure that radiologists can be confident both in making the diagnosis and re-assessment post-therapy.

OBJECTIVE: Head and neck (HN) cancer comprises the neoplasms originating from the oral cavity, pharynx and larynx. We aimed at reviewing the available literature on the effect of smoking cessation on HN cancer risk.
METHODS: We conducted a systematic search in Medline, PubMed and Embase to June 2022. We abstracted or calculated relative risks (RR) and 95% CIs of HN cancer after cessation of tobacco smoking (both former smoking status and duration of quitting) and combined them using random effects meta-analyses. Papers included were case-control or cohort studies available in the English language. Studies investigating smoking cessation after cancer diagnosis, case reports, intervention studies or animal studies were excluded. Quality and susceptibility to bias of each included study were evaluated using the Newcastle-Ottawa Scale. Publication bias was assessed using funnel plot and Egger\'s test.
RESULTS: A total of 65 studies were included in the review, including 5 cohort and 60 case-control studies. The RR of HN cancer for former smokers compared with current smokers was 0.40 (95% CI 0.35 to 0.46). In an analysis by cancer site, the RR of oral cancer was 0.44 (95% CI 0.35 to 0.55), that of pharyngeal cancer 0.44 (95% CI 0.32 to 0.60) and that of laryngeal cancer 0.38 (95% CI 0.29 to 0.50). The dose-response meta-analysis was based on 37 studies. The RR per 10-year increase in smoking cessation was 0.47 (95% CI 0.43 to 0.52).
CONCLUSIONS: The risk of HN cancer declines within the first 5 years of quitting smoking. Quitting smoking is an essential element of HN cancer prevention.
BACKGROUND: The protocol has been deposited in the PROSPERO repository (CRD42022338262).