UNASSIGNED: To evaluate the surgical and postoperative management strategies that contribute to minimizing the need for prophylactic tracheostomy for airway management in advanced oral cancer surgery.
UNASSIGNED: A retrospective review of the patients who underwent surgery for advanced oral cancer, in our institution from February 2015 to January 2024.
UNASSIGNED: In the present review, 66 patients (males, n = 54; females, n = 12; mean age 50.3 years) who were operated for advanced oral cancer (T3, T4 oral squamous cell carcinoma and osteosarcoma of the mandible requiring mandibular resection) in our institution were included. 60 patients (90.9%) had reconstruction after segmental resection of the mandible without the need for prophylactic tracheostomy. Out of these, eighteen patients (27.27%) required segmental resection of the mandible crossing midline. Six patients (9.1%) underwent prophylactic tracheostomy, of which two patients had unilateral tumor and four patients had tumor crossing midline. Comparison of hospital stays between patients who underwent prophylactic tracheostomy and those who did not yielded mean durations of 13.3 days and 7.6 days, respectively.
UNASSIGNED: Except a subset of patients with old age, obesity, bulky neck, and those with respiratory compromise, following the present guidelines, prophylactic tracheostomy can be avoided in patients undergoing surgery for advanced oral cancer.

OBJECTIVE: Early detection significantly improves the prognosis of oral cancer patients, contingent upon the knowledge of dental professionals. This study aimed to assess and compare the knowledge, practices and perceptions regarding oral cancer among dental professionals in Belgium.
METHODS: A cross-sectional survey was distributed via Qualtrics to general dentists, dental specialists, dental hygienists, and oral and maxillofacial surgeons. The self-administered questionnaire comprised three sections: demographics (4 questions), knowledge (9 questions) and clinical practices (19 questions) related to oral cancer detection and treatment. Descriptive statistics were employed for data analysis, with Chi-square tests assessing responses by specialization, gender, years of experience and number of oral cancer patients treated.
RESULTS: A total of 262 questionnaires were completed, with the majority of respondents being general dentists (61%) followed by dental specialists (25%), oral hygienists (8%) and oral and maxillofacial surgeons (6%). 70% of the respondents reported treating fewer than four oral cancer patients throughout their careers. 5 out of the 9 knowledge questions achieved over 50% correct responses, with an average correct answer rate of 54%. Oral and maxillofacial surgeons and dental professionals who have treated more than four oral cancer patients, demonstrated significantly higher scores on multiple knowledge questions. Responses to clinically oriented questions showed less diversity across professions, and generally aligning with guidelines from professional oncological societies.
CONCLUSIONS: This survey highlights the need for enhanced education on oral cancer among Belgian dental professionals. Knowledge levels were notably higher among more experienced respondents. The development and implementation of comprehensive guidelines tailored to dentists and oral hygienists for oral cancer prevention and patient care are warranted to optimize clinical practice standards.

Head and neck cancer (HNC) treatments have been based on single or multimodal therapies with surgery, radiotherapy (RT), chemotherapy, and immunotherapy. However, treatment recommendations among countries may differ due to technological/human resources and usual local practices. This scoping review aims to identify, compare, and map the clinical practice guidelines (CPGs) for treating squamous cell carcinoma (SCC) of the oral cavity, oropharynx, and larynx worldwide. A search strategy on global CPGs for HNC was performed by using five electronic databases and grey literature. CPGs were selected for inclusion using EndNote-20 and Rayyan online software. No language or publication date restrictions were applied. The results were analyzed descriptively considering the most updated CPG version. In total, 25 CPGs covering the head and neck region (10), the larynx (7), the oral cavity (5), and the oropharynx (3), were found in 13 geographical regions, and 19 were developed by medical societies from 1996 to 2023. Surgery and RT remain the main modalities for early-stage HNC, with surgery preferred in low-resource countries, and RT in selected cases, especially in the larynx/oropharynx aiming to achieve a cure with organ preservation. Human papillomavirus infection for oropharyngeal SCC is not tested in some Asian countries and there is still no consensus to treat p16-positive cases differently from p16-negative. Recommendations for larynx preservation vary according to facilities in each country, however, individualized choice is emphasized. Inequality across countries/continents is evident, with a similar pattern of recommendations among developed as well as developing ones. No CPGs were found in Latin America as well as Oceania countries, where the incidence of HNC is high and limitations of access to treatment may be encountered.

In recent years, oral cancer has become a huge solicitude in oncology with its accelerating incidence and has accounted for nearly 50% of cancers seen in India. Screening of patients and lack of awareness among people about the early signs and symptoms are the major factors for a late diagnosis. Although examination of the lesion clinically and diagnosis has a paramount role in early detection, different imaging techniques are required to accurately gauge the extent to local regions. Imaging plays a pivotal role in deciding the apt treatment strategy, assessing the resectability of the tumor, and gauging exact margins for resection. Thus, this study aims to describe a new clinical guideline using various available imaging systems and their importance in oral cancer management.

Large general hospitals currently play an increasingly important role in the diagnosis and treatment for acute critical patients and difficult diseases because of the development of dual referral system and hierarchical diagnosis, as well as the formation of medical treatment alliance. Patients with oral cancers are often associated with systemic diseases, which increases the complexity of the condition. Thus, meeting the demand through the traditional single medical model is difficult. As such, a multidisciplinary team (MDT) model has been proposed and has achieved a good clinical effect. To standardize the application of this model, we organized an event in which relevant experts discussed and formulated a consensus to provide standardized suggestions on the MDT process and the diagnosis and treatment of common systemic diseases as reference for clinical practice.
近年来，随着双向转诊、分级诊疗和医联体的建立，大型综合医院承担急危重症和疑难疾病诊疗的功能定位日益凸显，来诊的口腔癌患者常伴有全身情况复杂的系统性疾病，传统的单一诊疗模式难以达到医疗需求。为此，多学科协作诊疗（MDT）模式应运而生并在实践中应用，取得了良好的临床效果。为了进一步规范口腔癌患者的MDT，组织专家制订了本专家共识，对诊疗流程、常见系统性疾病的诊治等给出了规范化建议，供临床医师参考。.

BACKGROUND: Guidelines should provide accessible and reliable information for decision-making. Also, they should be translatable to multiple settings, allowing their use in diverse situations.
METHODS: We searched in GOOGLE, PUBMED, SCIELO, and SCOPUS for guidelines on oral squamous cell carcinoma. They were evaluated using the AGREE II protocol.
RESULTS: We identified 16 guidelines that fulfilled inclusion criteria. The mean score and range for each AGREE II domain were: \"scope and purpose\" 74.1% (6-100.0%); \"stakeholder\" 78.6% (0-100.0%); \"rigor of development\" 71.4% (0-100.0%); \"clarity of presentation\" 71.4% (6-100.0%); \"applicability\" 50.0% (0-85.7%); \"editorial independence\" 57.1% (14.3-85.7%) and \"overall assessment\" 57.1% (14.3-100.0%).
CONCLUSIONS: Guidelines for oral cancer present variable quality. Among those available, only four surpassed the 70% AGREE II score threshold.

The diagnosis and management of oral cavity cancer has been well described in developed countries, however, in regions with fewer medical resources, alternative methods may need to be used. We outline an approach to evaluation and treatment of oral cavity cancer in low-resource areas.
Reviews of the Cochrane and Pubmed databases were performed and literature compiled. Expert opinions from the American and African Head and Neck Societies were also provided.
Treatment guidelines for managing oral cavity cancer in low-resource regions are outlined and the level of supporting evidence is defined.
Successful treatment typically involves the use of upfront surgical resection of the primary lesion and any involved or at-risk cervical lymph node basins, with adjuvant therapy based on the final pathology findings. In situations where services such as adjuvant therapy and/or appropriate reconstruction are not available, alternative approaches to treatment may be needed.

Comparing accuracy results for mandibular reconstructions using computer-assisted surgery (CAS) is limited due to heterogeneity in image acquisition, extent of mandibular resection, and evaluation methodologies between studies. We propose a practical, feasible and reproducible guideline for standardizing evaluation methods to allow valid comparisons of postoperative results and facilitate meta-analyses in the future. It offers a guide to imaging, data comparison, volume assessment of 3-dimensional models, classification of defects, and it also contains a quantitative accuracy evaluation method.

OBJECTIVE: To assess the quality of clinical practice guidelines (CPGs) on screening and diagnosis of oral cancer and to describe the characteristics of their recommendations.
METHODS: We systematically searched EMBASE, MEDLINE, CPG\' websites, and dentistry and oncology scientific societies to identify CPGs that were related to screening and diagnosis of oral cancer. The quality of selected CPGs was independently assessed by four appraisers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. The inter-appraiser agreement was assessed. We performed a descriptive analysis of the recommendations included in the selected CPGs.
RESULTS: Eight CPGs were selected. The overall agreement among reviewers was considered very good (ICC: 0.823; 95% CI: 0.777-0.861). The median scores of the six AGREE II domains were as follows: \"scope and purpose\" 97.9% (IQR: 96.2-100.0%); \"stakeholder involvement\" 86.1% (IQR: 69.8-93.1%); \"rigor of development\" 75.3% (IQR: 64.2-94.3%); \"clarity of presentation\" 91.7% (IQR: 82.6-94.4%); \"applicability\" 53.1% (IQR: 19.3-74.2%); and \"editorial independence\" 83.3% (IQR: 67.2-93.8%). Four CPGs were assessed as \"recommended\", four \"recommended with modifications\", and none \"not recommended\". Twenty-three recommendations were provided, mostly with a low or very low level of evidence.
CONCLUSIONS: The methodological quality of CPGs on screening and diagnosis of oral cancer is moderate. The \"applicability\" domain scored the lowest. Most recommendations were based on a low o very low level of evidence.
CONCLUSIONS: Greater efforts are needed to provide healthcare based on high-quality evidence-based CPGs in this field.

A systematic review was conducted to update evidence on the effect of total dietary starch and of replacing rapidly digestible starches (RDSs) with slowly digestible starches (SDSs) on oral health outcomes to inform updating of World Health Organization guidance on carbohydrate intake. Data sources included MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, LILACS, and Wanfang. Eligible studies were comparative and reported any intervention with a different starch content of diets or foods and data on oral health outcomes relating to dental caries, periodontal disease, or oral cancer. Studies that reported total dietary starch intake or change in starch intake were included or where comparisons or exposure included diets and foods that compared RDSs and/or SDSs. The review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) statement, and evidence was assessed with the GRADE Working Group guidelines. From 6,080 papers identified, 33 (28 studies) were included in the RDS versus SDS comparison: 15 (14 studies) assessed the relationship between SDS and/or RDS and dental caries; 16 (12 studies) considered oral cancer; and 2 studied periodontal disease. For total starch, 23 papers (22 studies) were included: 22 assessed the effects on dental caries, and 1 considered oral cancer. GRADE assessment indicated low-quality evidence, suggesting no association between total starch intake and caries risk but that RDS intake may significantly increase caries risk. Very low-quality evidence suggested no association between total starch and oral cancer risk, and low-quality evidence suggested that SDS decreases oral cancer risk. Data on RDS and oral cancer risk were inconclusive. Very low-quality data relating to periodontitis suggested a protective effect of whole grain starches (SDS). The best available evidence suggests that only RDS adversely affects oral health.