Although HPV status is known to provide an improved prognosis in initial treatments of HPV-positive oropharyngeal squamous cell carcinoma (OPSCC), it is unclear how it affects patients who receive salvage surgery (SS), which has historically poor survival rates. The purpose of this study was to evaluate the role of SS for patients with locoregional recurrence (LRR) of HPV-positive OPSCC and its impact survival rates. We conducted a scoping review of literature through October 2022 and included 995 individuals. Survival endpoints, such as overall survival (OS), Kaplan–Meier curves, and median post-recurrence survival, were analyzed in addition to demographics. Of all studies, 18.8% (6/32) reported any survival data for SS patients, with the most prevalent reporting 2- and 5-year OS in two studies. Median post-recurrence survival was not reported for SS. These findings reveal the limited and unpredictable reporting of survival-specific data on SS for HPV-positive OPSCC. With limited survival assessment, it is difficult to assess the potential advantages and disadvantages of this therapy to guide clinical decision-making.

Objective: Studies evaluating the ability to diagnose and accurately predict the severity of micrognathia prenatally have yielded inconsistent results. This review aimed to evaluate reliability of prenatal diagnostic imaging in the diagnosis and characterization of micrognathia. Design: Systematic review and meta-analysis. Setting: Studies with a prenatal diagnosis of micrognathia via ultrasound with a confirmatory postnatal examination were included. Prenatal severity was defined with and without mandibular measurements. Extent of airway obstruction at birth was defined by level of intervention required. Meta-analyses of proportions and relative risk were performed. Patients: A total of 16 studies with 2753 neonates were included. Main Outcome Measures: Primary outcome was the efficacy of characterizing the degree of micrognathia on prenatal imaging as it relates to respiratory obstruction at birth. Secondary outcome was the accuracy of prenatal diagnosis with the utilization of mandibular measurements versus without. Results: Performing meta-analysis of proportions, the proportion of missed prenatal diagnoses of micrognathia made without mandibular measurements was 11.62% (95%CI 2.58-25.94). Utilizing mandibular measurements, the proportion of cases missed were statistically lower (0.20% [95%CI 0.00-0.70]). Patients determined to have severe micrognathia by prenatal imaging did not have a statistically significant increase in risk for more severe respiratory obstruction at birth (RR 3.13 [95%CI 0.59-16.55], P = .180). Conclusion: The proportion micrognathia cases missed when prenatal diagnosis was made without mandibular measurements was over 1 in 10, with mandibular measures improving accuracy. This study highlights the need for a uniform objective criterion to improve prenatal diagnosis and planning for postnatal care.

In patients receiving treatment for head and neck cancer (HNC), there is a correlation between quality of life (QoL) scores and treatment outcomes. Higher QoL scores have been associated with improved survival. Despite this, the assessment of QoL in clinical trials varies considerably. Three databases (Scopus, PubMed, and Cinahl) were queried for articles published in English between 2006 and 2022. Two reviewers (SRS and ANT) performed study screening, data extraction, and risk of bias assessment. The authors identified 21 articles that met the inclusion criteria. A total of 5961 patients were evaluated. QoL was reported as average scores for specific variables across five different surveys in 12 included articles. Supplemental QoL data were available in 10 included studies. Critical appraisal of studies indicated a high risk of bias due to the inclusion of trials. There is no standard method for reporting QoL data in clinical trials for HNC patients undergoing treatment with anti-EGFR inhibitors. Future clinical trials should standardize their method for assessing and reporting quality-of-life data to increase patient-centered care and refine treatment choices to optimize survival.

Purpose: This review aims to characterize the limitations of Gamma Knife radiosurgery (GKRS) with investigation of failure rates for primary and salvage (post-surgical) cases, identification of risk factors associated with increased rates of treatment failure, and evaluation adverse outcomes. Methods: A systematic search (Cochrane Library, PubMed, SCOPUS, and CINAHL) of studies on sporadic vestibular schwannomas treated with Gamma Knife radiosurgery was conducted in accordance with PRISMA guidelines. Primary outcome measures included continuous measures (mean), proportions (%), and relative risks (RR) with 95% confidence intervals (CI). Results: Forty-three studies ( n = 5619 patients) were included. The proportion of GKRS failure for primary (6.4% [95% CI 4.8–7.7]) and salvage treatment (9.0% [5.9–12.8]) did not differ (2.8%, [-0.2-6.9], p = 0.06). When stratified by various thresholds on imaging, an increase of greater than 15% in a tumor’s volume was seen 3.2% [2.1–4.6] which was less than rates in other volumetric thresholds of failure ( p = 0.0001). Treatment edema identified by brainstem hyperintensity on imaging was the most frequent toxicity (8.8% [7.1–10.8]) with symptomatic management in about 1 in 4 cases. New onset cranial nerve adverse outcomes occurred for trigeminal neuralgia 4.9% [2.8–7.6%], trigeminal numbness 4.3% [2.7–6.2%], and temporary facial paresis 3.2% [1.3–5.9%]. Conclusion: Gamma Knife radiosurgery is an effective treatment for sporadic vestibular schwannomas with low rates of failure. Our findings suggest failure rates are not affected by treatment timing and comparable for the smaller sized tumors. Gamma Knife radiosurgery is safe with minimal adverse outcomes such as cranial nerve dysfunction, required retreatment, or other radiation toxicity.