Head and neck cancer (HNC) represents a heterogeneous group of neoplasms with different biological and clinical behavior, which develops in the upper parts of the respiratory and digestive tract outside the esophagus. The majority (>90%) of HNCs arise from squamous epithelium and are classified as head and neck squamous cell carcinomas (HNSCCs). The main anatomical localizations of HNSCCs concern the paranasal sinuses, oral cavity, salivary glands, larynx, pharynx, and nasal cavity. Oncogenic viruses play an important role in the development of HNC. Human papillomavirus (HPV) has been extensively studied in relation to oropharyngeal carcinoma, but other oncogenic viruses also contribute to the HNC onset. This chapter summarizes advances in the pathogenesis, epidemiology and detection of oncogenic viruses implicated in HNC, recognizing the established role of HPV and discussing its relationship with other viruses. Epstein-Barr virus in particular has been associated with lymphoma and nasopharyngeal carcinoma. Merkel cell polyomavirus has been associated with a subset of HNC and human herpesvirus 8 is linked to Kaposi sarcoma. Hepatitis viruses have also been investigated for possible association with HNC.

The development of a second primary malignancy in patients with head and neck cancer (HNC) is not a rare event. According to the literature, the incidence of multiple HNCs is increasing in recent years due to improved diagnostic tests, meliorated screening and surveillance of patients with cancer, more sophisticated treatment, increased life expectancy and high population survival. The risk of developing second primary cancer increases by 3% per year in patients who have survived HNC. Second tumors can be diagnosed either simultaneously (synchronous) or more than six months after the index tumour (metachronous). Nowadays, the situation of patients with multiple primaries HNCs is of increasing relevance and importance and follow-up of those patients is recommended, not only to detect relapse and manage treatment-related toxicities but also for early detection of metachronous HNCs.

The interaction between immune cells and surrounding tissues that creates the tumor microenvironment may explain the high rates of recurrence and metastatic head and neck squamous cell carcinoma. Notably, head and neck squamous cell carcinoma can evade detection by the immune system while also exhibiting immunomodulatory effects. A variety of cell types comprise the tumor microenvironment, including T cells, cancer-associated stromal fibroblasts, macrophages, B cells, neutrophils, myeloid-derived suppressor cells, mast cells, and natural killer cells. These various cells not only inhabit the tumor but also engage with tumor cells and one another through a complex network. Both adaptive and innate immune cells are crucial for sustaining immune vigilance and regulating tumor growth. In this chapter, we explore the different subsets of immune cells and their roles in fostering an immunosuppressive tumor microenvironment in head and neck squamous cell carcinomas, aiming to enhance our understanding of the numerous factors that significantly influence head and neck squamous cell carcinoma tumorigenesis and progression.

Background and Objectives: Dysphagia is a frequently reported symptom among patients undergoing thyroidectomy, yet its incidence, underlying mechanisms, and temporal progression remain insufficiently clarified. The aim of the present systematic review was to synthesize the existing literature on the occurrence and evolution of swallowing disorders following thyroidectomy, without restriction regarding the extent of surgery, surgical approach, indication, or concomitant complications. Materials and Methods: A systematic literature review, according to PRISMA guidelines, was conducted in the electronic databases PubMed, MEDLINE, and SciELO, using the terms “dysphagia”, “deglutition disorder”, “swallowing disorder”, “thyroid surgery” and “thyroidectomy” in the appropriate combinations. A narrative synthesis of the results followed. Results: 31 eligible studies encompassing a total of 64,123 patients were included in the systematic review and analyzed concerning their type, sample, follow-up and results regarding thyroidectomy-related dysphagia. Data regarding pre- and postoperative dysphagia were extracted and compared. Both subjective patient-reported outcomes and objective assessments were considered. Reported preoperative dysphagia incidence varied widely (3.3–77.8%), with a pooled mean of approximately 25%. Dysphagia rates increased significantly within the first 1–2 postoperative weeks but generally declined to near preoperative levels by 2–3 months, with further improvement observed up to 4–6 months. Several factors were associated with persistent or more severe dysphagia, including the extent of surgery, older age, surgical techniques, central or lateral lymph node dissection, and the need for adjuvant therapies such as radioactive iodine or external beam radiotherapy. Conclusions: Dysphagia after thyroidectomy appears as a common but typically transient symptom, with the highest incidence occurring in the immediate postoperative period and a progressive return to baseline within three months. Although most patients experience improvement, a subset may report persistent symptoms with measurable impact on quality of life. Methodological heterogeneity, variability in symptom assessment tools, and limited long-term follow-up restrict the strength of available evidence. Standardization of outcome measures and longer follow-up periods are needed to achieve more reliable and generalizable conclusions.

Hereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber syndrome, is a rare autosomal dominant multisystem disorder. It is a mucocutaneous and fibrovascular dysplasia, the diagnosis of which is based on the fulfillment of the four Curaçao criteria: 1) recurrent epistaxis; 2) dermatovascular mucosal telangiectasias at characteristic sites: skin of the face, ears, fingertips, lips, tongue, and oral and nasal cavity; 3) arteriovenous malformations (AVMs) of visceral organs and central nervous system; and 4) family history: diagnosis of HHT in a first-degree relative. We describe a case of a 76-year-old patient who presented to our department with clinical manifestations of HHT in the skin (face, fingertips), lips, hard palate, tongue, ears, and nasal cavities. Individual and family history was obtained, as well as clinical laboratory examination, pan-endoscopy of the ear, nose, and throat (ENT) systems, and treatment of active foci of bleeding from the above areas. The otolaryngologist may be the first doctor to suspect Rendu-Osler-Weber syndrome and the one responsible for treating patients with HHT since recurrent epistaxis is the most frequent (90-96% of patients) and the earlier manifestation of the disease and the main reason for the arrival of these patients in the Emergency Department. The purpose of this study is to present a clinical case of Rendu-Osler-Weber syndrome with multiple ENT manifestations, as well as a review of the literature on their management and treatment.

In this paper, we present the case of acute airway obstruction due to tracheal carcinoma in a patient with glottic stenosis due to previously treated laryngeal carcinoma. Because of severe dyspnea from the obstructive endotracheal mass, tracheotomy under local anesthesia was immediately performed. Intubation with pediatric size (I.D. 4.5 mm) cuffed endotracheal tube was performed by the surgeon through tracheostomy under endoscopic visualization. Blakesley forceps and electrocautery were used for tumor debulking. Postoperatively there were no complications and the patient was discharged after four days. The histopathology report showed a squamous cell carcinoma. The tumor board decided on adjuvant chemoradiotherapy for the treatment of the patient.