Introduction: Globally, 600 million people chew areca nut, also known as betel nut, with habitual use being a major risk factor for oral cancer. Taiwan and India have some of the highest age-standardized incidence and mortality rates of oral cancer, underscoring the significant health burden in these countries. Aims: This observational cross-sectional study aims to investigate the betel nut consumption habits in the Taiwanese and Indian populations and assess their awareness of its association with oral cancer. Methodology: An interview was conducted and completed by 516 adults across Taiwan and 989 in India to assess betel nut habits and awareness of oral cancer risks. Results: In Taiwan, 95.2% (n = 491) were aware that betel nut can cause oral cancer versus 51.3% (n = 507) in India. Lifetime prevalence of betel nut use in Taiwan was 19.2% (n = 99) versus 42.6% (n = 421) in India. Only in India was betel nut chewing (OR: 0.6, 95% CI: 0.4–0.8, p < 0.001) associated with decreased awareness of the oral cancer risk linked to betel nut use. Using the population attributable fraction (PAF), an estimated 70.5% (95% CI: 46.0–85.5%) of oral cancer cases in India and 53.7% (95% CI: 42.2–64.1%) in Taiwan are potentially attributable to betel nut use. Conclusions: Betel nut use remains prevalent in India and Taiwan, with lack of awareness posing a greater challenge in India and betel nut use being associated with higher risks of self-reported oral cancer symptoms. Effective intervention requires country-specific strategies to curb usage, improve awareness of associated risks and government strategies to reduce betel nut cultivation and availability.

Objective: The objective of this article is to define a correct diagnostic pathway for oropharyngeal cancer of unknown primary (OPCUP) identification. Background: OPCUP represents one of the most frequent causes of neck metastases onset without the identification of the primary tumor. Therefore, there is a high percentage of late or missing diagnoses, resulting in treatment delay or in a wrong therapeutic process. The up-to-date diagnostic procedures can help us to begin therapies at the right time. Methods: This is a review of the latest articles about diagnostic pathways in the OPCUP. A selection of the references was carried out in PubMed, EMBASE, Cochrane, and CENTRAL electronic databases. Conclusion: The oropharynx represents the most common site of primary unknown head and neck cancer (HNCUP). Recent epidemiologic data reported an increasing incidence of HNCUP related to human papilloma virus positive squamous cell carcinoma. Positron emission tomography combined with computerized tomography scanning or magnetic resonance imaging allows for improving the detection of primary unknown tumors and distant and locoregional metastases. Finally, the introduction of the trans-oral robotic surgical approach has introduced a new role of surgery in the HNCUP diagnosis and treatment. Hence, the new technological improvement allows reaching in most HNCUP patients an early diagnosis, achieving targeted management and better treatment outcomes, as well as decreasing toxicity and the side effects of treatment options.

Tracheostomal stenosis is a troublesome and distressing complication in laryngectomy. There are numerous techniques that describe dilatation of tracheostoma which are mostly performed under general anesthesia with the intermittent apnea technique. We report an alternative dilatation method using a Foley catheter for laryngectomee with stomal stenosis. One case was performed under high-frequency jet ventilation and the other case was carried out with a conventional anesthesia machine. The Foley catheter is used as a conduit for ventilation and the balloon on the Foley catheter was used as a dilatator.