Iwona M. Tomaszewska

Measuring quality of life in patients with head and neck cancer: Update of the EORTC QLQ-H&N Module, Phase III.

The objective of this study was to pilot test an updated version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC QLQ‐H&N60).

Validation of the Polish version of the EORTC QLQ-CX24 module for the assessment of health-related quality of life in women with cervical cancer.

The aim of our study was to undertake a prospective validation study of the Polish version of the EORTC cervical cancer (EORTC QLQ-CX24) module used alongside the EORTC core measure. The translated module was pilot-tested according to the established EORTC guidelines. Patients with histological confirmation of cervical cancer were eligible for the study. All patients filled out the Polish version of the EORTC QLQ-CX24 module in addition to EORTC QLQ-C30 and a demographic questionnaire. Standardised validity and reliability analyses were performed. One hundred and seventy-one patients were enrolled into the study, mean age ± SD: 52.1 ± 9.6. Cronbach alpha coefficients, range 0.81-0.88, showed positive internal consistency. Re-test was undertaken with 40 patients (23.4%). Interclass correlations for the EORTC QLQ-CX24 ranged from 0.85 to 0.89 and proved appropriate test-retest reliability. Satisfactory convergent and discriminant validity in multi-trait scaling analyses was seen. Concluding, the Polish version of the EORTC QLQ-CX24 module is a reliable and valid tool for measuring HRQoL in patients with cervical cancer. It can be fully recommended for use in clinical and epidemiological settings in the Polish population.

Anatomical landmarks for the localization of the greater palatine foramen – a study of 1200 head CTs, 150 dry skulls, systematic review of literature and meta-analysis

Accurate knowledge of greater palatine foramen (GPF) anatomy is necessary when performing a variety of anaesthesiological, dental or surgical procedures. The first aim of this study was to localize the GPF in relation to multiple anatomical landmarks. The second aim was to perform a systematic review of literature, and to conduct a meta‐analysis on the subject of GPF position to aid clinicians in their practice. One‐hundred and fifty dry, adult, human skulls and 1200 archived head computed tomography scans were assessed and measured in terms of GPF relation to other anatomical reference points. A systematic literature search was performed using the PubMed, Embase and Web of Science databases, and a meta‐analysis on the subject of GPF relation to the maxillary molars was conducted. On average, in the Polish population, the GPF was positioned 15.9 ± 1.5 mm from the midline maxillary suture (MMS), 3.0 ± 1.2 mm from the alveolar ridge (AR) and 17.0 ± 1.5 mm from the posterior nasal spine (PNS); 74.7% of GPF were positioned opposite the third maxillary molar (M3). Twenty‐seven studies were included in the systematic review and 23 in the meta‐analysis (n = 6927 GPF). The pooled prevalence of the GPF being positioned opposite the M3 was 63.9% (95% confidence interval = 56.6–70.9%). Concluding, the GPF is most often located opposite the M3 in the majority of the worlds populations. The maxillary molars are the best landmarks for locating the GPF. In edentulous patients the most useful points for approximating the position of the GPF are the AR, MMS and PNS. This study introduces an easy and repeatable classification to reference the GPF to the maxillary molars.

Systematic review of the health-related quality of life issues facing adolescents and young adults with cancer

PurposeFor adolescents and young adults (AYAs), the impact of a cancer diagnosis and subsequent treatment is likely to be distinct from other age groups given the unique and complex psychosocial challenges of this developmental phase. In this review of the literature, we report the health-related quality of life (HRQoL) issues experienced by AYAs diagnosed with cancer and undergoing treatment.MethodsMEDLINE, EMBASE, CINAHL, PsychINFO and the Cochrane Library Databases were searched for publications reporting HRQoL of AYAs. Issues generated from interviews with AYAs or from responses to patient reported outcome measures (PROMs) were extracted.Results166 papers were reviewed in full and comprised 72 papers covering 69 primary studies, 49 measurement development or evaluation papers and 45 reviews. Of the 69 studies reviewed, 11 (16%) used interviews to elicit AYAs’ descriptions of HRQoL issues. The majority of the PROMs used in the studies represent adaptations of paediatric or adult measures. HRQoL issues were organised into the following categories: physical, cognitive, restricted activities, relationships with others, fertility, emotions, body image and spirituality/outlook on life.ConclusionThe HRQoL issues presented within this review are likely to be informative to health care professionals and AYAs. The extensive list of issues suggests that the impact of a cancer diagnosis and treatment during adolescence and young adulthood is widespread and reflects the complexities of this developmental phase.

Microanatomical study of the recurrent artery of Heubner.

The purpose of this study has been to describe the microanatomy of the recurrent artery of Heubner (RAH) in detail, to deepen anatomical knowledge and aid neurosurgeons in their work. The material was obtained from cadavers (ages 31-75 years) at routine autopsy. A total of 70 human brains (39 male and 31 female) were examined. People who died due to neurological disorders were not included in the study. Right after dissection, the arteries were perfused with acrylic paint emulsion, through the Circle of Willis or electively through the RAH. Brains were fixed in a 10% solution of formaldehyde, sectioned and placed in methyl salicylate for tissue transparency. To obtain corrosion-casts, the vessels were perfused with polyvinyl chloride or Mercox CL-2R resin and corroded using concentrated potassium chloride. The obtained material was analyzed using a stereoscopic light microscope. The RAH was present in 138 hemispheres with a mean of 1.99 RAH per hemisphere (275 RAH in total). The mean RAH length was 25.2 mm and the mean RAH diameter, in its place of origin, was 1 mm. Two to 30 branches (mean=9.4) originated from the stem of the RAH. The number of RAHs showed a negative correlation to the number of arteries from the medial group of lenticulo-striate arteries (LSA) (R=-0.62; p < 0.0001) which branch off the middle cerebral artery (MCA). This study further supports the RAH embryologic theory by Abbie. The RAH, in its extra- and intracerebral course, may join with the middle group of the LSA or directly with the MCA.

Validation of the Polish version of the EORTC QLQ-OV28 module for the assessment of health-related quality of life in women with ovarian cancer

The aim of our study was to undertake a prospective validation study of the Polish version of the EORTC ovarian cancer (EORTC QLQ-OV28) module used together with the EORTC QLQ-C30. The translated module was pilot-tested according to the EORTC guidelines. Patients with histological confirmation of ovarian cancer were eligible for the study. All patients filled out the Polish version of the EORTC QLQ-OV28, the EORTC QLQ-C30 and a demographic questionnaire. Standard validity and reliability analyses were performed. One-hundred and forty patients agreed to take part in the study (mean age ± standard deviation: 63.3 ± 10.2 years). Cronbachs alpha coefficients showed positive internal consistency (0.78–0.91). Interclass correlations for the EORTC QLQ-OV28 ranged from 0.77 to 0.93 and proved appropriate test-retest reliability. Satisfactory convergent and discriminant validity in multi-trait scaling analyses was seen. The Polish version of the EORTC QLQ-OV28 module proved to be a reliable and valid tool for measuring health-related quality of life in patients with ovarian cancer.

A micro-computed tomographic (micro-CT) analysis of the root canal morphology of maxillary third molar teeth

INTRODUCTION The aim of this study was to analyze the root canal morphology of maxillary third molars (MTMs) using micro-computed tomography (micro-CT). MATERIALS AND METHODS Seventy-eight consecutively-extracted human MTMs were scanned using micro-CT (spatial resolution=13.68μm per pixel). Dedicated software (SkyScan®) was used to create virtual reconstructions and perform 3D-analysis. A range of anatomical features were assessed; externally (root number, length, fusion, curvature, apex), within the pulp chamber (distance between canal orifices, floor thickness) and within the root canal system (root canal number, classification, ramifications, isthmuses, apical constriction). RESULTS The donor age ranged from 19 to 73 years (mean±SD 32.3±16.5years). MTMs possessed one or three roots, which principally curved buccally/palatally (75.9%), had 1-4 root canals and typically no apical constriction (84.4%). The average external root length was 11.89±1.53mm, while root canal length was 10.18±0.35mm. The root canal diameter 1mm from the apex was 0.37±0.23mm and negatively correlated with donors age (r=-0.76; p=0.01), while pulp chamber thickness positively correlated with age (r=0.58; p=0.035). Significantly, furcation canals, canal loops and root canal calcifications were sporadic findings. CONCLUSIONS In some cases the anatomy of MTMs may not be as complicated as previously documented, being similar to the reported anatomy of other maxillary molars. During root canal treatment of MTMs, the frequent deviation of the apical foramen from the radiographic apex should be considered, as should the absence of an apical constriction in the majority of cases. In addition, buccal/palatal root curvature, often undiagnosed radiographically, is the most common root curvature in MTMs.

Variable relationship of the recurrent laryngeal nerve to the inferior thyroid artery: A meta-analysis and surgical implications.

The relationship between the recurrent laryngeal nerve (RLN) and inferior thyroid artery (ITA) is highly variable and traceable back to embryological life.

The Reliability of the Tracheoesophageal Groove and the Ligament of Berry as Landmarks for Identifying the Recurrent Laryngeal Nerve: A Cadaveric Study and Meta-Analysis

Purpose. The aim of this meta-analysis was to provide a comprehensive evidence-based assessment, supplemented by cadaveric dissections, of the value of using the Ligament of Berry and Tracheoesophageal Groove as anatomical landmarks for identifying the Recurrent Laryngeal Nerve. Methods. Seven major databases were searched to identify studies for inclusion. Eligibility was judged by two reviewers. Suitable studies were identified and extracted. MetaXL was used for analysis. All pooled prevalence rates were calculated using a random effects model. Heterogeneity among included studies was assessed using the Chi2 test and the I2 statistic. Results. Sixteen studies (n = 2,470 nerves), including original cadaveric data, were analyzed for the BL/RLN relationship. The RLN was most often located superficial to the BL with a pooled prevalence estimate of 78.2% of nerves, followed by deep to the BL in 14.8%. Twenty-three studies (n = 5,970 nerves) examined the RLN/TEG relationship. The RLN was located inside the TEG in 63.7% (95% CI: 55.3–77.7) of sides. Conclusions. Both the BL and TEG are landmarks that can help surgeons provide patients with complication-free procedures. Our analysis showed that the BL is a more consistent anatomical landmark than the TEG, but it is necessary to use both to prevent iatrogenic RLN injuries during thyroidectomies.

Anatomy and clinical significance of the maxillary nerve: a literature review

BACKGROUND The aim of this paper was to summarise the anatomical knowledge on the subject of the maxillary nerve and its branches, and to show the clinical usefulness of such information in producing anaesthesia in the region of the maxilla. MATERIALS AND METHODS A literature search was performed in Pubmed, Scopus, Web of Science and Google Scholar databases, including studies published up to June 2014, with no lower data limit. RESULTS The maxillary nerve (V2) is the middle sized branch of the trigeminal nerve - the largest of the cranial nerves. The V2 is a purely sensory nerve supplying the maxillary teeth and gingiva, the adjoining part of the cheek, hard and soft palate mucosa, pharynx, nose, dura mater, skin of temple, face, lower eyelid and conjunctiva, upper lip, labial glands, oral mucosa, mucosa of the maxillary sinus, as well as the mobile part of the nasal septum. The branches of the maxillary nerve can be divided into four groups depending on the place of origin i.e. in the cranium, in the sphenopalatine fossa, in the infraorbital canal, and on the face. CONCLUSIONS This review summarises the data on the anatomy and variations of the maxillary nerve and its branches. A thorough understanding of the anatomy will allow for careful planning and execution of anaesthesiological and surgical procedures involving the maxillary nerve and its branches.