TIVAPs provide safe and reliable vascular access for patients on chemotherapy but require utmost care by a dedicated team of trained medical professionals and paramedics experienced with the use of such ports, in order to minimize the complications and their continued use while administering treatment.

Carotid body tumour (CBT) is one of the most common jugular paraganglioma involving the carotid body chemoreceptors. We report the case of a 22 year young man who presented with complain of large painless progressive swelling in right upper neck for 3 years duration. On examination, swelling appeared pulsatile and arising from carotid vessel. MRI Neck and MRA performed revealed large well defined hypervascular mass lesion encasing right common carotid artery, its bifurcation and ECA, with feeders from ECA. Patient was undertaken for surgical excision (Shamblin Grade-III) through exposure in neck, extended by midline sternotomy and mandibulotomy approach, tumour was completely dissected. Patient recovered well from surgery without any sequale. HPE revealed CB paraganglioma. At two years follow up, he is recurrence free. The surgical removal of CBT has a good result.

India has a huge burden of head and neck cancer and specifically oral cancer. Supportive oral care is not a standard of care in our population and is often neglected. Currently, there are no specific guidelines for such care in India which could be followed. The aim of this study is to validate a novel institutional supportive oral care protocol (SOCP) for head and neck cancer patients. This protocol is specific to our population developed for head and neck/dental oncology experts working in cancer centres to provide comprehensive care. This is a cross-sectional validity study. Fifteen dental oncology experts working in cancer centres/hospitals across India and six oncology experts from our centre were enrolled. All experts provided their inputs on 41 points of the SOCP. The data was analysed for item validity, content validity index and inter-rater agreement. The statistical analyses used were kappa measure for inter-rater agreement and content validity index for item-wise agreement. Out of 861 responses from all the reviewers, 91% agreed, 8.4% agreed with modification and 0.6% disagreed. The content validity index and agreement between reviewers ranged from 0.9 to 1 for kappa measure. The SOCP of our institution was shown to be a valid protocol. SOCP addresses oral and dental supportive care and rehabilitation as part of overall comprehensive care for head and neck cancer patients in our population.

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