BackgroundThis study aims to evaluate and analyze the clinical features and outcomes of oral and oropharyngeal squamous cell carcinoma (SCC) in patients < 45-years old in our center.Material and MethodsA retrospective analysis was conducted using the records of patients diagnosed with oral and oropharyngeal SCC between 1998 and 2011 in the University Hospital of Granada (Spain). The analysis identified 33 patients with oral and oropharyngeal SCC with an age of <45 years. Moreover, during the years studied, a further 472 patients were diagnosed with oral and oropharyngeal SCC in our center. Thus, 100 SCC patients with an age of >45 years were randomly selected from the same database. A retrospective analysis was conducted to determine specific features including sites of occurrence, risk factors, sex distribution, socio-economic status, T stage at diagnosis, nodal involvement, degree of tumor differentiation, locoregional failure and overall survival at 5 years was. Further, the results of both groups were compared.ResultsThe male-female ratio was 1.2:1 in the group of young adults and 2.03:1 in the group of patients with an age of >45 years. No significant differences were found in terms of site, nodal involvement, locoregional failure, and overall survival. However, there were statistically significant differences between the two groups in terms of features such as risk factors, socio-economic status, T stage at diagnosis, and degree of tumor differentiation. The overall 5-year survival rate was 62% for patients >45 years old, whilst for the group of young adults this rate was 48.4% (p= 0.17).ConclusionsThe poor association between the common risk factors and oral and oropharyngeal cancers in young adults suggests that other pathogenic mechanisms should be investigated. For young patients, the data show evidence of poorer outcomes in terms of overall survival (p=0.17), and locoregional failure (p=0.23). Nevertheless, the literature shows that the results in this field are particularly inconsistent, and further research is therefore needed to provide more in-depth knowledge of the disease in this age group. Key words:Oral and oropharyngeal squamous cell carcinoma, young adults, poor prognosis,risk factors.

BackgroundTapia’s syndrome is an uncommon disease described in 1904 by Antonio Garcia Tapia, a Spanish otolaryngologist. It is characterized by concomitant paralysis of the hypoglossal (XIIth) and pneumogastric (Xth) nerves. Only 69 cases have been described in the literature. Typically, the reported patients presented with a history of orotracheal intubation. Common symptoms are dysphonia, tongue deviation toward the affected side, lingual motility disturbance, and swallowing difficulty.Case presentationIn the report, we describe three cases of Tapia’s syndrome in three Caucasian patients who underwent surgery with general anesthesia. Two of these patients underwent neck abscess drainage, and the third had an open reduction of a shoulder fracture. The clinical symptoms of Tapia’s syndrome appeared after extubation. All three of our patients recovered their lost function at 3 months after diagnosis.ConclusionsWe underline the importance of performing airway endoscopy and a specific program of swallowing rehabilitation for the proper management of Tapia’s syndrome.

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The main aim of the present report is to study the pattern of distribution of cervical metastasis in buccal mucosa cancer and to discuss the various therapeutic options available. Fifty-three patients with squamous cell carcinoma of the buccal mucosa treated with tumorectomy and selective neck dissection were included in the study. We also studied the relationship between specific pathological features and overall survival. Level Ib was the most affected level, followed by level IIa. T stage, N stage, N involvement tumor thickness, extracapsular spread (ECS), and vascular invasion were associated with poorer outcomes regarding overall survival ( p < 0.001). Carcinoma of the buccal mucosa should be treated aggressively from the early stages. A large tumorectomy of the primary tumor is required to reduce the number of local recurrences. Moreover, we recommend performing a supraomohyoid neck dissection even in cT1N0 if there is a suspicion that the tumor thickness may be greater than 0.4 cm. The high risk of local recurrence obliges protection of the neck from a future cervical recurrence even in T1 small tumors. This could reduce the risk of cervical involvement during the follow-up and improve overall survival rates.

Reconstruction of head and neck defects following oncological ablative surgery represents a considerable challenge for reconstructive surgeons. Common reconstruction options are the fibula, iliac crest, tip scapular and lateral scapula border free flap. The vascularized iliac crest free flap was first described by Taylor et al. in 1979 and it has been widely used for the reconstruction of composite head and neck defects. This flap guarantees excellent functional and aesthetic outcomes in the reconstruction of posterior segmental mandible defects. For the reconstruction of maxillary defects, it is important to note that the iliac crest bone shape usually allows for an adequate reconstruction without the need to conduct any osteotomies, and this substantially facilitates the flap inset. Thus, the iliac crest free flap offers a valuable reconstructive alternative that should be part of the armamentarium of all head and neck reconstructive surgeons. When this option is well indicated, the success rate, as well as functional and aesthetic outcomes, are comparable to other flaps used for reconstructing the maxillofacial area. The main aim of the present report is to analyze the importance of the DCIA flap for the reconstruction of complex defects of the maxillofacial region and to present possible applications, suggestions, and pitfalls associated with this technique.