No abstract

One way of early diagnosis of cancer is by detecting the biomarkers that get introduced into easily accessible body fluids. We report the development of portable and rapid electronic biosensors for quantitative detection of two secretive cancer biomarkers–Carcinoembryonic antigen (CEA) and Cytokeratin fragment 19 (CYFRA 21-1). The reduced graphene oxide (rGO)/ melamine (MEL)/antibodies/ bovine serum albumin (BSA) based devices were tested for 1 pg/mL to 800 ng/mL of CEA and CYFRA 21-1. The responses of the sensors ranged from 7.14 to 59.1% and from 6.18 to 64% for 1 pg/mL to 800 ng/mL CEA and CYFRA 21-1 respectively. A read-out circuit was assembled to develop a portable prototype which was used to assess the concentrations of the two antigens present in saliva samples of 14 subjects. The prototype could accurately discriminate between 9 oral squamous cell carcinoma patients and 5 healthy controls.

The neck dissection has remained a pivotal aspect of head and neck cancer management for over a century. During this time its role has expanded from a purely therapeutic option to an elective setting. Since vital anatomical structures are close, certain risks and complications are inherent to this procedure. Since neck surgery remains the most frequently performed form of therapeutic surgery in head and neck cancer irrespective of primary disease site, our objective is to report the complications in various types neck dissections and to seek improved outcome. A cross sectional retrospective study of 52 patients who underwent neck dissection from August 2015 to August 2019 was conducted to analyse intra operative and post-operative complications which aroused due to neck dissection. Indications for neck dissection depended on neck staging (N): selective neck dissection was done when evident disease was absent; Modified radical neck dissection was done if there was clinically evident neck node, preserving non-lymphatic neck structures (accessory nerve, internal jugular vein and internal jugular vein) as long as surgical completeness was not compromised. Bilateral neck dissection was indicated if contralateral disease was suspected or present. Out of 52 patients, one radical neck dissection, 14 modified radical and 37 selective neck dissection, of which 32 underwent supra omohyoid neck dissection and 5 underwent anterolateral and posterolateral neck dissection. The most frequent complication was marginal mandibular nerve injury (5.5%), followed by accessory nerve injury (2.1%). There was one death. A careful preoperative assessment of the patient, meticulous surgical techniques, good-quality postoperative care and appropriate rehabilitation are the cornerstones of preventing and managing complications of neck dissection.

Pectoralis major myocutaneous (PMMC) flap is versatile flap used for reconstruction of various head and neck defects created after excision of tumors. Due to the rapid advancement of reconstructive microsurgery, micro vascularised free flap transfer is becoming the main method of head and neck reconstruction. Presently PMMC flap reconstruction is used as an option for salvage surgery post free flap transfer failure and also in patients who are poor candidates for free flap transfer. However in developing countries like India where there are limited resources and the patient's presents in advanced stage of the disease PMMC flap is a viable option for reconstruction. Aim is to study the outcome of PMMC flap reconstruction in head and neck malignancy. A prospective analysis was done with 20 patients who underwent wide local excision with marginal or hemi mandibulectomy with PMMC flap reconstruction and neck dissection from January 2017 to January 2019 in tertiary care center. Follow up was done for every 2 weeks for first 2 months, then every month for a period of 6 months. Out of all the patients who underwent PMMC flap reconstruction, 2 patients developed partial flap necrosis, 1 had wound dehiscence and fistula and 1 patient had local recurrence. For remaining patients no complications were noted in the follow up period.

Background: Carcinoma larynx is one among the most common head and neck malignancy which accounts for 2% of all cancers whereas hypopharyngeal cancer is one of the most aggressive tumor with poorer prognosis. Total laryngectomy/laryngopharyngectomy (TL/TLP) is the treatment of choice for locally advanced laryngeal and hypopharyngeal cancers. Objectives: To study the complications associated with primary TL/TLP along with the sociodemographic profile and clinicopathologic features of laryngeal and hypopharyngeal cancers. We also aimed to assess the risk factors associated with complications. Methods: All stage III or IVA laryngeal and hypopharyngeal malignancy cases as per American Joint Committee on Cancer (AJCC) 8 th edition staging, who underwent primary total laryngectomy/total laryngopharyngectomy during the year 2018-2019 in our institute, KIMS Hubli, have been studied. Sociodemographic profile and clinicopathological features were noted. These patients were followed up for 6 months for any local complications. Results: Mean age of the study population was 58 years with male predominance. Primary glottic carcinoma was most common. Most common presenting symptom was change in voice and most common anatomical site involved was true cords. Overall complication rate was 32%. Most common complication encountered was wound infection and pharyngocutaneous fistula (8% each). As complications set in length of hospital stay increases. We found significant association with PCF and length of hospital stay. Conclusion: With proper case selection, and regular wound care, complications can be avoided in case of TL/TLP. Once complications set in, it increases hospital stay and the expenditure, hence is traumatizing to the patient and hence should be avoided.