Head and neck cancers, Version 2.2014. Clinical practice guidelines in oncology.

This selection from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Head and Neck Cancers focuses on glottic laryngeal cancer, which is the most common type of laryngeal cancer and has an excellent cure rate. The lymphatic drainage of the glottis is sparse, and early stage primaries rarely spread to regional nodes. Because hoarseness is an early symptom, most glottic laryngeal cancer is early stage at diagnosis. Updates to these guidelines for 2014 include revisions to "Principles of Radiation Therapy" for each site and "Principles of Surgery," and the addition of a new section on "Principles of Dental Evaluation and Management."

Impact of palatal prosthodontic intervention on communication performance of patients' maxillectomy defects: a multilevel outcome study.

BACKGROUND: Obturators have been developed for surgical defects caused by cancer of the maxillary sinus and alveolar ridge. Outcome research is necessary to develop evidence-based practice guidelines. METHODS: Thirty-two consecutively treated maxillectomy patients seen in the Facial Prosthetics Clinic at UNMC from 1994 through 1996 had their defects obturated for 1 month when speech intelligibility, speaking rate, nasality, and communication effectiveness were measured. RESULTS: With the obturator removed, mean speech intelligibility was 61%, speaking rate was 138 words per minute, and nasality was rated as 5.8 on a 0-7 point scale. With the obturator inserted, mean speech intelligibility was 94%, speaking rate was 164 words per minute, and nasality was rated as 1.6. The mean self-perception of communication effectiveness was 75% of what it was before the diagnosis of cancer. CONCLUSIONS: Obturation is an effective intervention for defects of the maxillary sinus and alveolar ridge on speech performance. Variations in effectiveness were noted based on site of defect and patient satisfaction with the intervention.