ABSTRACT
Sentinel lymph node biopsy (SLNB) for staging oral squamous cell carcinoma (OSCC) patients presenting with early (T1 and T2 N0) disease in preference to elective neck dissection (END) remains controversial worldwide. A retrospective analysis of 145 patients who underwent sentinel lymph node biopsy for a previously untreated early oral cancer between 2010 and 2020 was performed. The primary outcome measures were predictors of occult metastases, accuracy of SLNB and disease specific plus overall survival. The negative predictive value, the false negative rate, and sensitivity for SLNB were 97%, 7.8%, and 92%, respectively. Depth of invasion (DOI) was a significant predictor of N status, overall survival, and disease specific survival. There was a significant difference in the incidence of the neck node metastasis in patients with DOI <5mm compared to those with DOI >5mm. For tumours >5mm there was a moderate to good correlation between radiological depth on contrast enhanced computed tomography (CECT) and histopathological DOI. Preoperative estimation of DOI may be a useful tool in the counselling of patients in the selection of either SLNB or END for N staging purposes in early OSCC.
Subject(s)
Carcinoma, Squamous Cell , Mouth Neoplasms , Carcinoma, Squamous Cell/diagnostic imaging , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/surgery , Humans , Lymph Nodes/pathology , Mouth Neoplasms/diagnostic imaging , Mouth Neoplasms/pathology , Mouth Neoplasms/surgery , Neoplasm Staging , Patient Selection , Retrospective Studies , Sentinel Lymph Node BiopsyABSTRACT
Head and neck necrotising soft-tissue infection is exceptionally uncommon in the paediatric population. necrotising soft-tissue infection is severe and often life-threatening. Rapid spread of infection and systemic illness make necrotising soft-tissue infection a challenge for the medical and surgical teams. Early identification and surgical intervention are essential for a favourable patient outcome. This report details the case of periorbital necrotising soft-tissue infection in a 12-year-old male patient following an uncomplicated facial laceration. Prompt surgical debridement with planned return visits to theatre and guided empirical antibiotic therapy ensured that a satisfactory patient outcome was achieved. The failure of current necrotising soft-tissue infection diagnostic scoring tools to be positive in this case may suggest that these tools require refinement and validation.