HEAD AND NECK

Background: It can be difficult for head and neck cancer patients and their families to fully understand the impact that cancer procedures and treatments can have on a cancer patient’s life. Procedures used to treat head and neck cancer may result in significant changes to the patients’ physical appearance and/or functional abilities (talking, eating, and breathing). Lack of understanding as it relates to the effects of cancer treatments can have a significant impact on the patient’s post-operative success.

In an effort to help educate head and neck cancer patients and their families during this difficult time, the UIC department of Otolaryngology-HNS has created an informational website. The website educates cancer patients and their families regarding various cancer treatments and therapies.

Objectives: of this research are to evaluate 1) the change in subject knowledge before and after using the study head and neck cancer website, and 2) to determine whether a head and neck website is beneficial to study subjects in providing information that will result in improved compliance and ultimately long-term outcomes.

Background: The Medrobotics Flex Robotic System is an operator controlled computer assisted flexible endoscope commonly used for trans-oral surgical (TORS) procedures. The robotic device gives physicians the ability to easily visualize, access, and manipulate tissues and structures within the oropharynx, hypopharynx, and larynx remotely. As this is a new technology, it is important to collect and evaluate information on the various uses and outcomes of the device. Data gathered from the study will be shared with producers and users of the Medrobotics Flex Robotic System. This is the first multi-centered database created for the collection and analysis of patients who have undergone procedures using the Medrobotics Flex Robotic System.

Objectives: The specific aims of this project are to: 1) Collect data and evaluate the effectiveness of using the Medrobotics Flex Robotic System for specific surgical cases and 2) Use the data to improve surgical outcomes, assess patient safety, evaluate potential quality of life issues, and to increase the availability of information on the benefits and limitations of the robotic system for treating cancers of the upper airway.

Background: Photoimmunotherapy (PIT) is a new cancer-targeted therapy. PIT is a combination drug and device anti-cancer treatment that utilizes monoclonal antibodies conjugated to a dye, that can be activated upon nonthermal 690 nm red light illumination to induce rapid cell death only at cells expressing the antigen and only after antibody binding to the cellular antigen. The requirement of light-induced activation and antigen-antibody binding to induce cell death enables the selective and specific destruction of tumor cells with minimum damage to healthy tissue surrounding the tumor cells.

PIT requires two treatment steps in sequence: (i) the administration of the experimental drug by infusion and (ii) the illumination of the tumor with 690 nm nonthermal red light using sufficient energy to induce cell death. Light illumination is administered 24 ± 4 hours post-ASP-1929 infusion. The lag is intended to enable drug distribution within the tumor prior to drug activation by the application of light.

The experimental drug therapy targets epidermal growth factor receptor (EGFR) antigens. EGFR is highly expressed in squamous cell carcinomas of the head and neck.

Objectives: This global, multi-centered trial evaluates the efficacy and safety of PIT as monotherapy for the treatment of locoregional, recurrent HNSCC in patients who have failed or progressed on or after 2 lines of therapy.

Background: Delayed or poor post-operative wound healing accounts for the majority of complications associated with major head and neck surgery. These complications lead to increased length of hospital stay, increased hospital costs, and delayed adjuvant treatment such as radiation and chemotherapy.

The head and neck cancer population is especially vulnerable to malnutrition; many of these patients experience dysphagia and odynophagia as cancer related symptoms due to the location of the primary tumor. Even in the absence of these symptoms, patients may have occult sarcopenia, which can be a predisposition to delayed wound healing after surgery.

IMPACT is an immune-based nutritional supplement containing arginine and omega 3 fatty acids. The IMPACT supplement has shown to decrease the incidence of infection, mortality, ventilator days, and length of ICU and hospital stay in critically ill patients.

Objectives: The purpose of this study is to determine whether nutritional optimization in head and neck cancer patients undergoing major surgery will decrease post-operative wound complications. It is likely that many head and neck cancer patients suffer from sarcopenia, and this contributes to many wound complications, including wound infection, dehiscence, fistula formation, and free flap tissue loss. We hypothesize that nutritional supplementation with Nestle Impact AR will decrease the rate of wound complications after surgery.

Background: Widespread antibiotic usage has led to an increase in antibiotic resistant bacteria and an increase in allergies to antibiotics. Penicillin antibiotics have been the gold standard for head and neck surgical prophylaxis, but unfortunately, more and more patients have developed allergies to this antibiotic.

Currently, surgical antibiotic prophylaxis for head and neck cancer patients varies from institution to institution, as well as between surgeons of the same institution. To date, no one antibiotic regimen has been found to be superior for treating head and neck cancer patients with penicillin allergies.

Objectives: The purpose of this retrospective research is to evaluate the prophylactic surgical antibiotic regimens used for head and neck cancer resections: specifically in those patients with penicillin allergies. The study will evaluate which antibiotic regimen, if any, provides the lowest rates of post-operative surgical site infections. We hypothesize that subjects with penicillin antibiotic allergies have a higher rate of post-operative surgical site infections after head and neck cancer resections than patients without this allergy.

Background: It is the standard of care in head and neck oncology practice to collect information pertaining to patient quality of life, voice, and swallowing function as part of a comprehensive initial examination, as well as in subsequent follow up visits following definitive treatment for surveillance.

In this study, the researchers collect both retrospective and prospective data to evaluate factors associated with outcomes, quality of life, as well as voice and swallowing function in the management of patients with head and neck carcinoma. Data is review to identify factors associated with poor functional outcomes before and after treatment with the goal of adding to the body of knowledge regarding this devastating disease.

Objectives: 1) Determine clinical outcomes and identify factors associated with outcome, quality of life, and voice and swallowing function in the management of patients with head and neck carcinoma. 2) Determine if pre-treatment voice and swallow exercises continued during treatment and one year after treatment improve patient outcomes and quality of life related to voice, speech and swallow. 3) Evaluate the effectiveness of treatment paradigms used based on multiple criteria to provide evidence that either supports, or suggests modification, of currently used treatment paradigms.

Background: Patients who have undergone head and neck cancer treatment, often develop post-treatment associated muscle damage. The resulting muscle damage has a long lasting effect on range of motion (ROM) and swallow dysfunction. This is a common early and late sequela following either surgery-based or radiation-based therapy for head and neck cancer (HNC). The treatment related toxicity is strongly correlated with reduced quality of life.

Myofascial release (MFR) therapy is an accepted treatment modality by physical therapists and speech language pathologists used to 1) reduce symptoms of hypertonicity, and 2) improve ROM after an injury. Following injury, muscle and surrounding tissues, including fascial tissue overlying the muscle, may contract and tighten as a part of the healing process. This tightening of the muscle and fascial tissues often results in muscle tightness, a decrease in ROM, and pain during activity. MFR is a form of deep tissue massage used to soften, stretch, and “release” areas of tightness (trigger points) in the myofascial region.

Objectives: The purpose of this prospective pilot study is to evaluate the use of myofascial release techniques on the muscles of the head and neck following surgery and/or radiation treatment for head and neck cancer.

Background: Venous thromboembolism (VTE) is a disease process characterized by blood clot formation in the deep veins of the lower extremities, known as deep vein thrombosis. In some, a blood clot may dislodge and travel into the vessels of the lungs causing a pulmonary embolism (PE). The incidence of this disease is increased by factors that 1) cause damage to blood vessels, 2) decrease blood circulation, and 3) increase thickness of the blood.

Head and neck cancer patients who undergo surgical procedures requiring extensive tissue removal and reconstruction are prone to VTE risk factors and appear to have a higher incidence of venous thromboembolism than other surgical patient populations. The incidence of VTE in head and neck cancer patients undergoing cancer resection followed by reconstructive procedures, including microvascular anastomosis, is shown to be as high as 5.8 %. This is in accordance with the investigators' observations in their own clinical practice of head and neck cancer patients that undergo resection with microvascular reconstruction.

Objectives: The purpose of this study is to compare the incidence of VTE and PE in UIC head and neck cancer patients who 1) did not have a reconstruction procedure following cancer resection and 2) those that did have a reconstruction procedure following cancer resection. We hypothesize that the incidence of VTE will be higher in patients that underwent resection and microvascular free tissue transfer reconstruction than in head and neck cancer patients who did not undergone this type of reconstruction. Further, we hypothesize that the Caprini scores of the patients that developed VTE will be higher than those that did not.