Otolaryngology (ENT)

Oral and dental complications after head and neck cancer: umbrella review finds fragmented, low-confidence evidence

Head and neck cancer survivors commonly experience oral mucositis, xerostomia, dysphagia, trismus, dental caries, and dysgeusia. The umbrella review included 131 systematic reviews, most rated low or critically low confidence using AMSTAR-2. Photobiomodulation reduced oral mucositis in reviewed studies and IMRT was associated with less xerostomia and mandibular osteoradionecrosis. Overall, preventive and therapeutic interventions are widely reported but supported mainly by low-quality heterogeneous evidence. 1

OPHL II commonly results in post‑operative OSA; CT measurements correlate with severity

In this prospective pilot of 10 OPHL II patients evaluated ≥1 year postoperatively, OSA was present in all patients (40% mild, 30% moderate, 30% severe). Mean AHI was 25.5 ± 18.9 events/hour and AHI strongly correlated with OSA severity (rho 0.94). CT-derived SVTV correlated positively with OSA severity (rho 0.82) while BTCB correlated negatively (rho -0.71). Findings suggest routine postoperative sleep assessment and consideration of radiologic measures to guide multidisciplinary management, pending larger validation. 2

Community health worker–led patient education increases precision medicine knowledge and uptake

In a randomized trial of 110 low-income, racially diverse oncology patients, adding a 12-month CHW-led education component increased precision medicine knowledge versus control (mean difference 4.17, 95% CI 2.33–7.48; p<0.001). The intervention also improved patient activation and satisfaction and reduced emergency visits and hospitalizations. Intervention participants had greater receipt of molecular testing and targeted therapy compared with clinician-payer only efforts. Multilevel programs that include patient-facing education may close gaps in precision-oncology delivery in community settings. 3