Head and neck cancer patients are at high risk of developing dysphagia from undergoing cancer treatment. It is essential for medical and dental practitioners to recognize speech-language pathologists' role and dysphagia symptoms to provide a timely referral to speech-language pathologists. This study aims to determine the level of awareness, knowledge, and involvement of medical and dental practitioners in dysphagia management. A total of 391 medical and dental practitioners from 22 government hospitals across Malaysia participated in this cross-sectional study. Participants completed the questionnaire specifically on the level of involvement, knowledge, awareness regarding the role of SLP and dysphagia symptoms. The results revealed a statistically significant relationship between the level of awareness of the role of SLP, χ 2 (4, 391) = 9.87, p = 0.043 and the level of involvement of medical and dental practitioners, χ 2 (8, 391) = 27.68, p = 0.001 and percentage of referring head and neck cancer patients. The odds of referring head and neck cancer patients for pre-treatment assessment increased three times for each one unit of the participation of medical and dental practitioners [OR] 3.65 (1.56, 8.51) p = 0.003 among those who are already highly involved in dysphagia management. These findings compel healthcare practitioners in head and neck cancer to revisit their collaborative practices. Head and neck cancer patients should receive swallowing management from speech-language pathologists to improve their swallowing function and avoid further complications such as dehydration, malnutrition, and death.
<p class="abstract">Carotid body tumour is a form of paraganglioma which arises from the carotid body. This tumour is known for its rich vascular supply mainly contributed by the ascending pharyngeal artery, a branch from external carotid artery. Surgical excision preceded by pre-operatic embolization remains the definitive treatment despite the countless feared complications. We present our experience with a case of carotid body tumour which was embolised prior to surgical excision, unfortunately complicated with a thromboembolic event. This patient was found to have an anatomical variation in the cerebrovascular anatomy known as a fetal posterior cerebral artery which led to a paradoxical PCA infarction post-embolization. We would like to highlight this rare presentation along with its management as there were scarce evidence of this case in the literature.</p>
The incidence of radiation-induced sarcoma (RIS) in head and neck region is increasing in trend nowadays. There are few cases have been reported. However, the exact aetiology of radiation-induced sarcoma (RIS) is still unknown. We report two cases of radiation-induced sarcoma (RIS) which the primary malignancy were basal cell carcinoma of the cheek and nasopharyngeal carcinoma. These patients had received a total of 70Gy and 65Gy radiotherapy for 13 years and 6 years back respectively. Histopathological examinations for both of these patients revealed a spindle cell sarcoma and a high-grade sarcoma respectively. Both cases were inoperable in view of advanced disease at presentation. We will discuss on the clinical findings, histopathological findings and the main characteristic of radiation-induced sarcoma (RIS) in imaging. The dilemma of managing radiation induce sarcoma in head and neck patient will also be discussed as managing previously radiated head and neck primary is undeniable challenging
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