Objective To introduce the experience of the cl inical appl ication of vertical trapezius myocutaneous flap in repairing soft tissue defects after head and neck tumor resection. Methods Between June 2008 and February 2010, 12 cases of soft tissue defect caused by head and neck tumor resection were repaired with vertical trapezius myocutaneous flap.There were 9 males and 3 females with an age range from 32 to 76 years (median, 54 years). Twelve cases including 2 cases of basal cell carcinoma of orbital skin, 2 cases of squamous cell carcinoma of the parotid gland, 2 cases of submandibular gland mal ignant mixed tumor, 2 cases of metastatic lymph nodes of nasopharyngea carcinoma after radiotherapy, 1 case of squamous cell carcinoma of tongue, and 3 cases of squamous cell carcinoma of occipital skin, and all were classified as TNM stages T3 or T4. The area of soft tissue defect ranged from 13 cm × 6 cm to 25 cm × 13 cm. The vertical trapezius myocutaneous flap ranged from 14 cm × 7 cm to 26 cm × 14 cm and was transfered to repair defect tissue in the homolateral wounds after tumor resection and neck dissection homochronously. The donor sites were sutured directly. Results All incisions healed primarily without infection. Eleven flaps survived except 1 flap with edge necrosis, which was cured after dressing change. Subcutaneous hematocele and effusion occurred in 2 cases on the back after tube was removed at 7 days postoperatively, and they were cured by sucted and pressured dressing. Eleven patients were followed up 1-3 years (mean, 2 years). Nine cases had no tumor recurrence and the flaps had statisfactory appearance; the abduction function of shoulder joint were normal. One case of orbit basal cell carcinoma occurred 3 months after operation and 1 case of nasopharyngeal carcinoma died of brain metastasis 12 months after operation. Conclusion It is an easy and simple therapy to repair head and neck soft tissue defect using the vertical trapezius myocutaneous flap, which can meet the needs of repairing tissue defect of head and neck.
ObjectiveTo systematically evaluate the composition spectrum of oral microbiota diversity in patients with head and neck tumors undergoing radiotherapy. MethodsComputer searches were conducted on CNKI, CBM, WanFang Data, PubMed, Embase, and Web of Science databases to collect cohort and control studies on changes in oral microbiota in patients with head and neck tumors after radiotherapy. The search period was from January 1, 2015 to June 1, 2025. Two researchers screened and evaluated literature, extracted data, and conducted meta-analysis using RevMan 5.4 software. ResultsA total of 25 studies were included, including 731 patients with head and neck tumors and 275 healthy controls. The meta-analysis results indicated that compared with the control group not exposed to radiotherapy, the detection rates of major oral opportunistic pathogens such as Candida albicans and Streptococcus mutans had significantly increased (OR=3.62, 95%CI 2.23 to 5.89, P<0.01). The Shannon index and Chao1 index for oral alpha diversity had decreased after radiotherapy (SMD=?0.78, 95%CI ?1.23 to 0.34, P<0.01; SMD=?0.64, 95%CI ?1.14 to ?0.15, P<0.001), and the differences were statistically significant. Qualitative analysis showed that after radiotherapy, the relative abundance of Firmicutes, Streptococcus, Lactobacillus, etc. in patients increased, while the relative abundance of Clostridium, Neisseria, etc. decreased. ConclusionThere are changes in the oral microbiota of patients with head and neck tumors after radiotherapy, mainly manifested as an increase in the detection rate of opportunistic pathogens, a decrease in alpha diversity, and an imbalance in the relative abundance of some bacterial phyla. This suggests that oral care should be taken seriously for radiotherapy patients.
Radiation-induced optic neuropathy (RION) is a severe complication of radiotherapy for head and neck tumors, characterized by painless, often irreversible visual decline after a long and highly variable latent period. Its incidence correlates with radiotherapy techniques and tumor types, with radiation dose constituting the principal risk factor. Advanced age and pre-existing vascular conditions can further elevate the risk of RION. The underlying pathology is thought to involve vascular injury, dysregulated molecular signaling, and impaired axoplasmic transport, although these mechanisms are not fully understood. Diagnosis in clinical practice remains largely exclusionary, based on patient history, imaging, and visual function testing. No specific cure exists, so management focuses on symptomatic relief and vision stabilization. Adherence to established safe radiation dose thresholds is the most effective strategy for reducing RION incidence. This review synthesizes clinical insights to summarize the epidemiology, risk factors, pathophysiology, diagnosis, and management of RION, discusses ongoing challenges in its prevention and treatment, and aims to inform more precise prevention and personalized therapeutic strategies.