ICAR: endoscopic skull‐base surgery

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International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Multiple oral cancer development—Clinico‐pathological features in the Hong Kong population

Background: Multiple squamous cell carcinoma (SCC) development within the oral cavity is an important consequence of mucosal field cancerization. We have previously profiled contemporaneous demographics and confirmed a rising incidence of oral cancer within the Hong Kong population. In this further study, we sought to characterize the presenting clinico-pathological features and clinical outcome consequent upon multiple primary tumour (PT) development. Methods: Having accessed the Hong Kong Hospital Authority (HA) database to identify new cases of oral SCC diagnosed during an 18-year period (November 1999 to October 2018), specific clinico-pathological data were retrieved for patients who developed multiple oral SCCs during the study period. Results: Out of 6706 identified SCC cases, 769 patients (11.5%) developed multiple PTs, most commonly 2 (663) but 3 (91), 4 (12), 5 (2) and 6 (1) were also observed. The male to female ratio was 2.25 to 1 (P =.004), with female patients significantly older at first tumour presentation (P =.002), demonstrating longer periods before second PT development (P =.001) and better long-term survival than males (P =.001). Buccal mucosa (143), oropharynx (134) and tongue (112) were the sites most frequently affected by second tumours. Whilst buccal SCC showed a propensity for subsequent buccal tumour development (60), oropharynx primaries developed second PTs most frequently on the tonsil (28) and tongue (27). Tongue primaries were associated with second PTs on the floor of mouth (61) and oropharynx (57). Conclusion: Development of multiple oral cancers is a significant risk in Hong Kong, particularly for male patients. Following initial tumour management, regular and careful patient follow-up is important for early recognition of multiple SCC development