Orbital apex syndrome affecting head and neck cancer patients : a case series

Orbital apex syndrome (OAS) is a complex and uncommon disorder that typically damages multiple cranial nerves in association with optic nerve dysfunction. OAS is associated with several different pathologies, however; only a few cases have been reported in association with head and neck cancer (HNC) so far. A case series of HNC patients diagnosed with OAS is described including clinicopathological data, image findings, and disease outcome. Ptosis and diplopia were diagnosed in four male patients with mean age of 61.2 years who were undergoing treatment for late-stage carcinomas of the tongue, larynx, and nasopharynx, eventually leading to the diagnosis of OAS. The mean overall survival rate after the diagnosis of OAS was 9.5 months. The current study reinforces evidence that OAS indicates poor prognosis and highlights the importance of early diagnosis

Current knowledge regarding medication-related osteonecrosis of the jaw among different health professionals

Purpose To assess the current knowledge regarding medication-related osteonecrosis of the jaw (MRONJ); the adverse effects of anti-resorptive (AR) and anti-angiogenic (AA) drugs; strategies for MRONJ prevention and treatment; and perception of the dentist’s role in assisting patients who use these drugs among physicians, dentists, and nurses. Methods Using questionnaires, the current knowledge of MRONJ was assessed among dentists, physicians, and nurses, who were divided into group I, which included specialties that directly assist cancer patients, and group II, which included other specialties. The questionnaires assessed the characteristics of the health professionals, training time, and specialties; their knowledge of AR and AA drugs; and their knowledge of MRONJ. Results A total of 1370 health professionals participated in the study, including 1032 dentists, 239 physicians, and 99 nurses. Among dentists and physicians, the training time (p = 0.036 and p < 0.001, respectively) and specialization in group I domains (p < 0.001 and p < 0.001, respectively) had a significant impact on MRONJ knowledge, while nurses showed no significant impact regardless of the training time and specialty. Less than 10% of the physicians and dentists could correlate the signs and symptoms of all stages of MRONJ. Conclusion The findings indicated a notable lack of knowledge regarding MRONJ among dental surgeons and physicians, and especially among nurses. More experienced professionals and specialists in the areas that assist cancer patients usually have a greater understanding of the dentist’s role in MRONJ prevention, diagnosis, treatment, and patient care and will introduce or are already using AR and AA drugs