Browsing by Author "Yesensky, Jessica"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Facial Nerve Sacrifice During Parotidectomy for Metastatic Cutaneous Squamous Cell Carcinoma
    (Sage, 2021-02-25) Yesensky, Jessica; Solis, Roberto N.; Bewley, Arnaud; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Objective: We analyzed the incidence of facial nerve sacrifice during parotidectomy for metastatic cutaneous squamous cell carcinoma (CSCC). Study design: We retrospectively reviewed the charts of patients with cutaneous squamous cell carcinoma. Setting: We used our CSCC institutional database, which includes patients treated at the University of California-Davis from 2001 to 2018. Methods: We evaluated patients who presented with biopsy-proven head and neck CSCC who underwent parotidectomy as a part of surgical treatment. We assessed the frequency of facial nerve sacrifice required in patients with normal preoperative facial nerve function with metastatic disease to the parotid. We evaluated the association between sacrifice and high-risk tumor variables using multivariate analysis. Results: We identified 53 patients with parotid metastasis and normal preoperative facial nerve function. Thirteen percent of patients required sacrifice of the main trunk of the facial nerve and 27% required sacrifice of a branch of the facial nerve. All patients who underwent facial nerve sacrifice had extracapsular spread (ECS). Perineural invasion (PNI) in the primary tumor (odds ratio [OR], 9.11; P = .041) and location of metastasis within the parotid body (OR, 6.6; P = .044) were independently associated with facial nerve sacrifice. Conclusion: Patients with regionally metastatic CSCC to the parotid gland frequently require sacrifice of all or a component of the facial nerve despite normal preoperative function. The likelihood of nerve sacrifice is highest for tumors with PNI and metastatic disease within the body of the parotid.
  • Thumbnail Image
    Item
    Isolated Kaposi sarcoma of the upper aerodigestive tract in immunocompetent individuals, an underrecognized entity with favorable prognosis
    (Sage, 2022-09-15) Shabaan, Abdelrahman; Alkashash, Ahmad; Hou, Tieying; Saeed, Omer; Yesensky, Jessica; Roshal, Anna; Mesa, Hector; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Kaposi sarcoma (KS) is a rare vascular neoplasm that most commonly arises in the setting of immunosuppression, in areas with high prevalence of Human Herpesvirus-8 infection, and when both situations coexist. Most cases affect the skin, isolated involvement of the upper respiratory tract without skin involvement is extremely rare with only a few cases reported in the literature. We present a case of isolated nasopharyngeal KS in an immunocompetent patient who achieved remission after multimodality therapy. Recent advances in KS-therapy are discussed.
  • Thumbnail Image
    Item
    Reconstructive options following orbital exenteration
    (Wolters Kluwer, 2020-10) Yesensky, Jessica; Lebo, Nicole; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Purpose of review The purpose of this review is to examine current trends in reconstruction following orbital exenteration. Defects ranging from isolated exenteration to more complex midface resections are explored. Recent findings Goals of reconstruction include separating the sino-orbital cavities and creating a safe, stable wound that can withstand adjuvant radiation. When planning for orbital rehabilitation, it is important to create a concave cavity that can accommodate a prosthesis. This is primarily achieved through secondary granulation or split-thickness skin grafts. Recently, the use of dermal allografts has been investigated and shown good success with epithelization of the orbital cavity. For complex orbitomaxillectomy defects, musculocutaneous free tissue flaps remain the mainstay for reconstruction. Summary Reconstructive options following orbital exenteration are based on extent of the defect, need for postoperative radiation, and plans for orbital rehabilitation with prosthesis.