John-Charles Hodge's research while affiliated with The Australian Society of Otolaryngology Head & Neck Surgery and other places

Publications (30)

Article
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Trans-oral robotic surgery for head and neck cancers can be performed using rigid, multi-port robots with linear access but the Medrobotics Flex® system offers an alternative as it is endo-luminal, single-port, and uses flexible instruments. To assess the utility of the Medrobotics Flex® system for head and neck cancer (HNC) resections. A retrospec...
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Objective: The objective of this review is to evaluate the accuracy of different imaging modalities in detecting extracapsular spread (ECS) of cervical lymph node metastases in human papillomavirus positive (HPV+) oropharyngeal squamous cell carcinoma (OPSCC). Introduction: Extracapsular spread of lymph node metastases is associated with poor pr...
Article
Study objectives: The Sleep Apnea Multilevel Surgery (SAMS) trial found that modified uvulopalatopharyngoplasty with tonsillectomy (if tonsils present) combined with radiofrequency tongue ablation reduced obstructive sleep apnea (OSA) severity and daytime sleepiness in moderate-severe OSA. This study aimed to investigate mechanisms of effect on Ap...
Article
Importance: Many adults with obstructive sleep apnea (OSA) use device treatments inadequately and remain untreated. Objective: To determine whether combined palatal and tongue surgery to enlarge or stabilize the upper airway is an effective treatment for patients with OSA when conventional device treatment failed. Design, setting, and participa...
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Full-text available
Background: Oropharyngeal squamous cell carcinoma (OPSCC) is often diagnosed at an advanced stage because the disease often causes minimal symptoms other than metastasis to neck lymph nodes. Better tools are required to assist with the early detection of OPSCC. MicroRNAs (miRNAs, miRs) are potential biomarkers for early head and neck squamous cell...
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Collapse of the resection plane presents a frustrating problem during transoral robotic resection, in a situation already typified by limited vision and access for instruments. We present a quick and cost-effective retraction technique to effectively mitigate this issue and increase the ease and reliability of robotic oropharyngeal resection. This...
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Full-text available
Transoral robotic surgery (TORS) has become an accepted treatment option for a variety of benign and malignant pathologies of the head and neck. The Medrobotics Flex® system is a novel single port platform available as an alternative tool to current multiport robotic technology. We present the Adelaide experience with this system thus far. The Medr...
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The advent of transoral robotic surgery (TORS) has allowed transoral approaches for parapharyngeal space (PPS) tumours to be re‐evaluated. It provides enhanced visualisation and instrument access for appropriate tumours. We describe a specific technique, TORS narrow‐field oropharyngectomy, that is ideal for benign PPS tumours which have been violat...
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Objective: Investigate the histological location and extent of perineural invasion (PNI) as prognostic factors. Design: Retrospective review of medical records and histological analysis of 116 patients with oral squamous cell carcinoma (OSCC). Setting: Two major public tertiary hospitals treating head and neck cancer, Royal Adelaide Hospital a...
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Objectives This study aimed to evaluate the effect of neck dissection on survival and complication rates in patients with no clinical or radiological evidence of cervical nodal disease (N 0 ) undergoing salvage laryngectomy. Methods A retrospective study was conducted of patients with squamous cell carcinoma of the larynx following primary radioth...
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Full-text available
Transoral robotic surgery (TORS) provides improved access to head and neck subsites resulting in well-validated functional and oncological outcomes, but access to and cost of robotic platforms can limit their use. Evidence suggests TORS is increasingly being adopted globally, but there is a paucity of data on the adoption and diffusion of TORS in A...
Article
Background Extracapsular spread (ECS) of lymph node metastases is associated with poor prognosis and is an indication for adjuvant chemoradiotherapy. Accurately identifying ECS using imaging may allow us to recommend primary chemoradiotherapy to avoid trimodality treatment. We investigated the accuracy of staging CT in diagnosing ECS in P16 + oroph...
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Secondary trache‐oesophageal puncture and fistula formation is often undertaken after laryngectomy to restore voice. The procedure was historically carried out under general anaesthesia (GA). This has been largely supplanted by local anaesthetic (LA) techniques as GA puts patients at a greater risk and the procedure is a more technically difficult...
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Background The role of panendoscopy in the modern investigation of head and neck cancer is changing with the development of improved radiological techniques, in-office biopsy capabilities and the low rate of synchronous primary tumours. This study aimed to review the indications for panendoscopy in the investigation of newly diagnosed head and neck...
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Objective To provide a summary of the current frailty literature relating to head and neck cancer. Data Sources Ovid MEDLINE, PubMed, Google Scholar. Methods A comprehensive review of the literature was performed from 2000 to 2017 using key words frailty, elderly, geriatric, surgery, otolaryngology, head and neck cancer. Results The aging popula...
Article
Lingual thyroglossal duct cysts are a rare and potentially difficult to manage tongue base lesion. We report a case of transoral robotic surgical excision of a lingual thyroglossal duct cyst, in an adult patient. A 68-year-old man presented with a large base of tongue mass, with appearance on ultrasound and computed tomography consistent with a lin...
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Background The incidence of oropharyngeal squamous cell carcinoma in the Western world is increasing, with the human papillomavirus epidemic implicated in this observed trend. The optimal treatment modality is yet undetermined regarding oncological outcomes. Methods This study comprised 98 patients with oropharyngeal squamous cell carcinoma, treat...
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Full-text available
Objective/review questions: The objective of this systematic review is to synthesize the best available evidence regarding the oncological and survival outcomes (as measured by disease control, disease-free survival, disease-specific survival and overall survival) of transoral robotic surgery (TORS) versus transoral laser microsurgery (TLM) in the...
Article
Full-text available
Objective: To evaluate the prevalence of variations in the anatomical route of the spinal accessory nerve from the base of the skull to the point where it enters the trapezius muscle. A case report is used to demonstrate an example of a rare but clinically important anatomical variant of this nerve. Methods: An independent review of the literature...
Article
A structured approach to Surgery for OSA has been clearly defined and accepted by the American Academy of Sleep Medicine. The aim of surgery is to address the collapsibility of structures of the upper airway. The da Vinci Robot (Intuitive Surgical, Sunnyvale, California, USA) has been validated and now approved by the Food and Drug Administration a...

Citations

... 28 This may reflect the recent findings that following CCT, tongue base volume did not significantly reduce though the position appeared to move superiorly. 42 ...
... Commonly, patients have obstructions of the airway at different levels and this derived to a trend towards multilevel surgery. Surgery treatment is unusual, due to the current controversial criteria that exist between specialists and the low success rate in OSA recoveries [88][89][90][91]. Importantly, surgical indication does not exclude other treatments, nor vice versa [89,90]. ...
... This study used a customized miRNA-array to assess 112 miRNAs. An 11 EV-miRNA signature differentiated HPV-associated OPSCCs from healthy controls and patients with GERD with 90% sensitivity and 79% specificity [121]. More recently, Shimada et al. focused on identifying discriminating markers for differential diagnosis of a primary lung squamous cell carcinoma vs. a solitary lung metastasis from previously resected head and neck squamous cell carcinoma. ...
... The median wait time of 45.5 days from referral to treatment initiation in this study is comparable to that presented in the local and international literature. In Australia, Flukes et al. [12] reported a median time of 61 days using the same timeframe definition, while Connell et al. [13] reported a mean time of 39.4 days from first ENT consultation to treatment initiation, which did not incorporate the time from referral to first consultation corresponding to the Australian guideline. International studies have largely reported the timeframe from histopathological diagnosis to treatment initiation, without reporting timing of referral or first specialist appointment. ...
... The advantages of endoscopically assisted approaches include the lack of any need for an external incision (eliminating scarring), a short hospital stay, minimal blood loss, and little postoperative pain. Recently, transoral robotic surgery (TORS) has been used for transoral removal of selected PPS schwannomas ( Fig. 1) [47]. Some authors are developing new surgical corridors to the PPS through transoral or retroauricular approaches, with outcomes comparable to those of conventional open surgery, but with less morbidity [48,49]. ...
... Another important clinicopathological feature of OSCC is perineural invasion (PNI), which has been considered an adverse feature of head and neck cancers in the National Comprehensive Cancer Network guidelines since 2017 [11,12]. In addition to the clear negative effects of PNI on outcome in OSCC patients [13][14][15], PNI status has been reported to be correlated with LNM in many studies [16][17][18]. A study published recently in Cell demonstrated that lymph nodes are innervated by a unique population of sensory nerves [19], indicating a potential anatomical connection between PNI and LNM based on the abundant innervation of the oral cavity. ...
... 11 Neck dissection at the time of salvage laryngectomy for the node-negative neck is controversial. 12 Proponents argue that it leads to better local disease control with more accurate pathological staging. However, this comes at the price of potentially increased surgical morbidity and a potentially low yield of positive nodes. ...
... In the eighth edition of the AJCC TNM classification, cENE was included for N3b stage classification and risk stratification of HNSCC because of uncertainty about the reliability of rENE (4). However, multiple studies now suggest that rENE can be reliably ascertained with high specificity if strict imaging criteria are used (17)(18)(19)(20)(21)(22)(23). Many previous reports have compared concordance between rENE and pENE (17)(18)(19)(20)(21)(22). ...
... TORS is now employed in the treatment of oropharyngeal cancers across Australia. The unit was the first in Australia to publish its results on the use of the Flex ® robotic system on 20 head and neck cases which included 11 procedures for cancers [2]. We demonstrated this to be a safe, reliable tool for TORS. ...
... However, such assessments are time-consuming, leading cancer specialists to seek a short screening tool that can separate fit older patient with cancer, who are able to receive standard cancer treatment, from vulnerable patients that should subsequently receive a full assessment to guide tailoring of their treatment regimen. Among the many screening instruments, which are used to predict the presence of impairments on CGA in elderly patients with cancer, are the Vulnerable Elders Survey-13 (VES-13), Geriatric 8 (G8), Triage Risk Screening Tool (TRST), Groningen Frailty Index (GFI), Fried frailty criteria, Barber and abbreviated CGA (aCGA) (98)(99)(100). The G8 screening tool, developed specifically for older patient with cancer, has the highest sensitivity, which is important to select patients who may benefit from CGA. ...