The intracranial antitumor efficacy of combination therapy with BRAF and MEK inhibitors in BRAF-mutated thyroid cancer has not been reported. Here, we describe a case of anaplastic thyroid cancer harboring BRAF V600E mutation with brain metastases which was treated with encorafenib plus binimetinib. The patient was initially diagnosed with T4bN1bM1 and experienced disease progression following surgery and lenvatinib treatment. Encorafenib plus binimetinib was initiated as second-line treatment seven months after the surgery. After achieving sustained disease stabilization, a solitary asymptomatic brain metastasis was detected following a three-week interruption due to COVID-19 infection. The lesion shrank after only two weeks of resumed encorafenib plus binimetinib, and additional stereotactic radiosurgery was performed without significant adverse events. This case suggests that the combination of BRAF and MEK inhibitors may be a viable treatment option for brain metastasis in BRAF-mutated thyroid cancer, despite general prioritization of local treatments. In addition, encorafenib plus binimetinib treatment may suppress the growth of microscopic metastasis. This possibility is supported by reliable evidence for the use of BRAF plus MEK inhibitor for brain metastasis from BRAF-mutated malignant melanoma. We conclude that encorafenib plus binimetinib treatment for brain metastasis from BRAF-mutated thyroid cancer is a safe and effective treatment choice.

The objective of this systematic review was to provide a comprehensive overview of the clinical characteristics of patients with parapharyngeal space (PPS) tumors treated with transoral robotic surgery (TORS). Additionally, comparative analyses were conducted to evaluate differences based on tumor histology, tumor location, and the type of transoral robotic approach used.

Radiotherapy (RT) is a cornerstone management strategy for head and neck cancer (HNC); however, local recurrence often requires salvage surgery, which is associated with an elevated risk of complications, particularly in previously irradiated fields. Boron neutron capture therapy (BNCT) has broadened treatment options; however, the safety and feasibility of salvage surgery after BNCT remain unclear owing to the limited case number. Herein, we describe a rare case of hypopharyngeal squamous cell carcinoma initially treated with RT, followed by BNCT for local recurrence, and ultimately with successful salvage surgery. The patient experienced no significant intraoperative or postoperative complications, and has remained recurrence-free for three years while maintaining adequate activities of daily living. Histopathological examination revealed no abnormal fibrosis exceeding that typically observed following standard RT alone throughout the resected specimen. Instead, edematous changes predominated over fibrotic alterations exclusively within the tumor region, presumed to be most affected by BNCT, accompanied by strong expression of L-type amino acid transporter 1, a potential surrogate marker of BNCT indication, suggesting the tumor-specific therapeutic effect of BNCT. This is the first report of salvage surgery for an organ previously treated with RT and BNCT, which provides valuable clinical and histopathological insights into this condition.

Antrochoanal polyps (ACPs) are benign lesions of the maxillary sinus mucosa that are often treated with endoscopic sinus surgery using middle meatal antrostomy (MMA). However, MMA alone may not provide sufficient access to the mucosal attachment site of polyp, particularly at the anterior or inferior wall of the maxillary sinus, and additional procedures may be required to achieve complete resection. Although many reports have described ACP resection with MMA in combination with supplementary procedures, no study has evaluated whether ACPs can be effectively removed using a single approach without MMA. Endoscopic modified medial maxillectomy (EMMM) provides wide access to the maxillary sinus without additional procedures. This study aimed to evaluate the efficacy of EMMM alone, without MMA, in achieving complete resection of ACPs.

Dysphagia is one of the most significant adverse effects after radiotherapy (RT) for advanced head and neck cancer (HNC). We hypothesized that neck stiffness may impair laryngeal elevation (LE) in HNC patients and contribute to post-RT dysphagia. We evaluated the association between cervical stiffness and swallowing dysfunction after RT for HNC.

Japanese cedar pollinosis (JCP) is the most prevalent seasonal allergic rhinitis in Japan. Many JCP patients are also sensitized to Japanese cypress pollen (JCyP), and their symptoms become exacerbated and prolonged during the JCyP dispersal period after JCP. To date, there have been no reports on the development of JCyP-specific allergen immunotherapy. For the future development of a JCyP-specific skin test and immunotherapy, we sought to develop a reference extract for future standardization of JCyP extract determined by the average threshold dilution eliciting a positive response in the intradermal skin test.

Sarcopenia and systemic inflammatory markers predict prognosis in various cancers, including head and neck cancer (HNC) treated with surgery or chemoradiotherapy. Their significance in patients receiving immune checkpoint inhibitors (ICIs), however, remains unclear. This study aims to determine whether skeletal muscle loss and systemic inflammation influence treatment response and survival in ICI-treated HNC, and whether composite indices provide prognostic value.

Sialolithiasis, the formation of calculi in the major salivary glands, is the leading cause of obstructive salivary disease and occurs predominantly in the submandibular gland. Traditional management of hilar or parenchymal stones has often required submandibular gland excision, which carries the risk of visible scarring and potential facial nerve injury. Sialendoscopy has emerged as a minimally invasive alternative for both diagnosis and treatment. Since its introduction in the 1990s and subsequent refinement, it has become standard therapy in Europe and North America, but in Japan, despite national insurance coverage since 2014, adoption remains limited because of technical complexity, high cost of consumables, and limited endoscope durability. A review of the literature and our own 144-case experience demonstrated a 40 % success rate for stone removal using sialendoscopy alone in Japan. Stone mobility was the most important predictor of success, while size greater than about 7.5 mm and parenchymal location markedly reduced success rates. Complications were generally mild and self-limiting: transient glandular swelling and lingual nerve paresis resolved within months, though occasional ranula formation or recurrence required secondary procedures. Similar factors predict outcomes in parotid stones, with reported endoscopic success of about 30-50 %. Fourier transform infrared spectrophotometry of 133 stones showed calcium phosphate and protein as the main components, and a higher calcium phosphate fraction correlated with stronger ductal adhesion and lower success rates. Sialendoscopy is therefore a safe, effective, and cosmetically advantageous alternative to gland excision, and we hope that this review will help lay the groundwork for its broader adoption and continued advancement in Japan.

To evaluate the safety and feasibility of transaxillary robotic thyroidectomy (TART) in Japan by comparing early cases with video-assisted neck surgery (VANS).

To evaluate the efficacy and safety of Kobayashi Plug Surgery (KPS) for patulous Eustachian tube (PET) performed under local anesthesia in the sitting position, using intraoperative subjective symptoms to guide plug size selection, and to investigate its effect on revision surgery rates.

This study had two primary objectives: first, to standardize a sound localization test across multiple facilities in Japan, and second, to use this standardized test to analyze sound localization ability in patients with unilateral hearing loss (UHL) and identify related clinical and demographic factors.

Lenvatinib, a multi-target tyrosine kinase inhibitor, has demonstrated efficacy in the treatment of various solid tumors, including thyroid cancer. However, life-threatening complications such as fistula formation have been observed in some cases. We report the case of a 47-year-old woman who developed an esophageal fistula following lenvatinib treatment for recurrent thyroid cancer. The patient initially underwent limited resection of the muscular layer of the cervical esophagus and preservation of the mucosa, followed by prophylactic radiotherapy because of inadequate surgical margins. Locoregional and pulmonary metastases developed 8 months postoperatively, and lenvatinib therapy was initiated at a dose of 24 mg. Subsequently, a fistula developed from the esophagus to the cervical skin. Esophageal fistula reconstruction was performed using a deltopectoral (DP) flap. Lenvatinib was resumed at a reduced dose of 14 mg two months after reconstruction. At 18 months after resuming lenvatinib, progression-free survival and adequate oral intake were achieved. The success of the DP flap reconstruction in this case highlights its potential as a durable solution for esophageal fistulas in patients receiving lenvatinib treatment. The robust blood supply provided by the DP flap may counteract the antiangiogenic effects of lenvatinib, thereby enabling continued treatment for locoregional recurrence.

The Japanese Clinical Practice Guidelines for Head and Neck Cancer - 2025 Edition were developed to provide clear evidence-based recommendations that reflect recent advancements and evolving clinical needs in head and neck cancer care. Advances in immunotherapy, targeted therapies, surgical techniques, and genomic medicine have expanded treatment options and added new complexities. This edition offers practical, up-to-date guidance to support consistent decision making across diverse clinical scenarios. Compared with the 2022 edition, the guidelines have been substantially expanded to 63 clinical questions (CQs) across 14 categories. A new feature is the inclusion of commentary columns that address clinically important topics not suited to the CQ format, such as special patient populations, novel therapies, and rare malignancies. To reflect the growing role of precision oncology, updated recommendations for molecular-targeted treatments have been added based on specific genomic alterations, in alignment with the current approvals in Japan. While maintaining the structure of previous editions, this edition addresses the changing clinical environment while also helping to inform future discussions and directions in head and neck cancer care.

This study investigates the effects of intratympanic glucocorticoid administration on the inner ear.

Infection prevention is crucial in head and neck cancer surgery due to the high risk of surgical site contamination by oral bacteria and pharyngeal secretions. The coronavirus disease 2019 (COVID-19) pandemic has introduced significant challenges to infection control in medical settings, including restrictions on patient care and changes to perioperative management. This study investigated the incidence of postoperative pneumonia (PP) and surgical site infection (SSI) before and during the COVID-19 pandemic, and examined how perioperative oral care and oral hygiene status were associated with the occurrence of postoperative infections.

Bronchial asthma (BA) and Chronic Obstructive Pulmonary Disease (COPD) have been considered as independent diseases, but in recent years, Asthma and COPD Overlap (ACO), which combines characteristics of BA and COPD, has been defined. Chronic rhinosinusitis (CRS) with nasal polyps and BA, both caused by similar type 2 inflammation, often coexist and are considered to have a "one airway, one disease" relationship. In ACO, airway inflammatory cells of BA (eosinophils and CD4 lymphocytes) and COPD (neutrophils, CD8+ lymphocytes and macrophages) coincide, theoretically leading to steroid resistance compared to BA alone. Based on the "one airway, one disease" concept, we hypothesized that clinical and pathological characteristics of CRS differs depending on its comorbidity with ACO or with BA alone.

The aim of this study was report the feasibility, safety profile, and within-patient voice outcomes of transoral injection laryngoplasty performed during a protocolized apneic window in unilateral vocal fold paralysis (UVFP).

Ménière's disease (MD) causes episodic vertigo and fluctuating hearing loss and is pathologically characterized by endolymphatic hydrops (EHs), often resulting from impaired endolymph absorption in the endolymphatic sac (ES). Although salt restriction is widely recommended, its mechanistic basis remains unclear. This study aims to examine how ES dysfunction and dietary salt intake interactively affect endolymphatic homeostasis, vestibular function, and aldosterone regulation.