this is a 90 minutes panel regarding Voice Evolution Across the Lifespan — Pediatric, Pubertal, Menopausal, and Elderly Voice

this is a keynote lecture about Dysphagia in Head and Neck Cancer, Management protocol and patients' journey

Background: Tracheal or stomal stenosis is a dreaded complication after tracheotomy. The incidence of tracheal stenosis after tracheotomy reaches up to 21% in certain series. The inferiorly based flap tracheotomy, known as Björk flap tracheotomy, was first described by Björk in 1952 following a patient mortality from a displaced cannula. It involves a flap of the anterior tracheal wall secured to the inferior edge of the skin incision by a non-absorbable silk suture. The Björk flap tracheotomy aims to lower the shearing pressures created by movement of the tracheotomy tube during coughing and breathing. Also, its resulting tract matures quickly. Furthermore, the trachea is pulled up to the skin and fastened even if the stoma has not been fully developed. This makes the tracheotomy tube changes safer and simpler.

Only 11% of Björk flap tracheotomy cases show narrowing of the tracheal lumen. The narrowing never exceeds 50% of the lumen. Furthermore, Björk flap tracheotomy cases show a decreased rate of stomal stenosis than the conventional tracheotomy ones. The chances of tracheal or stomal stenosis are higher in conventional tracheotomy because of the higher risk of stomal injury. Furthermore, the likelihood of peristomal granulation is lower in the Björk flap tracheotomy. These granulations are less likely to block the flap-based mature stoma.

Methodology: We will review the pathogenesis of the post tracheotomy tracheal stenosis. Then we will describe the surgical technique, tips and pearls of the Björk flap tracheotomy, detailing the differences between it and the conventional tracheotomy. We will underline the advantages of the Björk flap tracheotomy, especially in the prevention of tracheal stenosis.

Conclusion: Björk flap tracheotomy is much safer than the conventional tracheotomy. It shows fast recovery and is associated with less incidence of tracheal stenosis. The inverted U-shaped flap preserves the tracheal cartilage and maintains the lumen after tracheotomy. Björk flap tracheotomy is not far from becoming recommended as a best practice technique to lower the incidence and severity of post tracheotomy tracheal stenosis.

This is a keynote about Biomechanical Vocal Transnasal Flexible Evaluation to Plan & Choose the Voice Therapy

SUMMARY: Total thyroidectomy is often performed in head and neck surgery and is considered a less complicated procedure, but is still accompanied by a number of complications, the most common of which are recurrent lesions and endocrinological ones in the form of impaired regulation of hormonal status and disorders of calcium metabolism. The aim of the study was to examine the role and significance of total thyroidectomy for the occurrence of postoperative complications in correlation with pathohistological and endocrinological findings.

Methods: A cross-sectional study included 90 patients over 18 years of age, both sexes, in the period from 2022 to 2024, who underwent thyroid surgery at the University Clinical Center of the Republic of Srpska. Preoperatively, hormonal analyses and thyroid ultrasound examination as well as endovideolaryngoscopy examination (EVLS) were performed. Total thyroidectomy was performed in all patients. Postoperatively, pathohistological diagnostics, control hormonal analyses, and EVLS examination were performed.

Results: The most common indication for surgical intervention was goiter in women 81 (90%) with an average age of 54.18 years. Laryngeal symptoms in the form of hoarseness, cough, dyspnea and dysphagia after surgery were reported by 13 (14.4%). Paresis of the nerve recurrence was reported by 11 (12.2%), PH analysis showed that in the majority of cases it was goiter37 (41.1%), followed by follicular adenoma25 (27.8%) and papillary carcinoma18 (20%), the remaining 10 (11%) had endocrinological complications. 23.25% Hypocalcemia 67(74.4%) of which 16(17.8) severe form <1.9 mmol/l elevated PTH values 4.4%.

CONCLUSION: Patients with vocal cord paresis and hypocalcemia show the highest incidence of postoperative complications after total thyroidectomy due to histopathologically diagnosed goiter, follicular adenoma, and papillary thyroid carcinoma. These findings may be potentially useful in identifying elderly patients at increased risk of complications after total thyroidectomy that may significantly affect their quality of life.

this is a 90 minutes panel regarding Optimising outcomes in gender Affirming Laryngeal Surgery