{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:54:25Z","timestamp":1747184065235,"version":"3.40.5"},"reference-count":13,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,8,12]],"date-time":"2022-08-12T00:00:00Z","timestamp":1660262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Investigation of head and neck cancers places a significant burden on the National Health Service and effective resource allocation is of perpetual importance. Existing risk calculators are designed to stratify the likelihood of underlying malignancy according to symptoms, but are less relevant in secondary care as they do not integrate clinical examination findings (e.g. naso\u2010endoscopy). We looked to evaluate the utility of magnetic resonance imaging (MRI) in investigating patients with unilateral odynophagia and a normal clinical examination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was conducted over a 54\u2010month period; 484 consecutively\u2010recruited adult patients who underwent MRI of the neck for suspected malignancy were included. Imaging reports, case notes, and histopathology results were reviewed. Patients with previously diagnosed\/treated malignancy, undergoing surveillance, or those with pathology of the salivary glands, oral cavity or thyroid gland, were excluded. A multivariate binary logistical regression model was performed to calculate the odds ratios and probabilities of malignancy for each presenting symptom, with and without negative nasoendoscopy findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall incidence of malignancy within the cohort was 173\/484 patients (35.7%; 95% CI 31.5%\u201340.2%) with no cases of malignancy in patients presenting with odynophagia and a normal nasoendoscopy (0\/39). The presence of a neck lump was significantly associated with malignancy, (odds ratio [OR] 2.03, <jats:italic>p<\/jats:italic> =\u2009.001; 95% CI 1.59\u20132.58), as was dysphagia (OR 1.52, <jats:italic>p<\/jats:italic> =\u2009.009; 95% CI 1.11\u20132.11). Conversely, globus was found to have an inverse association (OR 0.41, <jats:italic>p<\/jats:italic> &lt;\u2009.001; 95% CI 0.24\u20130.70).<\/jats:p><\/jats:sec><jats:sec><jats:title>Summary<\/jats:title><jats:p>New patients presenting with odynophagia alone and normal endoscopy or globus have a low likelihood of underlying malignancy, justifying reassurance and follow\u2010up in the event of persistent symptoms. Contrariwise, patients with a neck lump, dysphagia, odynophagia and multiple concurrent aerodigestive tract symptoms, or an abnormal endoscopy have a high likelihood of underlying malignancy and should be investigated accordingly.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13967","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T11:44:17Z","timestamp":1659008657000},"page":"650-655","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Magnetic resonance imaging has a limited role in investigating odynophagia if examination is normal: A binary logistic regression analysis of 484 patients presenting to a tertiary head and neck clinic"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0104-9565","authenticated-orcid":false,"given":"Oliver","family":"Wright","sequence":"first","affiliation":[{"name":"Musgrove Park Hospital  Taunton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7584-1232","authenticated-orcid":false,"given":"Ting Ting","family":"Zhang","sequence":"additional","affiliation":[{"name":"University Hospitals Sussex NHS Trust  Brighton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominic Ayi","family":"Gyimah","sequence":"additional","affiliation":[{"name":"Bronglais Hospital  Aberystwyth UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6049-2703","authenticated-orcid":false,"given":"Cameron","family":"Davies\u2010Husband","sequence":"additional","affiliation":[{"name":"University Hospitals Sussex NHS Trust  Brighton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,12]]},"reference":[{"volume-title":"Cancer Research UK. Head and neck cancer incidence","year":"2021","key":"e_1_2_11_2_1"},{"key":"e_1_2_11_3_1","unstructured":"National Institute for Heath and Clinical Excellence.Suspected cancer: recognition and referral NICE guideline [Internet].2015. Available from:www.nice.org.uk\/guidance\/ng12"},{"volume-title":"NHS cancer targets [internet]","year":"2020","author":"Bate A","key":"e_1_2_11_4_1"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39258.688553.55"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215116000396"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.4329\/wjr.v2.i6.224"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2015.09.022"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32585-5"},{"key":"e_1_2_11_10_1","first-page":"98","volume-title":"The incidence and management of non\u2010head and neck incidentalomas for the head and neck surgeon","author":"Sahovaler A","year":"2017"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215116000360"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215116000372"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13511"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215116000529"}],"container-title":["Clinical Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.13967","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/coa.13967","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.13967","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T07:09:22Z","timestamp":1692688162000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.13967"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,12]]},"references-count":13,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1111\/coa.13967"],"URL":"https:\/\/doi.org\/10.1111\/coa.13967","archive":["Portico"],"relation":{},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"type":"print","value":"1749-4478"},{"type":"electronic","value":"1749-4486"}],"subject":[],"published":{"date-parts":[[2022,8,12]]},"assertion":[{"value":"2021-09-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}