bluuebunny/crossref_metadata_2025_split huggingface dataset:
4‐Year Demographic Study of Laryngeal Carcinoma
Authors: Smith Matthew D. , Fleming Jason , Lew‐Gor Simione , Simcock Richard , Weighill John , Harries Meredydd L. 
Published: February 2015

ObjectiveTo investigate the presenting features of cases of laryngeal carcinoma to a large tertiary head and neck center over a 4‐year period.MethodA retrospective cohort study was carried out on laryngeal cancer patients presenting to our head and neck center between 2007 and 2011. Information on sex, age, smoking status, presenting symptoms, tumor location, tumor staging, and histopathology was collected from the Somerset Cancer Registry, using hospital case notes for completion.ResultsA total of 105 cases presented during the study period, of which 88.6% were male. The mean age was 66.1 years (range, 37‐89). 89.6% of patients had a smoking history. The most common presenting symptom was voice change (79.1%), followed by throat pain (14.0%). 84.8% of tumors were glottic, with 15.2% supraglottic. 4.7% of tumors were diagnosed as stage‐0, 30.8% stage‐I, 22.4% stage‐II, 18.7% stage‐III, 9.3% stage‐IVA, 9.3% stage‐IVB, and 2.8% stage‐IVC. Twelve (11.4%) presented with nodal disease, and 3 with distant metastases (2.9%). On histopathology, 29.2% of tumors were well differentiated, 52.8% moderately differentiated and 18.0% poorly differentiated squamous cell carcinomas.ConclusionAdvanced age, smoking history, and dysphonia remain the most common features of laryngeal carcinoma presentations. Detection of early disease is vital to improve prognosis. Results should help focus referral pathways and enable family physicians to most easily identify those at risk. Smoking cessation programs must continue to be a priority.
Castleman’s Disease Masquerading as a Large Paraganglioma
Authors: Shires Courtney B. , Loevner Laurie A. , Lewis Cameron , O’Malley Bert W. , Rassekh Christopher H. 
Published: February 2015

Objective1) To describe a case of Castleman’s disease with unusual clinical and radiographic presentation as a somatostatin‐positive mass in the poststyloid parapharyngeal space (PPS). 2) To review the literature, which does not report Castleman’s disease of the PPS, somatostatin‐positive disease, or disease resulting in cranial neuropathy.MethodThe clinical presentation, imaging features, surgical findings, and pathology slides were reviewed in the case of an adult patient with a parapharyngeal space mass. The literature on Castleman’s disease was reviewed as was that on somatostatin‐positive parapharyngeal space lesions. Permission was obtained from the patient to publish the findings.ResultsA 51‐year‐old male with 3 months of otalgia, hearing loss, and tinnitus underwent audiogram, revealing asymmetric hearing loss. Laryngoscopy showed a paretic true vocal cord. Magnetic resonance imaging (MRI) showed a 4.5‐cm poststyloid PPS mass displacing the carotid artery anterolaterally. Octreoscan scan showed a significant uptake. Angiogram showed prominent vascular blush and feeders from the occipital artery. The patient underwent preoperative embolization of arterial feeders to the mass. A transcervical approach was used to access and remove the mass. Final histopathology is consistent with Castleman’s disease. Our review of the literature did not identify previously reported cases of octreotide‐positive lymphoproliferative diseases.ConclusionThis case demonstrates that poststyloid parapharyngeal masses in the medial portion of the parapharyngeal space may actually be lateral retropharyngeal nodes. Paragangliomas may also grow medially and present atypically and may be associated with vocal cord paralysis. This case is particularly unusual in that octreotide‐positive Castleman’s has never been reported.
Coblation for Laryngeal Papilloma in Adults
Authors: Zhang Qinfeng , Liu Delong , She Cuiping 
Published: February 2015

ObjectiveTo investigate the effect and feasibility of coblation for laryngeal papilloma in adults under suspension laryngoscope.MethodA retrospective study of the effect of coblation for 21 cases of laryngeal papilloma in adults was done from April 2008 to September 2010, including 4 multiple and 17 single laryngeal papilloma. All cases were treated with CoblatorTM ReFlex #7070 under general anesthesia without tracheotomy.ResultsAll the cases were treated in 1 session. Follow‐ups were performed from 17 months to 46 months after surgery with 2 cases of recurrence. The volume of bleeding loss during surgery varied from 1 mL to 10 mL, 2 mL on average, with no bleeding or other complications postoperatively.ConclusionCoblation under suspension laryngoscope for laryngeal papilloma in adults is an ideal method because of less bleeding and damage.
Comorbidity Measurement in Patients with Oral Cancer
Authors: Dedivitis Rogerio A. , Castro Mario A. , Aires Felipe T. , Bohn‐Pfuetzenreiter Nataniele P. , Pfuetzenreiter Elio G. , Ribeiro Daniel A. 
Published: February 2015

ObjectiveTo measure comorbidity in patients with oral or oropharyngeal squamous cell carcinoma.MethodProspective cohort study performed in 2 hospitals in Santos. A total of 116 adult patients treated for a newly diagnosed oral or oropharyngeal squamous cell carcinoma were evaluated on this study from 1996 to 2007. We measured comorbidity illness applying the some validated scales.ResultsAfter 4 years of follow‐up the mortality rate was 47.4%. Patients with high values in ACE‐27 and WUHNCI showed increased absolute risk of death in 25% and 31%, respectively. Of the 55 deaths in the period, 30.9% were due to other causes than cancer. Four indexes had predictive value on mortality due to other causes than cancer. Thus, patients who have high indexes on CIRS, KFC, ACE‐27, and WUHNCI had increased risk of death of 33%, 23%, 44%, and 51%, respectively. Thirty‐eight patients (69.1%) presented cancer‐related mortality. Only the WUHNCI presented significant difference capable of predicting mortality.ConclusionComorbidity is an independent prognostic factor in patients with oral or oropharyngeal cancer. Higher values in ACE‐27 and WUHNCI showed increased absolute risk of death. WUHNCI were capable of predicting cancer‐related mortality. Patients who have high indexes on CIRS, KFC, ACE‐27 and WUHNCI had increased risk of death due to noncancer causes.
Correlation of Thyroid Cytology with Surgical Histology
Authors: Chen Nan , Schneider Rebecca , Taylor Stephen , Zitsch Robert P. 
Published: February 2015

Objective1) To assess the predictive value of thyroid cytology by fine needle aspiration (FNA) at our institution in detecting thyroid malignancy since the introduction of the Bethesda System. 2) To identify other potential predictors of malignancy.MethodRecords of patients who underwent thyroid FNA and subsequent surgery at University of Missouri between 2007 and 2012 were reviewed. Data collected included cytologic and pathologic diagnoses as well as potential predictors of malignancy and demographic data, including radiation exposure, radiologic findings of calcification and increased vascularity, age, and gender.ResultsA total of 378 cases were eligible for review. Of these, one‐third met inclusion criteria. Cytology characterized as malignant or benign were found to have high concordance with surgical pathology findings. The diagnosis atypia of undetermined significance (AUS) and its malignancy risk were observed 2 to 3 times higher than that prescribed by the Bethesda guidelines. The majority of cases with cytologic features of follicular neoplasm were found to be benign. However, a significant number of incidental cases of papillary microcarcinoma were observed within this group. Papillary thyroid carcinoma was identified in 60% of cases with features suspicious for malignancy.ConclusionWhile benign and malignant cytologies are highly predictive, there exists wide variation in the interpretation of uncertain categories. Malignancy risk associated with AUS ranges from 6% to 28% in the literature. These results suggest that trends developed from institution‐specific data may be more predictive in guiding post‐FNA management.
Epidermal Growth Factor Receptor Inhibition’s Effects on Invasion within Head and Neck Squamous Cell Carcinomas
Authors: Bewley Arnaud F. , Rasanen Kaiti , Basu Devraj , Herlyn Meenhard , Montone Kathleen 
Published: February 2015

ObjectiveTargeted therapies can have mixed effects on cancer progression by limiting growth while simultaneously potentiating invasion and metastasis. Here we test the role of a mesenchymal‐like subpopulation (MLSP) of head and neck squamous cell carcinoma (HNSCC) cells in altering pattern of invasion (POI) during epidermal growth factor receptor (EGFR) inhibition.MethodThe contribution of MSLP cells to POI was evaluated in collagen‐embedded spheroids and patient‐derived xenografts (PDXs). MLSPs were identified by immunostaining for vimentin expression, E‐cadherin loss, and additional markers of epithelial to mesenchymal transition. Spheroids and xenografts undergoing anti‐EGFR treatment were evaluated for altered MLSP size, distribution, and invasion.ResultsMLSP cells were rare or absent in PDXs whose HNSCCs of origin contained less aggressive, pushing POIs. In contrast, abundant MLSP cells were seen in PDXs from tumors with highly infiltrative POIs. In collagen‐embedded spheroids, a pushing POI was mediated by collective migration of E‐cadherin‐positive cells, while infiltrative POIs arose from mesenchymal migration of MLSP cells. EGFR inhibition in spheroids produced a more aggressive POI by selectively targeting the epithelial subpopulation, which expressed higher levels of the receptor. Similarly, cetuximab treatment of xenografts enriched MLSP cells, which contributed to a more infiltrative invasion pattern in residual tumors.ConclusionDifferent HNSCC POIs arise from distinct migratory mechanisms used by E‐cadherin‐positive versus MLSP tumor cells. Cetuximab therapy potentiates the capacity of MLSP cells to produce an infiltrative POI. Anti‐EGFR therapy may therefore have disparate effects in altering progression of 2 HNSCC sub‐types, defined by presence or absence of MLSP cells.
Endoscopic Thyroidectomy with Miniature Tools in a Pig Model
Authors: Hain Moshe , Mintz Yoav , Halperin Doron 
Published: February 2015

ObjectiveAssess the feasibility of direct endoscopic thyroidectomy in a porcine model using CO2 pneumodissection, miniature cameras and endoscopic tools.MethodThe study was conducted during the second half of 2011. Endoscopic thyroid dissection was performed in a porcine model with CO2 pneumodissection, using cameras and endoscopic tools ranging in diameter between 2 and 5 mm.ResultsThyroid dissection was performed in a total of 10 pigs. Two were “open” procedures to learn the porcine anatomy. Eight were endoscopic procedures. Of them 5 used three 5‐mm incisions and 3 used three 2‐ to 3‐mm incisions for surgical tools and a 5‐mm incision for the endoscopic camera. In all cases the thyroid was completely dissected with the recurrent laryngeal nerve (RLN) identified and preserved. In 5 cases the thyroid was removed through the floor of the mouth. There was no major bleeding in the live pigs, and all the vital structures were identified and preserved.ConclusionEndoscopic thyroidectomy using miniature camera and tools in a porcine model seems to be feasible without major complications. The advantages of this approach include minimal scars and improved visualization. We believe that there is room for further development of minimal invasive techniques for thyroid surgery.
The Value of RLN Neurostimulation in Thyroid Surgery
Authors: Piccin Ottavio , Fernandez Ignacio J. , Sciascia Silvia , Marcantoni Alessandra , Cavicchi Ottavio , Caliceti Umberto 
Published: February 2015

ObjectiveNeurostimulation with laryngeal palpation (NSLP) is an intermittent monitoring technique that facilitates nerve identification and permits an assessment of the recurrent laryngeal nerve (RLN) function during thyroid surgery. In this study we report our experience with NSLP, evaluating the predictive value of this technique for postoperative RLN deficit.MethodWe analyzed retrospectively a consecutive series of 1584 patients undergoing thyroid surgery from 2002 to 2011 at Sant’Orsola ‐ Malpighi Hospital of Bologna. Sensitivity, specificity, PPV, and NPV were calculated for NSLP, considering an absent laryngeal twitch (LT) at the end of the surgical procedure as predictive for RLN palsy.ResultsThe incidence of nerve palsy, calculated on a total of 2917 nerves at risk, was 2.1% (64 cases). Sensitivity, specificity, and positive and negative predictive values resulted respectively: 53%, 96.5%, 34.9%, and 98.4%.ConclusionOur results indicate that NSLP is still a useful and economic tool for RLN monitoring during thyroid surgery. Moreover the high specificity and NPV of NSLP confirm that this technique provides important prognostic information regarding vocal cord function at the end of dissection of the first lobe during total thyroidectomy.
Tumor Volume Predicts Local Control in Head and Neck Cancer
Authors: Mansuri Mohamed‐Shaji , Alun‐Jones Tom , Pace‐Balzan Albert 
Published: February 2015

ObjectiveHead and neck squamous cell carcinomas (HNSCC) are staged using the Tumor Node Metastasis (TNM) classification; however, limitations in its prognostic accuracy are recognized. The objective was to determine if pretreatment gross tumor volume (GTV) could be used as a predictor of primary site recurrence and therefore improve current staging.MethodA retrospective analysis of 53 patients treated with non laryngeal primary HNSCC, diagnosed between 2006 and 2007, was performed. Pretreatment GTV was calculated using Medical Imaging Interaction Toolkit (MITK) analysis of the patients’ staging radiology. The time to local recurrence and the 24‐month actuarial local control rate were recorded.ResultsThe overall local control rate for the study group was 66%. Mean GTV was lower in patients without primary site recurrence, 8.47 cm3 (SD 6.42 cm3, range 2.52‐8.36 cm3), compared with patients with primary site recurrence, 18.58 cm3 (SD 9.94 cm3, range 5.24‐36.78 cm3). Patients with a GTV of <7.0 cm3 or >7.01 cm3 achieved control rates of 86.2% and 41.7%, respectively. Kaplan‐Meier and coregression analyses demonstrate GTV as a prognostic indicator in oral cavity or oropharyngeal SCC, with GTV >7.01 cm3 having a significantly poorer local primary site control (P =. 009). Multivariate analyses for all possible prognostic factors for primary site recurrence was only significant for GTV (P =. 016).ConclusionIn oral cavity and oropharyngeal SCC pretreatment GTV is a prognostic indicator for local control, with multivariate analysis showing it to be more significant than T staging within this study. GTV can be easily calculated using MITK software, raising the possibility of its inclusion into the current TNM staging system.
Laryngeal Biopsies: Are We Doing More? A Decade of Results
Authors: Lim Shueh Y. , Sau Phoebe Chung Y. , Cooper Lorna , McPhaden Allan , Mackenzie Kenneth 
Published: February 2015

ObjectiveLaryngeal biopsies are frequently performed in current ENT head and neck practice. Over the past decade, we have observed an escalating trend in the biopsies performed. The aim of this study is to quantify the rate of laryngeal biopsies and to record the indications from 2001‐2010 in North Glasgow, Scotland.MethodA retrospective analysis of laryngeal biopsies performed in North Glasgow, Scotland, between 2001 and 2010 was carried out through the North Glasgow Pathology Database. Data pertaining to the site and histopathological diagnoses were collected and analyzed for each biopsy incident. The diagnoses of the biopsies are categorized under 8 classifications.ResultsFrom 2001 to 2010, 3902 laryngeal biopsy episodes were identified with 888 (23%) diagnosed as squamous cell carcinoma (SCC), 705 (18%) as dysplasia, 831 (21%) as no tumor, and the remaining 1478 (38%) as benign pathology. Between 2001 and 2003, approximately 300 biopsies were performed annually. From 2004‐2010, over 400 biopsies were performed annually (χ2 = 115.0, P <. 01). Approximately 120 benign biopsy episodes and 90 SCC diagnostic biopsy episodes occurred annually. From 2004, there has been significant increase in dysplasia biopsy episodes and those for surveillance of SCC. The latter has increased 2‐ to 3‐fold and has remained constant (χ2 = 71.78, P <. 01).ConclusionThere has been an increase in biopsy episodes after 2004 with the incidence of SCC remaining relatively constant. It is hypothesized that organ preservation strategies, endoscopic resection in early laryngeal cancer, and chemoradiotherapy in advanced head and neck cancer are responsible for the increase in overall biopsy episodes from 2004.
Resection Bed Margins following Laser Cordectomy
Authors: Marshak Tal , Uri Nechama , Ronen Ohad , Doweck Ilana 
Published: February 2015

Objective1) To evaluate our experience with transoral CO2 laser microsurgery (TLM) in patients with early glottic cancer. 2) To evaluate the effect of positive additional biopsies taken from the resection bed on the outcome of patients.MethodRetrospective study of patients with early glottic cancer who were treated by TLM, between January 2001 and December 2009 at Carmel Medical Center. Resection bed margins (RBM) using cold instruments were taken from all patients. Local control rate, overall survival, and organ preservation rate were compared between patients with positive vs negative RBM.ResultsSixty‐four (24 Tis; 23 T1a; 10 T1b; 7 T2) patients were included in the study. Mean follow‐up was 50 months ± 34 (12‐130). Overall local control rate (LCR) was 81%. Only 10/64 (15%) patients had local failure and were referred to radiotherapy, after which 3 underwent salvage laryngectomy. Twenty‐nine patients had positive RBM, and 35 had negative margins. Patients with positive RBM had poorer LCR (59% vs 100%, P =. 0001) and lower organ preservation rate (84% vs 100%, P =. 09) compared to patients with negative margins. However, overall survival was not different between the 2 groups.ConclusionTLM is an effective treatment modality in early glottic cancer. Positive RBM may indicate a residual disease and hence a poorer outcome. We recommend that patients with positive RBM should be treated with re‐resection or radiation and should have close follow‐up.
The Efficacy of N‐Acetyl Cysteine in Reflux Laryngitis
Authors: Dabirmoghadam Payman , Samavatifard Mohammad R. 
Published: February 2015

ObjectiveLaryngopharyngeal reflux is a common disorder in otolaryngology patients. Some studies have shown that more than 50% of patients with hoarseness have evidence of laryngopharyngeal reflux. Because of mucosal dryness and mucus thickening in reflux laryngitis, we conducted a prospective study to evaluate the effects of N‐acetyl cysteine.MethodBetween 2009 and 2011, patients with a reflux symptom score of more than 10 were selected and underwent endoscopic examination. Patients were randomly allocated into 3 groups and received either omeprazole, N‐acetyl cysteine, or both of them. Patients were followed for 3 months, and examination was repeated after 1 and 3 months.ResultsNinety patients entered the study (30 patients in each group). Forty‐five of them were male, and 45 were females. Before treatment the reflux symptom scores were 18 ± 6, 16.3 ± 5, and 19.1 ± 3 for omeprazole, N‐acetyl cysteine, and both drugs, respectively. These figures changed to 10.8 ± 4.6, 15.9 ± 5.3, and 7.6 ± 4.3 and showed a significant difference (P value <.001) in favor of omeprazole plus N‐acetyl cysteine. After 3 months of treatment, the endoscopic findings score improved in 3 groups, but this change was significant in group 3 (omeprazole plus N‐acetyl cysteine).ConclusionOur study showed that combination of omeperazole and N‐acetylcysteine had a better influence on patients’ symptoms and endoscopic findings in reflux laryngitis comparing to the other 2 groups. All patients completed the treatment course very well without any major side effects.
Auditory Effects of Cranial Irradiation in a Mouse Model
Authors: Prasad Kumar G. , Gratton Michael Anne , Boettcher Flint , Phillips Grady 
Published: February 2015

Objective1) Determine whether radiation exposure in mice leads to measurable hearing losses similar to those seen in patients exposed to radiotherapy for acoustic neuromas, temporal bone malignancies, and nasopharyngeal carcinoma. 2) Assess for any associated pathologic changes in cochleas exposed to radiation.MethodAdult (11‐13 weeks) 129Sv/J mice were exposed to radiation using an animal irradiator, ranging from a single exposure of 10 Gy to 100 Gy. Pre‐ and postradiation audiometric brainstem response (ABR) data were recorded to document hearing loss, with subsequent analysis of cochlear ultrastructure using transmission and scanning electron microscopy.ResultsHigh‐frequency hearing loss was noted in exposures exceeding 40 Gy. Anorexia was observed by day 6 post‐ irradiation in all mice exposed to doses ≥20 Gy. Normal hearing following 20 Gy exposure suggests that hearing losses seen after ≥40 Gy exposures is secondary to radiation effects rather than any confounding metabolic disturbance. Ultrastructural analysis revealed dramatically decreased neuron density in Rosenthal’s canal and loss of the associated extracellular matrix. Negligible changes were seen in the outer and inner hair cells, with overall preservation of the stria vascularis and cochlear vasculature. Age‐matched controls failed to demonstrate similar histopathologic findings.ConclusionThis study demonstrates that the mouse is a viable model for the study of radiation‐induced hearing loss. The initial impact of the radiation appears to focus on the eighth nerve cell body and the axonal projections to the organ of Corti. Future studies should incorporate fractionation of the radiation dose.
Combination Therapy for the Treatment of Idiopathic SSNHL
Authors: Battaglia Alex , Lualhati Annette , Burchette Raoul , Cueva Roberto A. 
Published: February 2015

ObjectiveTo determine whether combination therapy (high‐dose prednisone taper [HDPT]+intratympanic dexamethasone [IT‐Dex]) improves pure tone average scores (PTA) and speech discrimination scores (SDS) relative to HDPT alone or intratympanic steroid (IT‐S) alone in patients with idiopathic sudden sensorineural hearing loss (ISSNHL).MethodFrom June 2008 to January 2012, 84 (15 dropouts) patients diagnosed with ISSNHL were administered IT‐De (10 mg/cc) once‐a‐week for 3 weeks + HDPT (60 mg/day for 7 days with 7‐day taper). Final audiogram results are compared to previously published results of combination therapy, HPDT alone, and IT‐S alone.ResultsTreatment began on average 6.6 days after onset of ISSNHL. The average pretreatment 3‐tone PTA was 83.2, and the average pretreatment SDS was 16%. The overall PTA improved significantly by an average of –38. The overall SDS improved significantly by an average of 49%. The average overall posttreatment SDS was 65%. 60/69 (87%) patients started with an SDS score less than or equal to 50%, and 38 (63%) of these ended above 50%. 24/42 (57%) of the profound patients recovered with an SDS above 50%. According to published reports, HDPT and IT‐S alone improve SDS by only 39%.ConclusionISSNHL patients treated with IT‐De+ HDPT experienced statistically significant PTA and SDS improvements, comparable to previously published combination therapy results. The audiologic data indicate that combination therapy improves hearing recovery relative to HDPT or IT‐S alone, possibly by improving hair cell and spiral ganglion survival.