bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective Randomized Control Trial Using Best‐Selling Smoking Cessation Book
Authors: Oh Anita , Luginbuhl Adam , Curry Joseph , Cognetti David M. 
Published: August 2013

Objectives:Test the efficacy of international best‐selling author Allen Carr's The Easy Way to Stop Smoking in an outpatient office‐based practice.Methods:Prospective randomized controlled study involving 58 active smokers who presented to an academic otolaryngology clinic. Study participants were recruited during regular office visits and randomized to receive a free copy of the book or to act as a control group receiving only the name of the book and author. Both cohorts received physician directed cessation counseling. Follow‐up phone calls were conducted at 2 weeks and 6 months to assess smoking status, whether the control group participants bought the book, and how many pages of the book were read.Results:At 2‐weeks, 4 patients in the book intervention group and 4 patients in non‐book group stated they were no longer smoking. (17.4% vs. 19.0%). Fifteen of the 31 patients that received the book reported having read some portion of it whereas 3 patients in the control group purchased the book based on recommendation during counseling.Conclusions:Smoking cessation rates were not significantly different between the participants who received the book versus those who did not, and were similarly low in both groups. The majority of participants in both groups reported a readiness to quit smoking; however, 97% did not read the book to completion. Although the low rate of readership precludes the ability to assess efficacy, this study indicates smokers’ willingness to read the book is a significant hurdle for its success.
Quality of Life in Early‐Stage Oral Cancer: Interim Results from the COOLS Trial
Authors: Cromwell Ian , Cressman Sonya , Poh Catherine , Durham Scott , Rosin Miriam P. , Peacock Stuart 
Published: August 2013

Objectives:1) Describe the quality of life experienced by oral cancer patients over time. 2) Explore subdimensions of quality of life over time.Methods:The pan‐Canadian Optically‐guided Oral Lesions Surgical (COOLS) Trial is a multi‐center randomized control trial evaluating a novel surgical staging method for the treatment of early‐stage oral cancer. Surveys were given to 92 participants at baseline, 6 weeks, and 3 months after surgery, collecting data on self‐reported quality of life (QoL).Results:Aggregate survey scores (EQ‐5D, FACT H&N) did not show much difference before or after surgery. Subscale analyses, however, revealed important differences in self‐reported pain, anxiety, and head/neck specific symptoms over time. Results are indicative of a recovery that happens over time, but it remains to be seen if this effect extends to the 12‐month follow‐up stage. QoL trajectory differs by surgical site, and the presence/absence of neck dissection. Selected relevant comparisons will be presented.Conclusions:At an aggregate level, surgery does not either improve or worsen QoL in early‐stage oral cancer patients; however, deeper examination of the data suggests that there are trends that will be clinically meaningful to patients and their families. These findings may help clinicians to better prepare their patients before surgery. Recovery to baseline QoL is achieved around 3 months, which suggests that surgery may improve long‐term (>12 month) QoL.
Relationship between Ultrasonographic Echogenecity and Intratumoral Fibrosis and Growth Pattern in Papillary Thyroid Carcinoma
Authors: Lim Yun‐Sung , Mun Mi‐Jin , Park Young‐Min , Lee Won‐Yong , Lee Jin‐Choon , Lee Byung‐Joo , Wang Soo‐Geun 
Published: August 2013

Objectives:Ultrasonography (USG) is a powerful tool for evaluation of papillary thyroid cancer (PTC). Preoperative USG characteristics correlated with several prognostic factors for PTC. Tumor fibrosis is known to be an important histologic prognostic features in head and neck cancer. However, there is a lack of studies for tumor fibrosis in PTC. This study aimed to evaluate the relationship between ultrasonographic finding and intratumoral fibrosis and growth pattern in PTC.Methods:In all, 170 fresh cases with PTC patients underwent total thyroidectomy with central neck dissection (CND). Lateral neck dissection was performed in case of lateral neck metastasis. Retrospective analysis for USG finding such as echogenicity and pathologic characteristics including intratumoral fibrosis and tumor growth pattern were conducted.Results:Ninety (53%) patients had USG finding with marked hypoechogenecity. According to histologic characteristics, group with marked hypoechogenecity had more tumor fibrosis and more invasive growth pattern than the group with iso‐ or hypoechogenecity. There was no significant difference in age, sex, tumor size, extrathyroidal extension, and presence of central or lateral neck metastasis between the two groups. In univariate and multiple regression analysis, tumor fibrosis and growth pattern were significantly associated with USG echogenecity.Conclusions:These findings suggest that intratumoral fibrosis and tumor growth pattern are important determinants of preoperative ultrasonographic echogenecity in PTC.
Risk Factors for Cervical Lymph Node Metastasis of Tongue Carcinoma to the Unaffected Side
Authors: Kida Kota , Terada Tomonori , Uwa Nobuhiro , Sagawa Kosuke , Sakagami Masafumi 
Published: August 2013

Objectives:Investigate the relationship between cervical lymph node metastasis of tongue carcinoma in unaffected and affected sides and factors related to the primary site.Methods:Between January 2000 and December 2009, 248 patients with primary N0 tongue carcinoma in the unaffected side were treated radically at the Department of Otolaryngology, Osaka Medical Center for Cancer and Cardiovascular Diseases. We evaluated clinical T stage, tumor size, tumor extension (oral floor, anterior part of the tongue, root of the tongue, depth into the tongue) and clinical N stage for risk factors influencing cervical lymph node metastasis to the unaffected side.Results:Fourteen of 248 patients (5.6%) showed cervical node metastasis in the unaffected side. The rate of metastasis to the unaffected side was 17% in patients with primary site extending to the anterior part of the back of the tongue (P < 0.01). The rate was 16% in patients with primary site extending to more than half of the tongue depth (P < 0.05). The rate was 14% in patients with cN+ in the affected side (P < 0.01). Other factors were not associated a significant difference.Conclusions:Extending to the anterior part of the back of the tongue, more than half of the tongue depth and cN+ in the affected side were high risk factors of cervical lymph node metastasis to the unaffected side.
Robotic‐Assisted Neck Dissection via Facelift Incision: Preliminary Findings in North American Patients
Authors: Byrd James K. , Albergotti William G. , Kim Seungwon , De Almeida John , Duvvuri Umamaheswar 
Published: August 2013

Objectives:Describe the technique and lymph node yield of robotic‐assisted neck dissection (RAND) via facelift incision in a North American cohort.Methods:Patients with squamous cell carcinoma of the head and neck at a tertiary hospital in 2012 were offered selective neck dissection via facelift incision. Operative time, estimated blood loss, complications, and lymph node yield were collected. Additionally, seven sequential open selective neck dissections were retrospectively reviewed for lymph node yield. A two‐tailed t‐test was used to compare nodal yield between the two groups (RAND vs open).Results:Four patients underwent five RANDs, including a simultaneous transoral robotic surgery base of tongue resection and one partial glossectomy. Four lateral neck dissections and one supraomohyoid neck dissection were performed. Mean operative time for the cohort was 4:29 +/‐ 1:33 (including extirpation); the average time for the three RAND only was 3:29 +/‐ 0:55. Average blood loss was 77 +/‐ 68 ml. The only complication was an intraoperative internal jugular vein injury, which was repaired with surgical clipping and suturing. The average number of lymph nodes removed was 29 in patients undergoing level 2‐4 RAND, compared to 35.9 in the open group (P = 0.28).Conclusions:Our preliminary experience suggests that RAND is feasible and safe in the North American population. Our data is also the first to demonstrate that nodal yield is the same between robotic‐assisted and open lymphadenectomy. Further study will determine the learning curve for the procedure, and long‐term oncologic follow up is needed.
Role of Bcl‐2 and Ki‐67 Expressions in Predicting the Response to Radiotherapy in Cancer Larynx
Authors: Gamea Ahmed , Eltatawi Faika 
Published: August 2013

Objectives:Study of Bcl‐2 protein and nuclear antigen Ki‐67 expressions in laryngeal squamous cell carcinoma and its importance in predicting the tumor response to radiotherapy.Methods:Retrospective and prospective study. This study was conducted on 60 paraffin blocks of patients with laryngeal squamous cell carcinoma (T1 and T2 N0M0) who were treated with radiotherapy between 2003 and 2009. Thirty blocks were collected from patients who failed radiotherapy and thirty blocks from patients who successfully improved by radiotherapy. The response to radiotherapy was assessed during the follow up period by direct laryngoscopy and biopsy every 3 months. Sections (4um) were cut to be stained with H&E and for immunohistochemical staining for Bcl‐2 and nuclear antigen Ki‐67.Results:Immunohistochemical study of Bcl‐2 revealed positive expression in 70% of radioresistant cases compared with 10% of radiosensitive cases. Negative expression of B‐cl2 occurred in 30% of radioresistant cases compared with 90% of radiosensitive cases. Bcl2 is 70% sensitive and 90% specific and has a 80% accuracy in predicting patient response to radiotherapy. On the other hand, the study revealed non significant expression of the proliferative marker Ki‐67 between radioresistant and radiosensitive group.Conclusions:Bcl‐2 predicts radioresistance in patients with squamous cell carcinoma of the larynx. It can be used as a marker of poor radiotherapy outcome. Bcl‐2 positive patients could be offered an established and equally effective alternative treatment to radiotherapy, eg, partial laryngectomy, resulting in improved patient survival and quality of life.
The Role of the Parotid Fascia in Identification of the Facial Nerve during Parotidectomy
Authors: Song Tara E. , Rasgon Barry M. 
Published: August 2013

Objectives:At the conclusion of the presentation, participants should be able to appreciate that performing a safe parotidectomy requires identification and preservation of the facial nerve. Participants will demonstrate understanding of the relationship between the parotid fascia and the location of the facial nerve trunk. Multiple standard anatomic landmarks have been used to help the surgeon identify the general location of the facial nerve trunk. To our knowledge, no study has evaluated the use of the parotid fascia that immediately overlies the trunk as a landmark.Methods:Prospective cadaver study. Dissection of the parotid fascia and identification of the facial nerve trunk was carried out in 8 fresh cadaveric parotid glands. The attachments of the parotid gland were evaluated, with special attention to the fascia overlying the facial nerve trunk.Results:The parotid fascia envelops the posterior aspect of the gland in an open book fashion. Posteriorly, it connects to the anterior and medial aspect of the mastoid tip. Postero‐superiorly it attaches to the inferior aspect of the tragal pointer. Directly medial to the fascia lies the facial nerve trunk.Conclusions:The parotid fascia can be used as an additional landmark, in conjunction with other commonly used standard anatomic landmarks to identify the facial nerve trunk. It is useful as a landmark of depth of the facial nerve trunk. It can be palpated from the mastoid to the parotid gland. Deep to this sling of fascia, the facial nerve trunk is identified.
The Safety of Outpatient Total Thyroidectomy
Authors: Khichi Sunny S. , Newman John R. , Peters Glenn E. 
Published: August 2013

Objectives:Establish whether total thyroidectomy can be performed safely in the outpatient setting.Methods:This was a retrospective review of 410 total thyroidectomies performed by a single surgeon between 2009‐2012. Of these, 241 were performed as an outpatient surgical procedure. Outcome measures included symptomatic hypocalcemia, readmission for hypocalcemia, true vocal cord paralysis/paresis, hematoma, and overall readmission rate.Results:Of the total thyroidectomies performed by a single‐surgeon between 2009‐2012, 241/410 (59%) were outpatient procedures. Symptomatic hypocalcemia occurred in 12/241 (4.9%) and readmission for hypocalcemia occurred in 4/241 (1.6%). True vocal cord paralysis was not observed, however 5/241 (2.1%) did have transient vocal cord weakness that resolved without further intervention. Hematoma requiring surgical intervention occurred in 2/241 (0.8%). Overall readmission rate was 5/241 (2.1%).Conclusions:Though traditionally an inpatient procedure; our experience indicates that outpatient thyroidectomy is a safe and reasonable option.
Sentinel Lymph Node Biopsy for Cutaneous Squamous Cell Carcinoma of the Head and Neck
Authors: Yan Jennifer , Gernon Thomas J. , Glazer Evan , Warneke James , Krouse Robert , Erman Audrey 
Published: August 2013

Objectives:Determine the safety and reliability of sentinel lymph node biopsy for head and neck cutaneous squamous cell carcinoma, the second most common skin cancer in the United States.Methods:One hundred four patients with cutaneous squamous cell carcinoma of the head and neck underwent sentinel lymph node biopsy at the University of Arizona Medical Center and the Southern Arizona Veterans Affairs Health Care System from 2001‐2012. Detailed histological and clinical data was extracted from a retrospectively collected, institutional review board–approved data set.Results:This is the largest series to date of patients with cutaneous squamous cell carcinoma of the head and neck who have undergone sentinel lymph node biopsy. In this series, a sentinel lymph node was positive for metastatic disease in 6.7% of patients. The negative predictive value, the false negative rate, and the false omission rate will be reported. Correlations between sentinel lymph node status and various clinicopathologic properties including size, patient age, comorbidities, rate of growth, differentiation at biopsy, outcome, patterns of failure, and nodal burden will be described.Conclusions:Sentinel lymph node biopsy in patients with cutaneous squamous cell carcinoma of the head and neck is a safe and reliable strategy to identify those patients who may benefit from therapeutic lymph node dissection and adjuvant therapies.
Recipient Artery Rupture in Free Tissue Transfer in Heavily Radiated Beds
Authors: Howard Brittany E. , Nagel Thomas H. , Donald Carrlene B. , Hayden Richard E. 
Published: August 2013

Objectives:Report a patient series of microvascular arterial rupture in fibula free flap tissue transfer for osteoradionecrosis of the mandible. 1) Evaluate the risk factors for arterial anastomotic rupture in free tissue transfer. 2) Evaluate management strategies and outcomes of these rare cases.Methods:Retrospective review of the senior surgeon's experience at a tertiary referral center for reconstruction of mandibulectomy defects for osteoradionecrosis with free tissue transfer from 2004 through 2013. Data collection included oncologic history, surgical resection and reconstructive details, postoperative course, complications, and outcomes.Results:Over a 10‐year period 38 patients underwent free fibula osseocutaneous flap reconstruction for a diagnosis of osteoradionecrosis of the mandible. There was a prevalence of 11% (4/38) that suffered delayed rupture of the recipient artery proximal to the microvascular anastomosis. Histopathology of the anastomotic segment demonstrated acute arteritis with acute inflammatory cells and pseudoaneurysm formation of the native vessel. The recipient artery of the anastomosis was the facial artery in 3 cases and the internal maxillary artery in 1 case. Timing to initial rupture ranged from 7 to 17 (median 8.5) days. In 2 of the 4 cases the anastomosis was revised, only to suffer repeat rupture. Ultimately all anastomoses required ligation, timing ranging from 10 to 20 (mean 15) days. There was 100% flap survival.Conclusions:Recipient arterial rupture is a rare occurrence, and in our experience heavily radiated tissue is the greatest risk factor. If salvage anastomosis with the same artery is undertaken, a high risk for repeat rupture exists.
Severe Prolonged Dysphagia following Transoral Resection of Bilateral Synchronous Tonsillar Carcinoma
Authors: Patel Alpen B. , Pollei Taylor R. , Hinni Michael L. , Moore Eric J. , Hayden Richard E. 
Published: August 2013

Objectives:1) Describe the complication of severe dysphagia following transoral surgical resection for bilateral simultaneous or synchronous tonsillar squamous cell carcinoma. 2) Analyze the incidence of bilateral simultaneous or synchronous tonsillar squamous cell carcinoma, as well as tumor multifocality in the setting of human papillomavirus.Methods:A retrospective review of four patients who presented to an academic, tertiary referral center between 2008‐2012 were reviewed; two treated with transoral laser microsurgery (TLM) and two with transoral robotic surgery (TORS) for biopsy proven previously untreated bilateral primary squamous cell carcinoma (SCCA). Main outcome measures included functional swallowing determined by the Functional Outcome Swallowing Scale (FOSS). The incidence of significant postoperative complications was recorded.Results:Two patients had surgery for discontiguous involvement of bilateral palatine tonsils with SCCA, while two patients had surgery for bilateral tonsillar SCCA with unilateral extension into the base of tongue. Complete swallowing failure as characterized by the FOSS was seen postoperatively in 3/4 patients who underwent TLM or TORS for bilateral simultaneous tonsillar carcinoma, while one patient was lost to follow‐up.Conclusions:Severe dysphagia in the setting of bilateral oropharyngectomy for simultaneous or synchronous tonsillar SCCA is rarely described but a significant concern. In an era with increased use of transoral surgery, along with increased human papillomavirus incidence, this unusual complication warrants discussion.
Socioeconomic Disparities in Mississippi Head and Neck Cancer Patients
Authors: Richardson Matthew A. , Tarsi Elizabeth J. , Replogle William H. , Jefferson Gina D. 
Published: August 2013

Objectives:Analyze the socioeconomic characteristics of head and neck cancer patients in Mississippi.Methods:Using a cross‐sectional study design, 1435 patients with squamous cell carcinoma of the upper aerodigestive tract who were treated at the single tertiary care center for the state of Mississippi and diagnosed between 1991 and 2012 were analyzed for correlation between overall cancer stage at presentation, race, sex, and several socioeconomic data points within their zip code, including median household income, percent population with less than a 9th grade education, and percent population with yearly income less than $10,000.Results:There were significant (P = 0.001) Spearman correlations between overall tumor stage and median household income, percent population with less than a 9th grade education, percent population with income less than $10,000, race of patient, and sex of patient. As median income increased, tumor stage tended to decrease. As the percentage making less than $10,000 and percentage below 9th grade education increased, tumor stage tended to increase. Controlling for sex and race, African‐Americans tended to have more advanced tumors than Caucasians, and males tended to have more advanced tumors than females. African‐American males had significantly advanced cancer stages at presentation than all other groups.Conclusions:To our knowledge, this study is the first to directly correlate overall stage of head and neck cancer patients with socioeconomic status and illustrates that patients with more advanced cancers are more likely to be African‐American males and live in economically disadvantaged areas.
Stretch of the Minimally Invasive Incision during Thyroid and Parathyroid Surgeries
Authors: Chen Nan , Zitsch Robert P. 
Published: August 2013

Objectives:1) Identify and quantify changes in length of the skin incision following minimally invasive thyroid and parathyroid surgery. 2) Determine whether these changes persist on follow‐up.Methods:Preliminary analysis of this ongoing prospective study is presented. Patients undergoing open minimally invasive thyroidectomy (open cervical approach through an incision <6 cm) and parathyroidectomy (incision <3 cm) were included. The length of the skin incision was measured at the start and end of each operation, and on postoperative follow‐up.Results:Data from 27 patients are available. Initial incision lengths ranged from 2 to 6 cm. The skin incisions on average lengthened by 3.9 mm during the surgery (95% confidence interval [CI] 2.6 to 5.0 mm), representing an average intraoperative stretch of 10.3%, P = 0.00. The lengths of the incision remained stable on 2‐week follow‐up. 6 of the 27 patients have returned 10 weeks following surgery. The lengths of the incisions have reduced by 4.8 mm on average from the 2‐week to the 10‐week measurement (95% CI ‐3.3 to ‐6.3 mm, P = 0.00).Conclusions:Preliminary data suggest the skin incision stretches during minimally invasive thyroid and parathyroid surgery. Based on available follow‐up data, the increase in incision length does not appear to be permanent.
The Submental Myocutaneous Flap for Circumferential Neopharyngeal Reconstruction: A Novel Technique
Authors: Tomblinson Courtney M. , Cervantes Sergio S. , Landry April M. , Hinni Michael L. 
Published: August 2013

Objectives:1) Describe a novel technique for circumferential neopharyngeal reconstruction utilizing a submental myocutaneous flap following total laryngopharyngectomy. 2) Discuss surgical planning and peri‐operative management for reconstruction. 3) Evaluate this technique's benefit over existing techniques.Methods:We describe a patient who underwent total laryngopharyngectomy with immediate neopharyngeal reconstruction using a myocutaneous submental flap. This is the first report of successful repair using this technique in the United States, according to our literature review. We compare this novel method with current techniques for repairing circumferential pharyngectomy defects.Results:Total laryngopharyngectomy was required for a recurrent squamous cell carcinoma of the hypopharynx, which involved the left arytenoid, pyriform sinus, and past midline posteriorly. The pharyngeal defect was circumferential measuring 8cm in length. A submental flap 8cm wide by 15cm long was elevated and tubed to form a neopharynx, was sutured longitudinally at one vertical seam, and attached to the superior and inferior borders of the native pharynx. A nasogastric tube remained in place for nine days to serve as a conduit in the newly formed pharyngeal construct. A swallow study did not demonstrate contrast extravasation or fistula. The patient completed adjuvant radiotherapy and is undergoing surveillance monitoring.Conclusions:The myocutaneous submental flap is a practical, regional option for immediate neopharyngeal reconstruction after total laryngopharyngectomy. Adequate time for wound healing before initiation of oral feeding is essential to prevent fistula formation. Functional recovery of swallowing is possible with the tubed submental flap and spares the patient morbidity associated with more complex reconstructions.