bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Can Physicians Identify Dysphagia in Patients with Head and Neck Cancer?
Authors: Krisciunas Gintas P. , Langmore Susan E. 
Published: February 2015

ObjectiveThe investigators sought to determine the most sensitive indicator for identifying a swallowing problem in patients with HNC who are treated with radiotherapy—patient‐report of dysphagia or diet level consumed.MethodData were taken from 113 HNC patients. Prevalence of dysphagia was determined by patient report and diet level, then broken out by gender and age. A web‐based survey of clinical practice included 759 SLPs who work with HNC patients. Referral patterns and time of first intervention were queried.ResultsOver the first year, prevalence of dysphagia was 8% to 20% higher (worse) by diet restriction than by report of a swallowing problem. Men reported a worse swallowing problem and more diet restrictions than did women (P =. 057). Patients younger than 60 years reported worse diet levels and diet restrictions than did older patients (ns). The survey found that 70.6% of SLPs reported no institutional policy, with referrals made on a case by case basis. The prevalent trend (nearly 50%) was for patients to be referred only when a dysphagia presented.ConclusionSince most MDs do not refer to SLPs for dysphagia unless the patient reports a problem, it is critical to query the patient carefully. Patients tend to underreport a problem compared to diet level, thus physicians should ask specifically about diet in order to maximize sensitivity. A standardized diet scale is recommended.
Laryngeal Laser Resections with Frozen Section
Authors: Zahoor Tosief , Dawson Rebecca , Makura Zvorufura G. G. 
Published: February 2015

ObjectiveTo demonstrate that laryngeal laser resections can be done as day case procedures and the use of frozen section histology negates the need for second look surgery that is recommended by the UK consensus report. Demonstrate patient preference for choice of treatment and comparable outcomes for voice with laser resections.MethodA retrospective study of patients who underwent laser resection for T1 and T2 laryngeal carcinoma from December 2002 to September 2009 with prospective analysis of functional outcomes and disease‐free survival. Suitable patients presenting to the Leeds Head & Neck Cancer Unit were offered a choice between radiotherapy and laser resection.ResultsA total of 60 patients underwent the procedure with greater than 42% patients over the age of 70 years. Ninety percent of patients had intraoperative frozen sections, with concordant histology with final histology in 96%. Forty‐two percent of patients had a repeat procedure on average at 10 months of which 36% were recurrence. The number of repeat procedures reduced as our experience for threshold for second look improved with experience. Greater than 50% patients had a single overnight stay for reasons mainly related to geography; a third of patients went home the same day. Greater than 85% of patients had voice that was acceptable or better.ConclusionLaryngeal laser resection with frozen section is a valid technique for the treatment of T1 and T2 laryngeal cancer and offers many advantages over radiotherapy. We found that with good pathological support cure can be achieved in a single day case procedure and negates the need for routine second look surgery.
Laryngeal Organ Preservation Protocols: Are They Effective?
Authors: Peixoto Maria C. , Branquinho Francisco , Guimarães Arnaldo , Gonçalves Sara , Khouri Leila , Silva Regina 
Published: February 2015

ObjectiveUnderstand the role of organ preservation protocol in locally advanced laryngeal carcinoma according to our experience and determine predictive factors.MethodThe study selected all patients treated between 2004 and 2009. During the study period, all patients began treatment with induction chemotherapy (3 cycles of cisplatin and 5‐fluoruracil in the majority of cases) followed by radiotherapy and concomitant or subsequent chemotherapy. The results were analyzed by clinical and image evaluation.ResultsThe study included 40 patients, with mean age of 55 years (range, 38 to 72 years), mainly men. Smoke and alcohol were present in more than 50%, and 70.7% had no comorbidities. Hypopharynx was the most common place (65.8%). At the end of induction chemotherapy 34.2% of patients had an answer >80%. The overall survival is 59% at 3 years. The relapse rate was of 24.7% with an average of time of 8 months (4 to 56 months). No statistical differences were found between different groups of TMN staging system.ConclusionDifferent studies have shown that chemotherapy followed by radiotherapy is a valid alternative to surgery in locally advanced operable head and neck cancer, involving the larynx. Our study confirms these results. Local and cervical disease staging did not contribute as a predictive factor for survival or relapse.
Localized Amyloidosis of the Tongue: Mayo Clinic Experience
Authors: O’Reilly Ashley , Price Daniel , D’Souza Anita 
Published: February 2015

Objective1) Review Mayo Clinic Rochester experience of localized tongue amyloidosis from 1961 to 2011. 2) Evaluate the workup of patients with localized amyloidosis, particularly exclusion of systemic amyloidosis. 3) Understand treatment and outcomes for patients with localized tongue amyloidosis.MethodWe reviewed the medical records of patients presenting to the Mayo Clinic Rochester from 1963 to 2011 for evaluation of amyloidosis who were found to have localized tongue amyloidosis, with no systemic involvement. Patients were followed over time to assess for disease recurrence and progression to systemic amyloidosis.ResultsBetween 1963 and 2011, 30 patients presented to the Mayo Clinic Rochester for evaluation of amyloidosis who underwent a tongue biopsy as part of the evaluation. Of these 30 patients, 2 were diagnosed with localized tongue amyloidosis with no systemic involvement. Both patients were treated with wide local excision of the lesion without complication. They have not had local recurrence and have not developed systemic amyloidosis.ConclusionLocalized tongue amyloidosis remains an extremely rare finding, with only 5 other cases reported in the English literature. Thorough evaluation is required in order to exclude systemic involvement. Treatment involves wide local excision of the lesion. Patients are not at increased risk for recurrence or of developing systemic amyloidosis.
Low Vitamin D and Risk of Post‐thyroidectomy Hypocalcemia
Authors: Nhan Carol , Dolev Yalon , Mijovic Tamara , Rivera Juan A. , Mlynarek Alex M. , Kallai‐Sanfaçon Mary‐Ann , Payne Richard J. 
Published: February 2015

Objective1) Determine if low vitamin D reduces risk of post‐thyroidectomy hypocalcemia. 2) Verify if this is an independent effect.MethodRetrospective study of 139 total thyroidectomy patients (October 2009‐October 2011) at a McGill University teaching hospital. Preoperative 25‐hydroxy‐vitamin D (25OHD), calcium, and PTH were measured. Patients were assessed for postoperative hypocalcemia. Low vitamin D (LVD) was defined as 25OHD ≤70 nmol/L (28 ng/mL) and optimal vitamin D (OVD) was defined as 25OHD >70 nmol/L (28 ng/mL).ResultsHypocalcemia occurred in 3.2% (2 of 62) patients with LVD and 10.4% (8 of 77) patients with OVD (OR 0.2875, P =. 124). No patients with vitamin D deficiency (VDD), defined as 25OHD ≤35 nmol/L (14 ng/mL), developed hypocalcemia. Univariate analysis did not show age, sex, malignancy, presence of thyroiditis, number of preserved parathyroids, parathyroid autotransplantation, preoperative PTH, or preoperative calcium to be significantly predictive. Multivariate analysis confirmed no confounding factors in vitamin D analysis, but also did not show any independent risk factors. Fisher analysis comparing total versus completion thyroidectomy was marginally significant (P =. 064) for predicting hypocalcemia.ConclusionTransient hypocalcemia appears to occur less frequently in patients with VDD, however in our limited study we were unable to elucidate whether this was significant. Future study observing a larger population and excluding completion thyroidectomy patients may help to clarify whether VDD impacts risk for hypocalcemia.
Rhinoplasty in the Andean Patient
Authors: Villagra Eric J. , Perales Marcos‐Antonio Rodriguez 
Published: February 2015

ObjectiveRhinoplasty is one of the most frequently performed surgeries and sought after worldwide. There are different types of races, such as African, Mediterranean, Middle East, Asian, European, and Latin American. The standards of beauty have changed over time, and rhinologists should know the standard of beauty for each race. The Andean nose (part of Latin America) requires intense work; osteocartilaginous humps are generally rather prominent; the skin tends to be at the thick nasal tip and lower lateral cartilages with little or no basal medium, which requires in most cases the use of structural grafts and intensive management of membranous septum. It is important to know what characteristics must be preserved and what features should be modified. The Caucasian nose and even other Latin American noses differ greatly from the Andean (Peru, Ecuador, Bolivia) nose, and therefore, the management should be fully individualized in each case in order to provide realistic patient surgical options according to their anatomic characteristics. This presentation aims to make known some features of the Andean race, as well as some tips and tricks to better manage their patients.MethodTransversal study from July 2006 to July 2012 (6 years). Six hundred rhinoplasty surgeries were performed.ResultsAndean rhinoplasty differs from conventional surgery and requires an individualized approach and management.ConclusionWe present a new armamentarium for your practice to manage Andean patients (Ecuador, Peru, Bolivia) and perform a most succesful rhinoplastic surgery.
Management of Oral Ranula
Authors: Woo Hyun‐Jae , Chi Deok Hwan 
Published: February 2015

ObjectivePreferred treatment of oral ranulas remains controversial. We present our experience with ranulas at Gumi CHA Medical Center (GCMC) and review the literature.MethodRetrospective review. From 2002 to 2010, 61 oral ranulas were treated at GCMC. Combining the GCMC series with the literature identified 271 cases for review.ResultsIn the GCMC series, procedures for oral ranulas varied from ranula excision (9 cases, 32%), marsupialization (18 cases), combined ranula and sublingual gland excision (24 cases, 45%), sclerotherapy with OK‐432 (10 cases, 23%). Recurrences of ranula excision only, marsupialization, combined ranula and sublingual gland excision, and sclerotherapy were 5 cases (56%), 5 cases (28 %), 0 cases (0%), and 5 cases (50%), respectively. Sixty complications were identified from the literature. Recurrence was considered a complication and was most prevalent (68%). Nonrecurrent complications included tongue hypesthesia (12%), bleeding/hematoma (12%), postoperative infection (7%), and Wharton’s duct injury (2%). Procedures and associated complication rates were: ranula excision only (20%), marsupialization (20%), combined ranula and sublingual gland excision (13%), and sclerotherapy (57%).ConclusionBased on our review, definitive treatment yielding lowest recurrence and complication rates for oral ranulas is transoral excision of the ipsilateral sublingual gland and ranula.
Sandwich Graft Technique Repair of Nasal Septal Perforation
Authors: Shin Myungseok 
Published: February 2015

ObjectiveThe aim of this study was to examine the surgical technique of sandwich graft using inferior turbinate mucoperiosteal flap and auricular cartilage via open rhinoplasty approach for repair of nasalseptal perforation.MethodRetrospective review of 7 patients operated from 2008 to 2010.ResultsSix of the 7 patients had a complete closure, and one patient achieved incomplete closure.ConclusionSandwich graft of inferior turbinate mucoperiosteal flap and auricular cartilage via open rhinoplasty approach showed high success rate and relatively easy surgical technique.
Partial Laryngectomy versus Chemoradiotherapy
Authors: De Arriba Alvaro , Castro Alejandro , Bernaldez Ricardo , Del Palacio Antonio , Del Rio Laura , Sanchez‐Cuadrado Isabel , Gavilan Javier 
Published: February 2015

ObjectiveChemoradiation protocols for organ preservation has relegated surgery to salvage in many institutions. However, open partial laryngectomies and endoscopic procedures provide an option for function preservation. The aim of this study is to review the outcomes of T2‐T4 laryngeal and hypopharyngeal cancer patients treated with either partial laryngectomy or chemoradiotherapy.MethodRetrospective review of patients with T2‐T4 laryngeal and hypopharyngeal squamous cell carcinoma treated with either partial laryngectomy or chemoradiotherapy between 2001 and 2009 at the authors’ institution. Primary endpoints were local control rate and laryngo‐esophageal dysfunction‐free local control (LEDFLC, patients without tracheostomy or feeding tube in the last contact).ResultsSurgical group: 47 patients, with 50% of locally advanced tumors (T3‐T4). Chemoradiotherapy group: 36 patients with 72% of locally advanced tumors. Median follow‐up was 49.5 months. Local control rate was statistically higher for the surgical group (84.3% vs 63.6%, P =. 021), although no differences in LEDLC were observed. When local control rate is analyzed by T stages, a significant difference is found for T2 (95.2% vs 70%, P =. 035) favoring surgical group, and a nonsignificant trend for T3‐T4 (72.7% vs 61.4%). A nonsignificant trend in overall survival, disease‐specific survival, and disease‐free survival favoring primary surgical treatment was found.ConclusionWhen properly indicated and performed, partial laryngectomy achieves similar function preservation outcomes to chemoradiation protocols. A noticeable better local control rate has been observed for the surgical group. These techniques should endure in the armamentarium of surgeons. Choosing the most appropriate treatment for each patient is the key for success.
Tissue Oximetry Free Flap Monitoring in the Head and Neck
Authors: Rabie Amr N. , Ibrahim Ahmed , Lin Samuel J. 
Published: February 2015

ObjectiveTo assess the effectiveness of continuous noninvasive tissue oximetry in free flap monitoring in head and neck reconstruction.MethodIn a retrospective case series, we report 5 patients over a period of 12 months who underwent head and neck reconstruction with free tissue transfer and postoperative monitoring using near‐infrared spectroscopy using the commercially available ViOptix Tissue Oximeter device (ViOptix, Fremont, California).ResultsThe use of near‐infrared spectroscopy (ViOptix) was successfully implemented in all 5 patients. Early experience with this technique in the head and neck demonstrates its feasibility in monitoring head and neck flaps, especially in areas where monitoring the skin paddle may be challenging for the observer. We report early success in using this device in postoperative monitoring.ConclusionNear infrared spectroscopy is a potential means of monitoring free tissue transfer in the head and neck. More research is needed to study the impact of using ViOptix in the early detection of free flap compromise and subsequent salvage and its impact on re‐exploration rates and overall flap survival rates.
Predictors of Neck Failure in T1/T2 ‐N0 Oral Tongue Squamous Cell Carcinoma
Authors: Moreno Mauricio A. , Cotrill Elizabeth , Vural Emre 
Published: February 2015

ObjectiveThe incidence of early squamous cell carcinoma of the oral tongue (SCCOT) is increasing, particularly among young patients. The development of loco‐regional recurrence is associated with poor survival. We sought to identify the predictors for nodal recurrence in early (T1/T2) SCCOT presenting with a radiologically N0 neck.MethodRetrospective chart review of 50 consecutive patients primarily treated for T1/T2‐N0 SCCOT at an academic tertiary institution between 1998 and 2007. N0 status confirmed by preoperative contrasted neck CT in all cases.ResultsTwenty‐six men and 24 women with a median age of 61 years (range, 24‐90 years); 46% presented with a T1 and 54% with a T2. Depth of invasion >4 mm was present in 76%; positive margins in 8%; dysplasia at the margin 6%; perineural invasion 18%; and lymphovascular invasion 12%. Ipsilateral neck dissection was performed in 60% (20% microscopically positive) while adjuvant radiation was used in 32%. Twenty percent of the patients recurred in the neck, ipsilateral in all cases. It presented between 4 and 47 months and was associated with dysplasia at the margin (P =. 037) and local recurrence (P =. 002), while pathological T‐stage (pT2/pT1) trended (P =. 087).ConclusionPathological T‐stage, field cancerization and development of local recurrence are predictors for regional failure in patients with early SCCOT. Neck recurrence appears to be primarily determined by biological behavior rather than treatment modality in this subset of patients.
Pre‐op Thyroglobulin and Sentinel Lymph Node Biopsy Outcomes
Authors: Maniakas Anastasios , Saliba Joe , Hier Michael P. , Mlynarek Alex M. , Caglar D. , Tamilia Michael , Payne Richard J. 
Published: February 2015

Objective1) To retrospectively assess the usefulness of preoperative thyroglobulin (Tg) levels in predicting sentinel lymph node (SLN) biopsy (SLNB) status. 2) To evaluate the correlation between preoperative Tg levels and the overall number of positive SLNs. 3) To compare primary tumor (T) classification in patients according to SLNB outcome.MethodData from patients operated for well‐differentiated thyroid carcinoma (WDTC) at the McGill University Thyroid Cancer Center were collected from January 2007 to January 2012. Statistical analyses were performed using a Mann‐Whitney‐Wilcoxon test, a Pearson correlation coefficient and a Pearson χ2 test.ResultsPreoperative Tg levels and SLNB results were available in 74 patients (51 negative and 23 positive SLNBs). Mean preoperative Tg levels for negative and positive SLNB groups were 105.2 and 85.9 ng/mL, respectively, yielding no statistically significant difference (P =. 143). Moreover, no statistically significant correlation was found between Tg levels and the number of positive SLNs (P =. 515). While 82.4% of patients with negative SLNBs had a T1 or T2 class WDTC, 82.6% of patients with positive SLNBs had a T3 or higher class, yielding a statistically significant difference between the 2 groups (P <. 001).ConclusionPreoperative Tg levels are not significantly different in patients with positive SLNBs as compared to negative SLNBs, and show no significant correlation with the number of positive SLNs. Thus, an elevated preoperative Tg is not a predictor of SLN status. Patients with positive SLNBs, however, have significantly worse T classifications.
Quality of Life of Head and Neck Cancer Patients in Ghana
Authors: Hills Susannah E. , Prince Mark E. 
Published: February 2015

Objective1) Investigate quality of life (QOL) of patients undergoing radiation therapy for head and neck cancer at KATH hospital in Ghana. 2) Compare QOL of these patients with a healthy Ghanaian population. 3) Compare QOL for Ghanian patients with QOL of head and neck cancer patients in the United States.MethodData collection is ongoing. We anticipate inclusion of 30 Ghanaian head and neck cancer patients, and 30 healthy Ghanaian controls. Participants complete the FACT‐H+N QOL Question‐naire. Data for patients in the United States are obtained from the FACIT database. Outcome measures include means, medians, standard deviations, and analysis of variance.ResultsPreliminary results demonstrate lower QOL scores among Ghanaian patients undergoing treatment compared with healthy controls (94.5 vs 111). Patients undergoing treatment also have lower scores for physical well‐being (22.5 vs 26.4), functional well‐being (14 vs 18.5), and head and neck–specific symptoms (20.5 vs 36.4). Ghanaians undergoing treatment had higher scores for emotional well‐being compared with healthy Ghanaians (22 vs 16.1). Initial comparison of the Ghanaian and American treatment groups revealed similar scores for physical well‐being (22.5 vs 18.9) and functional impairment (14 vs 15.3). However, the Ghanaian patients had higher scores for emotional well‐being (22 vs 16.8).ConclusionQOL of Ghanaian head and neck cancer patients is significantly worse than healthy controls. Patients are most affected by physical and functional impairments. Emotional well‐being is not worse for Ghanaians undergoing treatment. Ghanaian patients are similar to Americans in physical and functional well‐being. However, Ghanaian patients demonstrate greater sense of emotional well‐being.
Quality‐of‐Life Tools in Oral and Oropharyngeal Cancer
Authors: Moubayed Sami P. , Sampalis John S. , Christopoulos Apostolos 
Published: February 2015

Objective1) To identify and evaluate patient‐reported quality of life (QOL) questionnaires used in studies of oral and oropharyngeal cancer. 2) To provide information on the trends of use of each questionnaire according to language, country of origin, publication date, and type of treatment.MethodSystematic review of the English‐language literature. A search using the Medical Subject Headings (MeSH) queries (“Oropharyngeal Neoplasms” OR “Mouth Neoplasms”) AND “Quality of Life” was carried out by using a publicly available MEDLINE interface (PubMed). A total of 371 articles were identified and reviewed. We identified all English‐language studies of oral or oropharyngeal cancer patients that measure QOL using a patient‐reported questionnaire. Exclusion criteria are review article, comment, non‐English‐language study, wrong disease, and absence of quality of life measure.ResultsIdentified questionnaires will be summarized. Each instrument will be compared against the standards for health outcome instrument development and evaluation of the Scientific Advisory Committee of the Medical Outcomes Trust. Descriptive statistics regarding identified studies will be presented regarding questionnaire use by language, country of origin, publication date, and type of treatment.ConclusionOur results will help identify well‐researched areas in patient‐reported measures of QOL, and areas where more research is required. This is also the first study to objectively measure the number of studies that use each patient‐reported QOL questionnaire according to language, country of origin, publication date, and type of treatment. Such data is crucial in helping adequate questionnaire selection for evaluation of QOL.