bluuebunny/crossref_metadata_2025_split huggingface dataset:
S158 – Surgical Outcomes in Olfactory Neuroblastoma
Authors: Petruzzelli Guy J , Somenek Michael T , Origitano Thomas 
Published: August 2008

ObjectivesTo report experience and oncologic outcomes of surgical resection and adjuvant therapy in the treatment of olfactory neuroblastoma.MethodsA retrospective chart review of 31 patients with a histologic diagnosis of olfactory neuroblastoma presenting to the senior author between February 1994 and August 2007.Results3 of the 31 patients presenting with altered mental status were found to have tumors with either advanced or metastatic tumors and were excluded from analysis. One patient opted for treatment elsewhere and 1 patient received neoadjuvant chemo‐radiation therapy and died prior to surgery, leaving 26 patients available for study. 3 patients received primary radiation and 23 had primary surgery. 2 patients had limited disease and were treated with solely with medial maxillectomy. 24 patients had surgical resection with an anterior craniofacial, either open (17) or endoscopic (5). Negative margins achieved in 8.2%. Adjuvant radiotherapy was performed in 19 patients, 5 of which received concurrent chemotherapy. Only 1 patient presented with clinically positive neck disease and delayed neck failure was observed in 11.5% of patients with a majority of failures being advanced disease. Median and median follow‐up were 56.42 and 42.6 months respectively. 21 patients (21/26 or 81%) are alive with no evidence of disease; 1 is alive with disease, and 4 patients are dead of disease.ConclusionsThe anterior craniofacial approach with adjuvant therapy used in this study has provided promising long‐term results for the patients involved. Given the high propensity for olfactory neuroblastoma to recur, long‐term follow‐up is indicated.
S159 – Inter‐capsular Resection of Cervical Schwannomas
Authors: Hashimoto Sho , Chiba Toshihiko , Katori Yukio , Yahata Izumi 
Published: August 2008

ObjectivesTo present a new concept of surgical procedure for total removal of cervical schwannomas with neural function preservation, and the outcomes of this procedure in a series of tumors, with special reference to postoperative function of the nerve of origin.MethodsA retrospective case study of consecutive 18 patients seen from January 2003 to December 2007 who underwent inter‐capsular resection of cervical schwanomas derived from the nerve of vagus, hypoglossus, sympathetic trunk, accesorius, etc. was performed. During the procedure, motor fibers were confirmed and located on the surface of the tumor using nerve stimulator. Avoiding motor fibers, nerve sheath (epineurium and perineurium) is cut with a scalpel and the true capsule of the tumor is recognized. By the dissection between nerve sheath and true capsule, tumor is completely removed. The senior author named this procedure “Inter‐capsular resection.”ResultsAll tumors were resected completely, being proven by pathological study. No motor function deficit resulted, but mild Horner's symptom was experienced in a case with the tumor of superior cervical ganglion origin. In a case of cervical plexus schwannoma, nerve fibers were seen in the tumor pathologically.ConclusionsCervical schwannoma can be totally removed by inter‐capsular resection without postoperative motor function deficit.
S160 – Salvage Operations after Chemoradiotherapy for SCCHN
Authors: Tokumaru Yutaka , Masato Fujii , Noboru Habu , Yoko Yajima 
Published: August 2008

ObjectivesConcurrent chemoradiotherapy (CCRT) is one of recent emerging modalities for squamous cell carcinoma of the head and neck (SCCHN), because of its good efficacy and functional preservation. However, some patients treated by CCRT have residual tumor or recurrence in primary sites and/or cervical lymph nodes. This study aims to analyze usefulness of the salvage operations after CCRT for SCCHN.MethodsThe medical records of 111 consecutive patients (stage II: 17%, stage III: 6%, stage IV: 77%) treated with CCRT for SCCHN from 2003 through 2008 were reviewed. 76 patients were treated with 2 cycles of CDDP (60mg/m2), 5‐FU (600mg/m2 ⋉ 4 days), and RT (2.0 Gy daily; total dose, 66–70Gy). 35 patients were treated with 6 cycles of weekly decetaxel (10mg/m2) and RT.ResultsThe overall clinical response rate was 93% (59% complete, 34% partial). 16 patients underwent 23 surgical procedures. The types of procedures performed are as follows: selective neck dissection, 16; total laryngopharyngectomy, 3; total laryngectomy, 3; partial glossectomy, 1. All 16 patients with salvage operations had good locoregional controls as of 2007. Major wound complication (pharyngocutaneous fistula after total laryngectomy) occurred in 1 (6%) of 16 patients and successfully closed using deltopectoral flap. There were few other minor complications such as wound infection and laryngeal edema.ConclusionsSalvage operations can be safely performed and considered to be useful in the point of locoregional control after intensive CCRT.
S166 – Partial Parotidectomy for Benign Parotid Tumors
Authors: Plaza Guillermo , Hernando Monica , Urbasos Maria , Martin Luz , Montojo Jose , Garcia‐Peces Victoria , Onrubia Tomas 
Published: August 2008

Objectives1) To evaluate our results and complications after partial parotidectomy vs. superficial parotidectomy, as primary treatment of benign parotid tumors. 2) To present an evidence‐based review on partial parotidectomy as the method of choice of treatment of benign parotid tumors.MethodsA case‐control study is presented on parotidec‐tomy, comparing a group of 25 patients treated by partial parotidectomy vs. a similar group of 25 patients treated by superficial parotidectomy. All patients had primary benign parotid tumors, were matched by sex and age, and had a minimum follow‐up of 12 months in a university hospital. Independent variables included sex, age, medical history, intraoperative variables (surgical time, estimated blood loss, type of drainage, use of collagen), fine‐needle aspiration, CT findings, and final histopathological diagnosis. Outcome measures were early and late complications, such as facial nerve paralysis, seroma, sialocele, Frey syndrome, and recurrence. Comparison of both groups was done by Chi‐squared and non‐parametric analysis, after a. 05 significance level, and multivariate regression analysis.ResultsPartial parotidectomy resulted in less early and late complications than superficial parotidectomy, with similar recurrence rates. Facial paresis was found in 24% of partial surgeries, vs. 36% of superficial ones (a significant difference); 3 months after surgery, only 1 patient has a persistent marginal nerve paresis. By contrast, only seroma was more common after partial parotidectomy (28% vs 16%).ConclusionsPartial parotidectomy achieves less early and late complications than superficial parotidectomy, with similar recurrence rates.
S167 – Supportive Physical Therapy on Head and Neck Cancer Patients
Authors: Targino Costa Márcia G. S. , Lima Roberto A. , Rabello Claudia , Lucena Rosana , Bacelar Silvia , Luiz Dias Fernando , Barbosa Mauro 
Published: August 2008

Objectives1) The aim of this paper is to identify the supportive profile of physical therapy attendments at Brazilian National Cancer Institute. 2) Look for patients’ main demands and their dysfunctional characteristics.MethodsThe physiotherapeutic consultations for head and neck cancer patients performed between 02/01/2007 and 12/31/2007 were retrospectively analyzed in their quantitative and qualitative aspects.Results1405 attendments were reviewed including 15% of first‐time patients. 60% of the consultations were to male patients. The main dysfunctions identified were on accessory nerve (27, 7%), followed by TMJ disorders (27, 6%), breathing complications (10, 6%), and restricted neck movement (10, 5%). The less frequent complications were paresis of facial nerve mandibular branch (4, 7%) and donor site dysfunctions (2, 5%). Pain was a complaint present in 39 (7%) of these attendments, and analgesia was responsible for 21 (2%) of the total procedures performed. In 24% of realized consults, 3 or more procedures were necessary, representing multiple dysfunctions on each patient.ConclusionsSecondary dysfunctions caused by head and neck cancer and/or its indicated treatment are important and quite frequent. Shoulder and TMJ dysfunctions as well as breathing disorders were the most frequent complications observed. Pain was seen in a significant number of patients under physical therapy. Patients’ total care has the intention of preventing known complications, and to allow early rehabilitation and sequelae management of installed dysfunctions.
S168 – The Use of a Harmonic Scalpel in Head & Neck Surgery
Authors: Janjanin Sasa , Prgomet Drago , Mario Bilic , Ratko Prstacic 
Published: August 2008

ObjectivesThe harmonic scalpel cuts and coagulates simultaneously using a mechanical vibration. We present our 1‐year experience in the use Harmonic ACE(tm), Harmonic FOCUS(tm) and harmonic scalpel with 5 mm curved blade in head and neck surgery (Ethicon Endo‐Surgery).MethodsOver period of 1 year we performed 295 thyroidectomies, 23 parotidectomies, and 45 tonsillectomies using the harmonic scalpel. Control group consisted of 106 thyroidectomies, 9 parotidectomies, and 30 tonsillectomies that were performed over previous 5 months with the use of conventional hemostatic techniques (electrocautery and knot tying).ResultsThe use of the harmonic scalpel shortened the duration of thyroid and parotid surgery by 20–30% as compared with the conventional techniques (p<0.05). The average skin incision length for those undergoing thyroidectomy with the harmonic scalpel was 1.8 cm shorter as compared with the conventional thyroidectomy group (p<0.05). Because of small skin incisions in thyroidectomy we preferred Harmonic ACE(tm) over Harmonic FOCUS(tm) due to longer shaft of scalpel, while Harmonic FOCUS(tm) was more suitable for parotidectomy. The use of Harmonic ACE(tm) shortened average duration of tonsillectomy by 5.5 minutes, while use of 5 mm curved blade (HF 105) did not affect significantly the average duration of tonsillectomy. Postoperative pain and complication rate were comparable for both groups (p>0.05).ConclusionsThe use of the harmonic scalpel reduces surgical time and intraoperative blood loss in head and neck procedures, and enables shorter incision length in thyroid surgery.
S170 – Neck Recurrences in T1 Oral Carcinomas
Authors: Lehn Carlos Neutzling , Porsani Alex Freitas , Costa Ana Carla 
Published: August 2008

ObjectivesTo evaluate the regional recurrences in 48 cases of T1 SCC of tongue and floor of mouth.MethodsRetrospective review of 48 cases of T1 SCC of tongue and floor of mouth treated primarily with local resection of the tumor. All the cases were reviewed concerning the tumor site, size and thickness, presence of perineural invasion, desmoplastic reaction, outcome and follow‐up.ResultsThere was a predominance of male patients (83.3%) with a mean age of 55.4 years old. All but 7 cases were tobacoo consumers and only 10 patients did not use alcohol. The floor of mouth was the primary site in 54.20% of cases. The mean diameter of tumors was 0.86cm and the mean thickness were 0.6mm. Neck recurrences occurred in 10 cases (20.83%) and in 2 of these cases there were local recurrence. All but 1 recurrent cases were treated with salvage surgery and 4 cases died of disease in a mean time of 11.7 months.ConclusionsThe high rate of neck recurrences in early oral carcinomas must be considered during the treatment planning of these cases and the need of neck dissection should be considered, even in tumors with less than 2.0cm.
S173 – Ectopic Intratracheal Thyroid Cancer
Authors: Brawner James T , Krempl Greg 
Published: August 2008

Objectives1) To describe a case of ectopic intratracheal thyroid cancer. 2) To review the literature describing ectopic intratracheal thyroid tissue.MethodsEctopic thyroid tissue is periodically encountered and can sometimes be malignant. The most common locations for ectopic thyroid tissue to be found are the tongue and along the tract of descent of the thyroid gland into the neck. We describe a case of ectopic intratracheal thyroid cancer and review the literature for similar cases. We also discuss possible explanations for this phenomenon.ResultsA total thyroidectomy with tracheal resection was performed. The patient received postoperative I131 therapy and has no detectable serum thyroglobulin to date. There is a small number of cases that report ectopic thyroid tissue found in the trachea. 3 of these were malignant. Including the current case, 26% of ectopic intratracheal tissue is malignant.ConclusionsEctopic intratracheal thyroid tissue is rare. Since 26% of reported cases have been malignant, we suggest that resection is the appropriate therapy, as opposed to the alternative endoscopic laser debulking.
S175 – Endoscopic and Open Approaches for Zenker's Diverticulum
Authors: Seth Rahul , Koch Carl , Lorenz Robert R , Scharpf Joseph , Lee Walter 
Published: August 2008

ObjectivesTo compare 1) long‐term symptomatic outcomes and 2) patient satisfaction between open‐neck surgery and endoscopic stapling diverticulotomy (ESD) for Zenker's diverticulum.MethodsPatients undergoing operation for Zenker's diverticulum during the last 10 years (1998 through 2007) at our institution were telephoned and questioned of dysphagia, coughing and choking, regurgitation, halitosis, weight loss, and recurrent pneumonia based on a validated Gastrointestinal Quality‐of‐Life Index. Symptom degree pre‐operatively, one‐month postoperatively, and time of phone call were recorded.Results39 of 81 patients were contacted. Of these, 14 underwent ESD and 25 had open‐neck procedures. Average follow‐up time was longer for the open‐neck group (4.6 vs. 1.8 years, p<0.01, t‐test). Age at operation, diverticulum size, pre‐operative symptom scores, and long‐term follow‐up scores at phone call were not statistically different between the two groups. When patients were asked if symptom relief was complete, improved, unchanged, or worse, a greater proportion of open‐neck patients claimed a complete response (67% vs. 43%, p=0.09, contingency analysis) at longer follow‐up times. The recurrence of symptoms leading to re‐operation was higher for ESD (4 versus 2).ConclusionsLong‐term symptomatic outcomes between the 2 populations are similar. However, a greater proportion of patients with open‐neck procedures claimed complete response. Since the Zenker's location is unchanged in ESD, this may explain persistent symptoms the patient may be experiencing. Greater patient numbers are needed for statistical significance.
S183 – Intracordal Fat Assessment after Injection Laryngoplasty
Authors: Fang Tuan‐Jen , Wang Chao‐Jan , Li Hsueh‐Yu 
Published: August 2008

ObjectivesAutologous fat injection for unilateral vocal cord paralysis is a popular procedure for immediate symptoms control, but uneven long‐term outcomes were reported. Most authors believed that the continual resorption of injected fat was the cause of voice degradation. A long‐term residual fat volume was evaluated.MethodsWe retrospectively reviewed the patients following autologous fat injection for symptomatic unilateral vocal cord paralysis from 2002 Aug to 2006 July. The patients accepted head and neck computed tomogragphy (CT) evaluation following surgery were included. A three‐dimensional reconstruction of the images of larynx and upper airway was performed on the work station (Vitrea® 2, version 3.9). The volume of intracordal fat was then calculated.Results5 males and 15 females of the mean age 49 were enrolled. The mean duration from lipoinjection surgery to the CT study is 23.0 months (12–50 months). The injection fat was found in all study cases. The estimated fat volume ranged from 0.01 to 0.75 ml with a mean 0.33 ml. Compare with the injected fat volume, a mean 27.5% fat survived. The correlation between residual fat volume rate and duration of follow‐up is not significant.ConclusionsThe intracordal fat volume didn't decline from time. Long‐term intracordal injected fat diminished but survived in all cases. The degradation may be caused by absorption or immediate extrusion from injection wound. An over‐correction and prevention of extrusion postoperatively would improve the long‐term outcomes.
S184 – Communication Experiences and QOL after Laryngeal Cancer
Authors: Finizia Caterina A , Johansson Mia , Rydeé Anna 
Published: August 2008

Objectives1) To investigate the sensitivity to change of the Swedish Self‐Evaluation of Communication Experiences after Laryngeal Cancer questionnaire (S‐SECEL), addressing communication dysfunction in patients treated for laryngeal cancer. 2) To evaluate longitudinal score changes in relation to established and validated quality of life instruments.Methods100 patients with Tis‐T4 laryngeal cancer were included prior to treatment onset. Patients answered 4 questionnaires at 6 occasions during 1 year; the S‐SECEL, the EORTC Quality of Life Questionnaire, the EORTC Head and Neck cancer module, and Hospital Anxiety and Depression (HAD) scale. In addition, performance status was assessed. Differences within groups were tested with the Wilcoxon paired signed ranks test and between‐group analyses were carried out using the Mann‐Whitney U test. Magnitude of group differences was analyzed by means of effect sizes.ResultsS‐SECEL was well accepted with a response rate of 76%. Communication dysfunction increased at 1 month, followed by a continuous decrease throughout the year. Changes were statistically significant at most measurement (p < 0.001), demonstrating the sensitivity of the S‐SECEL to changes in communication over time. The S‐SECEL was more sensitive than EORTC regarding communication dysfunction.ConclusionsThe questionnaire was responsive to change and showed convergent results when compared to established HRQL questionnaires. As a routine screening instrument, the S‐SECEL could be a valuable tool for identifying patients at risk for psychosocial problems, to help plan rehabilitation and in‐depth counselling. It is therefore recommended for clinical use in evaluation of communication dysfunction for all patients with laryngeal cancer, irrespective of treatment.
S185 – Unilateral Vocal Cord Paralysis: The Miami Experience
Authors: Whitley Matthew , Casiano Roy R , Lundy Donna 
Published: August 2008

Objectives1) Understand the changing etiologies of unilateral vocal cord paralysis. 2) Learn the frequency of return of vocal cord function after paralysis.MethodsWe performed a retrospective analysis of 280 patients treated in the Department of Otolaryngology at the University of Miami for the diagnosis of unilateral vocal cord paralysis from 1999 to 2007. Medical records were reviewed in order to ascertain the etiology of the paralysis and determine on follow‐up if there was recovery of function.ResultsThe majority of cases (46%) were of surgical origin, with the leading surgical injury being thyroid surgery. Despite a thorough workup, 28% of cases remained idiopathic in origin. 21 patients (7%) had recovery of vocal fold function, the majority of which had a surgical etiology.ConclusionsThe most common cause of unilateral vocal cord paralysis, in our experience, is surgery, with thyroid surgery being the leading cause. A large majority of these cases remain idiopathic in nature. A small subset of patients regain function of the paralyzed vocal cord.
S187 – Autoimmune Indicators in Idiopathic Subglottic Stenosis
Authors: Alon Eran E , Tombers Nicole M , Hinkley Lucinda , Michael Camilleri , Moore Eric J , Kasperbauer Jan L 
Published: August 2008

ObjectivesPresent new data regarding the role of autoimmune disease in Idiopathic Subglottic Stenosis.MethodsPatients with ISS identified between April 2007 and February 2008 were included. Directed subglottic biopsies and serum samples were collected after IRB approval and appropriate consent. Direct immunohistochemical staining was conducted on biopsy samples and indirect immunohistochemical staining was performed on serum samples.Results35 females were identified with ISS. The mean age was 51 (range 23–81). 12 patients underwent direct Immunofluorescence staining with biopsies taken from the stenotic region. Only 2 biopsies had adequate epithelial surface area to perform direct immunofluorescence, which was negative in both cases. Indirect immunofluorescence stains were performed on 18 samples using a monkey esophagus model and human salt split skin to identify autoimmune antibodies to epithelial and basement membrane components. For the same specimens, ELISA tests were performed for Desmoglein 1, Desmoglein 3, BP 180, and BP230 markers that are positive in various autoimmune mucocutaneous disorders. Only 2 serum specimens were weakly positive for BP180. However, 13 of 18 specimens (72%) displayed nonspecific nuclear staining indicative of a nuclear autoantibody component, suggesting a connective tissue disorder.ConclusionsThis work does not demonstrate clear evidence of an autoimmune mucocutaneous disorder involved in the pathogenesis of ISS; however, the non‐specific antinuclear staining may indicate an association with a connective tissue disorder. Further studies are required to identify the exact role and pathogenesis that the immune system plays in ISS for future targeted therapy.
S189 – Tracheotomy Tube Occlusion Status and Swallowing Function
Authors: Donzelli Joseph J , Brady Susan L , Kaszuba Scott M , Wesling Michele W 
Published: August 2008

ObjectivesTo compare the effects, if any, various types of tracheotomy occlusion conditions may have upon swallowing during either the videofluoroscopic swallow study (VFSS) or fiberoptic endoscopic exam of the swallow (FEES).MethodsProspective, repeated measure design. Patients underwent randomized order of tracheotomy occlusion conditions (open, finger, one‐way valve, capped) during selected swallows. Main outcome measures were the presence or absence of aspiration/laryngeal penetration.Results39 participants have completed the protocol, 19 males/20 females, mean age of 59.41 years (SD=19.31). 20 underwent the VFSS and 19 underwent FEES. The majority of participants (58.9%, 28/39) were able to safely swallow without any airway invasion under all occlusion conditions. Change in swallow function under 1 or more of the occlusion conditions was present in 25.6% (10/39) of the participants. 4 subjects had increased airway invasion with no occlusion (open), 4 with finger occlusion, and 2 while capped. One subject had less airway invasion with the 1‐way valve as compared to the other conditions. One subject aspirated under all occlusion conditions.ConclusionsNo clear patterns for optimal occlusion condition for swallowing were identified. Results of this study suggest that swallowing disorders in patients with a tracheotomy tube is a multifactiorial problem and several factors may be associated with the swallowing dysfunction. Therefore, patients should be evaluated under various occlusion conditions to determine their specific optimal swallowing condition.