bluuebunny/crossref_metadata_2025_split huggingface dataset:
S134 – Active MMP‐7 Expression in Buccal Cancer
Authors: Chuang Hui‐Ching , Chien Chih‐Yen , Huang Chao‐Cheng 
Published: August 2008

ObjectivesTo evaluate the active MMP‐7 expression in buccal cancer and correlate the expressions with clinicopath‐ological features.MethodsTissue microarrays, immunohistochemistry, and Western blotting were used to detect the expression of active MMP‐7 in oral tumor from 24 patients with buccal squamous cell carcinoma (BSCC).ResultsTotal MMP‐7 was detected on Western blots in 9 of 15 tumor tissue samples (60%) and in 2 of 15 normal mucosal samples (13.3%); this difference was significant (p = 0.008). Moreover, the active form of MMP‐7 was expressed in 8 (88.9%) of the 9 tumor samples that expressed MMP‐7, and in none of the normal tissue samples, regardless of the expression status of the pro‐form. Immunostaining of total MMP‐7 was observed histologically in both tumor and non‐neoplastic epithelium, but immunostaining of active MMP‐7 was present only in tumor nests. Expression of active MMP‐7 was associated with larger tumor size (p = 0.022) and was significantly higher in BSCC with skin or bone invasion (p = 0.036).ConclusionsActive MMP‐7 expression was associated with more aggressive buccal squamous cell carcinomas.
S143 – Benign and Malignant Lipogenic Tumors of the Retropharynx
Authors: Mendelsohn Abie , Kedeshian Paul , Cohen Marc , Chhetri Dinesh K 
Published: August 2008

ObjectivesLipogenic tumors of the retropharyngeal space are neoplasms that can grow to a considerable size before becoming symptomatic. In this study we compare clinical, radiologic, and histologic findings of benign versus malignant lipogenic tumors of the retropharyngeal space.MethodsRetrospective review of a case series.Results2 patients were identified with large lipogenic tumors of the retropharynx. The first patient was 66‐year‐old female with a 6‐week history of progressive airway difficulty and dysphagia requiring tracheostomy and gastrostomy‐tube placement. Preoperative imaging revealed a lipoma of the retropharynx. A transcervical excision of her retropharyngeal mass revealed a 10⋉9⋉4.8 cm lipoma. The second patient was a 57‐year‐old female with a 4‐week history of progressive left neck swelling, airway compromise, and odynophagia. Preoperative imaging revealed a heterogeneous mass in the retropharynx with fatty and solid components. After an initial awake tracheostomy a transcervical excision of a 15⋉5.5⋉4.0 cm mass was performed. Pathology revealed liposarcoma with scattered dedifferentiated regions. Postoperative radiation therapy was given for focally positive surgical margins. Both patients are recurrence‐free at 36 months follow‐up.ConclusionsAlthough lipogenic tumors of the retropharyngeal space are rare these cases illustrate that they present at advanced stages, often requiring tracheostomy for airway control. The clinical course of lipomas and liposarcomas can be similar. However, careful inspection of preoperative imaging will heighten suspicion for malignancy, which is critical in surgical planning.
S146 – COX‐2 & IL‐10 Polymorphisms with Head and Neck Carcinoma
Authors: Jeong Seung‐Won , Seokyoung Kang , Hee‐Ok Kim , Cho Seok Hyun , Kim Kyung‐Rae , Tae Kyung , Park Chul‐Won 
Published: August 2008

ObjectivesThe objectives of this study are to investigate the frequencies of single nucleotide polymorphism (SNP) of COX‐2 and IL‐10 in control group and the head and neck squamous cell carcinoma (HNSCC) patient group in Korean population and to analyze the correlation of COX‐2 (−1329A>G, + 1266C>T, +6365T>C) and IL‐10(−1082A>G, +920T>G, +3917T>C) polymorphisms of HNSCC patient group in Korean population.MethodsStudy was performed for 290 Korean head and neck squamous cell carcinoma patients and 358 healthy controls. DNA extraction of peripheral whole blood was done and genotyping was done by single base extension(SBE) and Taq‐Man assay. We analyze the frequencies of SNP of cox‐2(−1329A>G, +1266C>T, +6365T>C) and IL‐10(−1082A>G, +920T>G, +3917T⋉C) and the following results were obtained.ResultsThere is no statistical difference between carcinoma patients and healthy controls about frequencies of SNP of cox‐2(−1329A>G, +1266C>T, +6365T>C) and IL‐10 (−1082A>G, +920T>G, +3917T>C) except haplotype3(‐/‐, ht3/‐, ht3/ht3) of COX‐2 (−1329A>G, +1266C>T, +6365T>C) (Odds ratio: 0.60, p value: 0.03) in Korean populations.ConclusionsBased on these results, it is suggested that COX‐2(−1329A>G, +1266C>T, +6365T>C), IL‐10 (−1082A>G, +920T>G, +3917T>C) genetic polymorphisms might not be correlated with head and neck squamous cell carcinoma in Korean populations but haplotype3 (ht3) of COX‐2 might be associated with HNSCC.
S147 – Pectoralis Major Flaps: A Workhorse in Today's Free Flap Era
Authors: Tan Barrie Yau‐Boon , Khoo Mark 
Published: August 2008

ObjectivesTo study the use, complication rate, and efficacy of pedicled local regional flaps for head and neck reconstruction, and to compare these results with those of microvascular free flap reconstruction.MethodsRetrospective analysis of all head and neck oncologic resections requiring flap reconstruction in a tertiary head and neck surgery centre over a 6‐year period from 2001–2007.ResultsIn total, 77 operations with flap reconstruction were performed. 44 resections employed pedicled locoregional flaps, comprising 33 pectoralis major, 3 trapezius, 3 cervical rotation, 1 deltopectoral, 1 temporalis muscle, 2 nasolabial, 1 cheek rotation, and 2 bilobed rotation flaps. 2 patients had a combination of 2 regional flaps. There was 1 flap failure. Minor complications occurred in 25% of patients comprising wound seromas (3), wound dehiscence (6), fibrotic band formation (1) and pharyngocutaneous fistula (1). 33 resections employed free flap microvascular reconstructions, comprising 22 free radial forearm, 7 free rectus abdominis, 1 free jejunal, 1 free fibular, and 2 anterolateral thigh flaps. There was 1 flap failure. Minor complications occurred in 33% of patients, comprising donor site wound dehiscence (4), recipient site wound dehiscence or seroma (4), plate extrusion (1), abscess and wound breakdown (2).ConclusionsDespite the ready access to free flap reconstruction today, pedicled flaps, especially the pectoralis major flap, remain a major workhorse in head and neck reconstruction. They are hardy, reliable, cost‐effective, and can be done in a short operative time. Moreover, for several regions, the functional outcome is no worse than free flap reconstruction.
S150 – Clinical Study of 13 cases of Olfactory Neuroblastoma
Authors: Uwa Nobuhiro , Yoshino Kunitoshi , Fujii Takashi , Terada Tomonori , Saeki Nobuo , Sagawa Kousuke , Sakagami Masafumi 
Published: August 2008

ObjectivesOlfactory neuroblastoma is a rare neuroendocrine tumor that arises in the upper nasal cavity of the olfactory epithelium. We examined 13 patients with olfactory neuroblastoma and report the findings.MethodsThe subjects were the primary treated patients of olfactory neuroblastoma at our departments between 1986 and 2008 (age: 29–72). Using the clinical staging proposed by Dulguerov, we examined the treatment methods, the sites of recurrence, and the prognoses in those cases.ResultsAccording to Dulguerov's staging, 1 patient was categorized as T1, 3 patients as T2, 8 patients as T3, and 1 patient as T4. Among the 4 cases in T1 and T2, 3 patients underwent radiotherapy as their primary treatment, whereas the remaining 1 patient underwent endoscopic surgery. Eight patients in T3 and T4, whose tumors were resectable, underwent skull base surgery combined with radiotherapy. Among the 13 cases, 4 patients developed primary recurrence, 3 patients developed neck lymph node metastasis, and one patient developed lung metastasis. The overall 10‐year survival rate of the 13 cases was 83.3%. The primary tumors could be controlled in all of the 8 patients who underwent skull base surgery and radiotherapy. All of those patients are currently alive without disease. There was 1 patient whose tumor recurred approximately 20 years after the initial treatment.ConclusionsThe survival rate can be improved performing skull base surgery combined with radiotherapy provided that the tumors are resectable. Long‐term clinical follow‐up is also significant.
S151 – The Impact of Second Primary Tumors on Survival
Authors: Rennemo Erlend , Zatterstrom Ulf Kaare 
Published: August 2008

Objectives1) Evaluate what impact second primary tumors have on prognosis in HNSCC. 2) Identify patients that run the highest risk of obtaining a second primary tumor after successful treatment of primary HNSCC.MethodsA retrospective analysis of 2063 patients treated over a 15‐year period for tumors of the oral cavity, larynx, oropharynx, and hypopharynx, was undertaken. Survival was analysed for the group of patients presenting second primary tumors, and the descriptive characteristics of these patients were compared to the remaining group of patients.ResultsSecond primary tumors correlated with low patient age (p=0.02), less advanced disease (p<0.05), and were more common after primary tumors of the larynx and oral cavity. Mean time to diagnosis of a second primary tumor was more than 4 years from the date of the initial tumor. From the date of primary tumor treatment, overall median survival among patients that later developed second primary tumors compared to all other patients was 6 years vs. 3 years. Prognosis was poor after the diagnosis of a second primary, as median survival was 12 months and 5‐year survival, 16%.ConclusionsPatients at risk of a second primary tumor were younger than median with stage I and II primary tumors of the larynx and the oral cavity. This group had a favorable outcome after treatment of their primary tumor and therefore initially a better overall survival. However, after diagnosis of the second tumor, prognosis was extremely poor.
S180 – Change of Mucosal Immunity Due to Radiotherapy to Larynx
Authors: Nakashima Tadashi , Tomita Hideichiro 
Published: August 2008

ObjectivesRadiation‐induced xerostomia is known to be a significant complication in head and neck cancer patients receiving radiation. As the larynx is endowed with a rich supply of glands, the survey of the secretory immunoglobulins as well as the glandular distribution in human larynx should provide a valuable baseline for understanding the immunological status of the larynx. The aim of this study is to assess the influence of radiation on the larynx in patients who received radiotherapy on the neck.MethodsLaryngeal fluids or tissues were obtained from 111 human adults who received surgery or radiation therapy for hypopharyngeal or laryngeal cancer. From patients who had to undergo a total laryngectomy, the larynges were examined histopathologically. The change of the glandular distribution was measured using the image analyzing system. The levels of immunoglobulins, as well as the concentration of laryngeal glands, were compared between individuals with or without radiotherapy.ResultsThe laryngeal secretion contained immunological factors such as secretory IgA. The level of SIgA fell to low levels in patients with previous radiation therapy. The glandular acini are often replaced with fibrous connective tissue. The density of the glands decreased and the ratio of serous‐type glandular cells decreased.ConclusionsThese results indicate that not only the voice function, but also the local defense function of the larynx, might be impaired after radiotherapy.
S181 – Injection Laryngoplasty with Hyaluronic Acid
Authors: Lau David P , Lee Gwyneth , Wong Seng Mun , Chan Yiong Huak , Tan Nam Guan , Rammage Linda , Morrison Murray 
Published: August 2008

ObjectivesTo determine if particle size affects durability of medialisation in patients undergoing injection laryngoplasty (IL) with hyaluronic acid (HA) for unilateral vocal cord paralysis (UVCP). Hypothesis: Larger particle‐size HA persists longer after injection to produce a more durable vocal result.MethodsStudy Design: Prospective randomized controlled single‐blind trial. Years conducted: 2005–2007. Condition studied: UVCP. Subjects: Patients over the age of 18 requiring medialisation for UVCP. Setting: Outpatient clinic setting. Intervention: Patients underwent transcutaneous IL with Restylane (small particle‐size HA) or Perlane (large particle‐size HA). Outcome measurement: The Voice Handicap Index (VHI) at 6 months post‐injection was the primary outcome measure. Secondary outcomes included videostroboscopic findings, and objective acoustic and aerodynamic measures. Statistical methods: Differences between groups were compared using the Mann Whitney U test and adjusted for age & gender using ANCOVA.Results17 patients (8 Restylane, 9 Perlane) were available for follow‐up at 6 months. Normalised VHI scores at 6 months after IL were significantly lower in the Perlane group compared to the Restylane group when not adjusted for age and sex (p=0.027). After adjustment the difference was not significant (p=0.053) but the Perlane group trended towards lower normalised VHI scores.ConclusionsThe findings support the hypothesis that the larger particle size of Perlane makes this material more durable than Restylane for IL. This material may be considered for temporary medialisation in patients with UVCP in whom medium‐term improvement of at least 6 months is desirable. The trans‐cutaneous route can be used safely in the office setting in non‐anti‐coagulated patients.
S182 – A Modified Collar for Post‐Tracheal Resection Immobilization
Authors: Goyal Neerav , Gaslin Michael , Boon Maurits 
Published: August 2008

Objectives1) Determine the possible use of a modified cervical collar as an effective immobilization technique post tracheal resection. 2) Demonstrate the use of this alternate technique in clinical practice.Methods2 patients requiring tracheal resection for tracheal stenosis were identified as having been placed in an Aspen cervical collar brace with modification in the postoperative period to keep the patient's neck immobilized and flexed. Cervical collar braces usually keep a patient's neck in constant extension, but with our modifications, we keep the neck in constant flexion. This method was used in lieu of the traditional ‘chin stitch’ to relieve tension on the tracheal anastamosis in the immediate postoperative period. Patients were assessed during the inpatient postoperative period for comfort level, pain, and mobility in the collar. Patients were followed up as outpatients to evaluate tracheal patency.ResultsBoth patients utilized the cervical collar for the duration of their inpatient stay. One patient had some complaints of difficulty breathing and increased anxiety due to the collar. Overall, both patients found the collar tolerable and denied any pain due to the collar. Patients were followed after discharge from the hospital in the outpatient clinic, and neither patient had evidence of restenosis at 2‐month follow‐up.ConclusionsThough more research needs to be conducted, this approach represents a possibly more comfortable, yet still effective, method of tracheal immobilization status post‐resection as compared to the traditional ‘chin stitch.’
S186 – Necessity of Drain Placement for Thyroplasty
Authors: Jackson Kenneth D. , Garnett James David , Larsen Christopher G. , Sykes Kevin J. , Nguyen Amy Mai 
Published: August 2008

ObjectivesReview the complication rate and drain output characteristics during the immediate postoperative period for open thyroplasty via anterior neck approach with drain placement.MethodsA retrospective cohort review of patients requiring open thyroplasty at 2 academic medical centers in the Midwestern United States between 1/1/1997 and 6/30/2007. Charts of patients receiving a thyroplasty were selected by CPT code and reviewed for rates of postoperative hemorrhage, hematoma formation, seroma formation, and upper airway compromise. Drain output quantities were examined, where available.ResultsCharts of 107 patients and 112 total procedures were reviewed. 18 procedures were excluded from this series due to simultaneous performance of other procedures. One (1/94) patient developed postoperative hematoma with upper airway obstruction. Hematoma evacuation was performed and the patient was subsequently discharged in stable condition. Average patient age was 59.3 years. Postoperative drain output was recorded as “minimal” in 58/94 (62%) of cases. Average drain output was 17.7 mL for those which were recorded. Hospital stay was less than 24‐hours for 89/94 (95%) of cases.ConclusionsIn this series, patients having undergone open thyroplasty have had little to no drain output prior to the discontinuation of the drain. This, as well as the low rate of overall complication associated with this procedure, would support the opinion that such drains may be unnecessary in these cases.
S191 – Unilateral Vocal Fold Paralysis: Medialization Results
Authors: Lundy Donna , Casiano Roy R , Landera Mario Alberto , Bublik Michael 
Published: August 2008

ObjectivesManagement of glottal insufficiency due to unilateral vocal fold paralysis (UVFP) has evolved from trans‐oral injection to external thyroplasty to revisited injections (transoral or transcutaneous). Currently, preference is given to the less invasive injection medialization. Multiple injectable materials have been utilized with newer ones being introduced to manage concerns over permanency and vocal fold vibratory patterns. The purpose of this study is to evaluate the long‐term results of injection medialization for UVFP in terms of stability of glottal closure and voice outcome vs. need for reinjection.MethodsAll patients with UVFP that underwent injection medialization and had follow‐up studies more than 6 months were eligible for inclusion. Parameters studied included demographic data (age, gender), side of paralysis, etiology, degree of pre‐injection glottal insufficiency, length of follow‐up, degree of post‐injection glottal closure, mucosal wave resolution, and Voice Handicap Index.Results146 patients were identified with a mean age of 61.7 years (17–94); males (55%) and females (45%). Etiology was idiopathic (56%); iatrogenic (48%); tumor‐related (9%); trauma (3%); and neurologic (2%). Degree of glottal insufficiency was mild (21%); moderate (29%); and severe (50%). Material injected was Cymetra in 80 patients and Radiesse in 66 patients. 45 (33%) patients underwent more than 1 injection. Details of patients requiring repeat injections with regards to the material injected and the other parameters will be presented.ConclusionsInjection medialization via a transcutaneous approach has long‐lasting results making it an appropriate minimally‐invasive option for long‐term medialization for UVFP.
S193 – Voice and Swallowing after Jugular Foramen Surgery
Authors: Oestreicher‐Kedem Yael , Damrose Edward J , Agrawal Sumit Kishore , Jackler Robert K 
Published: August 2008

ObjectivesThis study was designed to evaluate the role and timing of surgical procedures for voice and swallowing rehabilitation in patients after surgery for jugular foramen tumors.MethodsA retrospective case series. The records of patients operated for jugular foramen tumors from January 2002 to February 2008 were reviewed for lower cranial nerves function, hoarseness, dysphagia and aspiration, recovery course and rehabilitation procedures.Results17 patients underwent surgery for jugular foramen tumors. Tumors included 12 glomus jugulare, 4 schwannomas and 1 meningioma. 3 patients had presented with vagal and glossopharyngeal paralysis and 6 more patients developed post‐operative paralysis. All patients with paralysis experienced dysphagia and hoarsheness. 6 experienced aspiration. Gastrostomy or nasogastric tube feeding were required in 3 patients. 7 patients did not recover nerve function by the end of follow‐up. Treatments to improve voice and swallowing included vocal cord medialization by collagen injection (n=3), thyroplasty type 1 (n=5) with arytenoid adduction (n=4), cricopharyngeal myotomy (n=2), and palatal adhesion (n=3).ConclusionsPostoperative dysphonia, dysphagia, and aspiration are common in patients after surgery for jugular foramen tumors. Most patients are unlikely to regain vagal or glossopharyngeal nerve functions at 1 year of follow‐up, and will eventually elect to undergo corrective surgery to improve voice quality and swallowing function. Preoperative evaluation and close postoperative follow‐up by an experienced laryngologist will help identify patients who will benefit from early surgical rehabilitation.
S194 – Pharyngeal Thickness in Young and Elderly Normal Subjects
Authors: Aminpour Shervin , Fuller Scott , Rebecca Leonard , Belafsky Peter C 
Published: August 2008

ObjectivesPrevious research has demonstrated pharyngeal size and constriction differences between normal young and elderly adults. Evidence suggests that the pharynx of elderly subjects dilates and does not constrict as well as younger persons. The distance between the larynx and the hyoid at rest is greater in the elderly, as is the anterior‐posterior width of the pharynx maximally expanded. We have noticed that the pharynx of elderly persons appears to atrophy with age. The purpose of this investigation was to compare pharyngeal wall thickness in young vs. elderly persons.MethodsVideofluoroscopic swallow studies were performed on 82 normal adults under the age of 65 years and on 89 normal adults over the age of 65. Measures of posterior pharyngeal wall thickness (PWT) were determined at rest and at the same point during maximum constriction of the pharynx on a 20‐cc bolus swallow. Data were compared with the independent samples t‐test.ResultsNo gender differences were identified for the younger or elderly groups. Mean PWT at rest was. 40cm (±. 08) for the younger group and 30cm (±. 08) for the elderly (p <0.01). Pharyngeal wall thickness measured at the same point during maximum constriction was 1.08cm (±38) for the younger group and. 92cm (±36) for the elderly (p <0.01).ConclusionsData from the current study suggest that the posterior pharyngeal wall is thinner in elderly individuals older than 65 as compared to younger adults. These differences may help explain differences in pharyngeal strength, swallowing efficiency, and safety in the elderly.
S196 – Phonation and Electric Activity in Adductor Dystonia
Authors: Silveira Paula Lorenzon , De Biase Noemi , Korn Gustavo Polacow , Vilanova Luiz Celso , Padovani Marina , Moraes MIriam , Madazio Glaucya 
Published: August 2008

ObjectivesTo compare the degree of dysphonia's severity with the latency between the electrophysiological activation of the TA muscle and the phonation onset in patients with adductor laryngeal dystonia.Methods21 patients with adductor dystonia and 15 controls underwent laryngeal electromyography (EMG) exam of the left TA muscle. The latency time was registered from rise of the electric activity of the TA muscle until the phonation onset. Perceptual evaluation of voice quality was performed for the study group and judged by consensus of three speech‐pathologists/voice specialists. The evaluation considered 4 tasks: 1) sustained vowel /e/ in habitual pitch and loudness; 2) sustained vowel /i/ in ascending and descending glissando; 3) sustained vowel /i/ at high pitch; 4) phrases including words with voiced and voiceless phonemes. The dysphonia's severity degree was classified in the following scale: 0 ‐; no alteration perceived; 1 ‐; mild degree; 2 ‐; moderate degree; 3 ‐; severe degree. The Spearman's Correlation Test was used to compare the latency time values and the dysphonia's severity degree (p<0,05).ResultsThe average latency time registered for patients with mild dysphonia was 332ms, for moderate dysphonia it was 426ms, and for the severe group was 791ms (p=0.02*).ConclusionsThe latency time was significantly and directly related to the degree of dysphonia's severity.