bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Matched Survival Analysis for Squamous Cell Carcinoma of the Head and Neck in the Elderly
Authors: Bhattacharyya Neil 
Published: November 2003

AbstractObjective To determine whether elderly patients manifest poorer survivals for head and neck squamous cell carcinoma.Methods Cases of squamous cell carcinoma of the glottic larynx, oral tongue, and tonsil were extracted from the Surveillance, Epidemiology and End Results database for 1988 to 1998. For each primary site, patients were segregated into two age groups: 50 to 69 years of age and 70 years of age and older. For each case in the latter, elderly group, a reference group case was randomly matched for gender, year of diagnosis, cancer stage, extent of surgery, and radiation therapy. Overall survival and disease‐specific survival were compared between the two groups with stage stratification with the Kaplan‐Meier method.Results Cases of glottic carcinoma (1882), tongue carcinoma (426), and tonsillar carcinoma (200) in elderly patients were matched to the reference group. Overall mean survival differences were significant for glottic carcinoma (73.9 vs. 96.7 mo, elderly and younger groups, respectively) (P <.001) and tongue carcinoma (59.5 vs. 73.1 mo) (P = .002) but not for tonsillar carcinoma (46.0 vs. 54.4 mo) (P = .220). Disease‐specific survival differences were significant but small in magnitude for glottic carcinoma (105.9 vs. 114.1 mo, respectively (P <.001) and tongue carcinoma (81.6 vs. 93.6 mo) (P = .009) but not for tonsillar carcinoma (71.5 vs. 70.7 mo) (P = .422). However, after stage stratification, elderly patients often did not exhibit statistically or practically significant poorer overall or disease‐specific survivals.Conclusions Elderly patients do not necessarily exhibit clinically significant poorer survivals for head and neck squamous cell carcinoma. Age alone should not be used to determine treatment options for elderly patients with squamous cell carcinoma.
Total Glossectomy Without Laryngectomy as First‐Line or Salvage Therapy
Authors: Barry Béatrix , Baujat Bertrand , Albert Sébastien , Nallet Emmanuel , Depondt Joël , Guedon Charles , Gehanno Pierre 
Published: November 2003

AbstractObjectives/Hypothesis Advanced carcinoma of the tongue can require total glossectomy. Although radiation therapy is of limited efficacy in T3 and T4 tumors involving the base of the tongue, many surgeons are reluctant to suggest highly mutilating surgery.Study Design Retrospective cohort study.Methods We compared early postoperative complications, hospital stay duration, function, and oncological outcomes in patients who underwent total glossectomy without laryngectomy as first‐line or salvage therapy.Results Postoperative course and functional outcomes were similar in the two groups. Overall survival was 32% at 3 years and 21% at 5 years. The risk factors for shorter survival were positive margins of resection (P = .002) and tumor spread into the mandible (P = .04). Salvage surgery was not associated with significantly lower survival (P = .09 [NS]).Conclusions Postoperative morbidity and functional outcomes are similar after first‐line and salvage total glossectomy without laryngectomy. Local tumor control is the main factor influencing survival.
The Anatomical Basis for Mandibulotomy: Midline Versus Paramidline
Authors: Pan Whei‐Lin , Hao Sheng‐Po , Lin Yaoh‐Shiang , Chang Kai‐Ping , Su Jen‐Liang 
Published: November 2003

AbstractObjectiveTo provide an anatomical basis for mandibulotomy.Study DesignProspective.MethodsThe angles between the long axis of the two mandibular central incisors and between the lateral incisor and canine and the corresponding root length were measured in panoramic films of 50 Taiwanese patients who had oral or oropharyngeal carcinomas.ResultsThe angle and horizontal distance between the mandibular lateral incisor and canine were significantly wider than between the two central incisors. The root length of the canine measured 16 mm on average.ConclusionsParamidline mandibulotomy, which cuts through a wider space between the lateral incisor and canine, preserves dentition and the genioglossus and geniohyoid muscles. It appears to be a more preferable approach than midline mandibulotomy.
Potential Biomarkers for Head and Neck Squamous Cell Carcinoma
Authors: Brown Jimmy J. , Xu Helen , Nishitani Junko , Mohammed Hezla , Osborne Ryan , Teklehaimanot Senait , Gill Gus , Liu Xuan 
Published: November 2003

AbstractObjective The purpose of the study was twofold: 1) to search for potential biomarkers that were overexpressed in cell lines that could represent both a clinical premalignant (immortalized) and a malignant state, and 2) to attempt to correlate metallothionein gene expression with clinical outcome in laryngeal carcinoma.Study Design A series of in vitro experiments were used to unearth differentially expressed genes among normal, immortalized and tumorigenic cell lines. Secondarily, a retrospective analysis was undertaken.Methods Differential display analysis was conducted to identify differentially expressed genes between human papillomavirus–infected immortalized HOK16B and benzo[a]pyrene–derived tumorigenic cell line, HOK16B‐BaP‐T. The cell‐specific expressions were examined by Northern blot analysis and compared with other known immortalized and cancer cell lines. Immunohistochemical staining was also conducted to localize metallothionein (MT I/II) protein expression among the different cell lines studied. A retrospective analysis of laryngeal specimens from archival tissues of 29 cancer patients who underwent primary surgical resection was also undertaken after immunohistochemical staining.Results Twenty‐one differentially expressed complementary cDNA clones, both novel and known, were identified using the differential display analysis. Northern blot analysis confirmed that clone 6 hybridized to a 1.6‐kb RNA in HOK16B‐Bap‐T cell line. Clone 4 showed decreased expression in immortalized and cancer cell compared with NHOK. MT I/II transcript was observed in HOK16B, which was further elevated in HOK16B‐Bap‐T. Retrospective analysis showed that high immunoreactivity to MT I/II in surgically resected laryngeal cancer specimen correlated with increased frequency of recurrence within 2 years of surgery.Conclusion These findings suggest that clone 4 may potentially function as a tumor suppressor gene, which may be significant in tumor progression and invasion. Clone 6 may participate in viral‐mediated oncogenic transformation of normal cells. Clone 6 may also have potential as a tumor maker differentiating normal from malignant tissue, as in the determination of surgical resection margins. MT I/II gene product may serve as a prognostic biomarker for laryngeal squamous cell carcinoma. The differentially expressed genes and gene products may serve as sensitive biomarkers for improved early detection, diagnosis, and prognosis of head and neck squamous cell carcinoma.
Subglottic Laryngeal Paraganglioma
Authors: Maisel Robert , Schmidt Derek , Pambuccian Stefan 
Published: November 2003

AbstractObjectives To review the clinical and pathological picture of laryngeal paragangliomas and compare laryngeal paragangliomas with the three other types of laryngeal neuroendocrine neoplasms.Study Design The study presents a case review of a patient with a subglottic laryngeal paraganglioma treated at our institution, with a literature review of the laryngeal neuroendocrine neoplasms. Included is a review of all four neuroendocrine neoplasms, taking a close look at a comparison between laryngeal paragangliomas and atypical carcinoids tumors. All cases of subglottic laryngeal paragangliomas reported in the literature were also compiled and tabulated.Methods The patient's record was reviewed for age, symptomatology, workup, and surgical procedures performed.Results The patient was disease free 36 months after undergoing a tracheostomy for airway control, followed by a cricoid split for complete excision of the tumor.Conclusions It is important to differentiate among the four laryngeal neuroendocrine neoplasms, especially between atypical carcinoids and paragangliomas. Each tumor requires different treatments, with the former requiring a more aggressive approach. Paragangliomas must be completely excised to prevent their recurrence, and this approach should be considered a curative treatment. In addition, the immunohistochemical battery is of paramount importance in obtaining the correct pathological diagnosis.
Comparative Study of Cochlear Damage With Three Perimodiolar Electrode Designs
Authors: Eshraghi Adrien A. , Yang Nathaniel W. , Balkany Thomas J. 
Published: November 2003

AbstractObjective To describe intracochlear insertion trauma caused by three perimodiolar cochlear implant electrodes.Study Design Descriptive histological study of 15 human cadaver temporal bones.Methods Fifteen cadaver temporal bones underwent surface preparation and were implanted with one of the following perimodiolar electrode arrays: Combi 40+PM (MedEl Corporation), HiFocus II (Advanced Bionics Corporation), or Contour (Cochlear Corporation). A cryosectioning technique was used to study horizontal sections at 200‐μm intervals with the electrode in place. Image‐enhanced videofluoroscopy and computer‐assisted morphometrics were used to assess the mechanism of insertion trauma and to determine electrode position within the modiolus.Results Histological examination revealed varying degrees of damage to the spiral ligament, basilar membrane, and osseous spiral lamina. Using a novel grading system for electrode trauma, there was no statistically significant difference among the three electrodes. A literature search of histological studies of a commonly used “standard” electrode showed damage equal to or greater than that seen in the current study.Conclusions Insertion trauma caused by periomodiolar electrodes occurs to an acceptable degree. Refinement of electrodes based on mechanisms of trauma may be able to further reduce damage.
Expression of a Cathelicidin Antimicrobial Peptide Is Augmented in Cholesteatoma
Authors: Jung Hak Hyun , Chae Sung Won , Jung Seol Ki , Kim Seon Tae , Lee Heung Man , Hwang Soon Jae 
Published: November 2003

AbstractObjectives/Hypothesis Antimicrobial peptides are active defense components of innate immunity. Their importance was confirmed at epithelial surfaces as immediate barrier effectors in preventing infection. Cathelicidins are peptide antibiotics that are receiving increasing attention. Several studies have shown that overexpression of cathelicidin results in augmented protection against bacterial infection and prevention of local infection and systemic invasion of microbes. The goal of the study was to investigate whether cathelicidin is upregulated in cholesteatoma epithelium compared with normal skin.Study Design Twenty patients from a prospective study of cholesteatoma tissues and normal skins were enrolled in the study. The specimens were divided into two portions. One portion was used for subsequent RNA studies; the other was used for immunohistochemical staining.Methods Reverse transcriptase–polymerase chain reaction was used to assess the expression levels of cathelicidin messenger RNA (mRNA) both in cholesteatoma and in normal skin. Presumptive concentration of cathelicidin mRNA and β2‐microglobulin mRNA was evaluated. Ratio of β2‐microglobulin to cathelicidin was analyzed in each group. The expressions of cathelicidin in cholesteatoma and normal skin epithelium were investigated by an immunohistochemical technique.Results Cathelicidin mRNA in cholesteatoma epithelium was increased 5.5‐fold compared with normal skin of the ear canal. In cholesteatoma epithelium, cathelicidin was located in all the layers, but in the normal skin it was expressed only in the granular and prickle cell layers.Conclusions Cathelicidin is augmented in cholesteatoma epithelium, and the data in the present study are in agreement with the hypothesis that cathelicidin is likely to act as a key component in the first line of defense at the surface epithelium.
Evidence Against Neonatal Aspiration of Keratinizing Epithelium as a Cause of Congenital Cholesteatoma
Authors: Bernal‐Sprekelsen Manuel , Sudhoff Holger , Hildmann Henning 
Published: November 2003

AbstractObjectives/Hypothesis It has been suggested that congenital cholesteatoma may be caused by perinatal aspiration of squamous epithelium.Study Design Microscopic study of fetal temporal bones.Methods Thirty‐one temporal bones from infants who died of sudden infant death syndrome before 1 year of age and 27 temporal bones obtained from preterm fetal deaths aged 4 to 8 months of fetal development were studied to assess signs of aspiration of squamous epithelium in the middle ear.Results None of the prenatal or postnatal temporal bones showed keratinizing epithelial cells or lanugo. A certain number of specimens displayed a nonspecific inflammatory lymphocytic infiltration.Conclusion The data in the present study do not support the theory of amniotic fluid and squamous epithelial aspiration as an origin of congenital cholesteatoma.
Dog Bites of the Scalp, Face, and Neck in Children
Authors: Mitchell Ron B. , Nañez Gary , Wagner Jon D. , Kelly James 
Published: November 2003

AbstractObjective To update the surgical management of injuries from dog bites of the scalp, face, and neck in children.Study Design Retrospective case review.Methods A retrospective review of 44 children with dog bites of the scalp, face, and neck was carried out at the University of New Mexico Health Sciences Center (Albuquerque, NM) between January 1, 1995, and December 31, 2000. Data on demographics, hospitalization, surgery, and outcome were collected and entered into an Access 2000 database.Results The children ranged in age from 1.0 to 12.1 years. The mean age of the study population was 5.2 years (±2.9 y standard deviation). Sixteen severely injured children (36%) were hospitalized to repair damage to the airway and blood vessels of the neck or to treat hemodynamic compromise. The length of stay in hospital ranged from 1 to 16 days. The most common injury in these children was a scalp laceration (57%). Twenty‐six less severely injured children (64%) were not hospitalized. The most common surgery in these children (88%) was repair of multiple facial lacerations. Attention deficit hyperactivity disorder was noted in the medical records of 12 children (29%). Complications occurred in five children (31%) who were hospitalized and nine children (35%) who were not hospitalized.Conclusions The injured child is typically a 5‐year‐old boy attacked by a familiar dog at home or in the local neighborhood. Children with the diagnosis of attention deficit hyperactivity disorder appear to be at a higher risk of dog bite injuries and should be monitored during interactions with dogs. The goal of surgical management for severely injured children is to avoid immediate mortality and to establish a schedule of multiple‐staged procedures for revision surgeries. An optimal cosmetic result is the principal goal for less severely injured children.
Olfactory Neuroblastoma: Past, Present, and Future?
Authors: Lund Valerie J. , Howard David , Wei William , Spittle Margaret 
Published: November 2003

AbstractObjective To consider the long‐term survival and outcomes in patients with olfactory neuroblastoma undergoing craniofacial resection.Study Design A single‐center prospective cohort study.Methods All patients with olfactory neuroblastoma treated in a 23‐year period with craniofacial resection (with or without radiotherapy) were analyzed; a multivariate analysis was included.Results Forty‐two patients aged 12 to 70 years were assessed, 83% of whom had received no preceding treatment. Craniofacial resection was used in all cases, combined with radiotherapy in 24 patients (57%). Duration of follow‐up ranged from 2 to 206 months (mean follow‐up period, 57 mo). The disease‐free actuarial survival and overall survival were 77% and 61% at 5 years and 53% and 42% at 10 years, respectively. A Cox regression analysis identified intracranial extension and orbital involvement as independent factors affecting outcome.Conclusion Craniofacial resection combined with radiotherapy offers the gold standard of care against which other approaches such as endoscopic resection must be judged.
Is the External Laryngeal Nerve an Exclusively Motor Nerve? The Cricothyroid Connection Branch
Authors: Maranillo Eva , León Xavier , Quer Miquel , Orús César , Sañudo Jose Ramón 
Published: November 2003

AbstractObjectives To obtain an accurate morphological description of the nerve that provides communication between the external laryngeal nerve and the recurrent laryngeal nerve in a large sample of human larynges.Study Design Morphological study of human larynges.Methods Microdissection of 103 human larynges obtained from necropsies was performed. Both the external laryngeal nerve and the recurrent laryngeal nerve were identified and dissected. The existence of a communication between the two nerves was evaluated.Results A neural communication between the external laryngeal nerve and the recurrent laryngeal nerve was found in 85% of the larynges studied (bilaterally in 44% and unilaterally in 41%). Two patterns of communication (with single or double branches) were found. The communication between the nerves can appear at different levels, giving off collateral branches to the cricothyroid muscle (23%), the cricothyroid joint capsule (49%), and the subglottic mucosa (50%).Conclusions The nerve supply of the human larynx is more complex than classically considered. Our study does not support the classic neuroanatomical belief that the external laryngeal nerve is purely a motor nerve to the cricothyroid muscle. Our results reveal that it carries sensory and motor fibers on to other muscles (thyroarytenoid) or regions (subglottis mucosa and cricothyroid joint), as has been demonstrated in experimental studies in cats and dogs.
Intracordal Injection of Autologous Fat in Patients With Unilateral Laryngeal Nerve Paralysis: Long‐Term Results From the Patient's Perspective
Authors: Laccourreye Ollivier , Papon Jean‐François , Kania Romain , Crevier‐Buchman Lise , Brasnu Daniel , Hans Stéphane 
Published: November 2003

AbstractObjective Based on 80 patients with a previously nonsurgically treated unilateral laryngeal nerve paralysis (ULNP) and according to the patient's self‐assessment, the authors document the long‐term results achieved with the intracordal injection of autologous fat.Study Design Retrospective series, inception cohort.Methods Kaplan‐Meier actuarial life table method and univariate analysis.Results None of the 80 patients died in the immediate postoperative period. Morbidity included hematoma at the donor site (in three patients), development of an intracordal cyst at the injection site (in three patients), fat extrusion at the injection site (in one patient), and temporary tracheotomy (in one patient). The initial and ultimate overall success rates were 96.2% and 77.2%, respectively. In univariate analysis, none of the variables under analysis (gender, age, associated neurological lesions, associated pneumonectomy, associated neoplasia, cause of the ULNP, side of the ULNP, nerve involved, delay between the onset of the ULNP and the intracordal injection, severity of the symptoms, mode of harvesting the autologous fat, and surgeon who performed the injection) was statistically related to the ultimate outcome after the intracordal injection of autologous fat. Among the group of 45 patients in whom the intracordal injection was initially considered to be successful with no further recovery of motion of the true vocal cord and a minimum survival of 12 months, the ultimate overall success rate was 62.2%, and the 3‐month, 6‐month, and 12‐month Kaplan‐Meier actuarial estimates for success were 91.1%, 72.8%, and 63.1%, respectively.Conclusions In the present study, data confirm that the intracordal injection of autologous fat is a useful and safe procedure in patients with ULNP. However, the impossibility of exactly predicting the amount of resorption of the injected fat and the lack of predictability of the duration of the results, together with the good and stable results achieved at the authors' department with the medialization thyroplasty led the authors to reduce its current use.
Variability of the Nerve Supply Patterns of the Human Posterior Cricoarytenoid Muscle
Authors: Maranillo Eva , León Xavier , Ibañez Marta , Orús César , Quer Miguel , Sañudo José Ramón 
Published: November 2003

AbstractObjectives/Hypothesis To achieve a successful selective reinnervation of the larynx, an accurate knowledge of the nerve supply of each individual muscle is required. The posterior cricoarytenoid muscle, the only abductor or respiratory muscle of the larynx, plays a vital role in cases of recurrent palsy and orthotopic transplantation. Descriptions of the posterior cricoarytenoid muscle nerve supply pattern vary considerably. The goal of the present study was to establish an accurate morphological description of the posterior cricoarytenoid muscle nerve supply in a large sample of human larynges.Study Design Morphologic study of human larynges.Methods The posterior cricoarytenoid muscle nerve supply was studied in a total sample of 75 human larynges obtained from necropsies (47 male and 28 female samples; age range, 41–95 y) and examined by careful dissection using a surgical microscope.Results The posterior cricoarytenoid muscle nerve supply in all cases (100%) came from the anterior division of the recurrent nerve. However, in six cases (4%) a small branch also arose from the ramus anastomoticus. The number of branches coming from the anterior division varied, ranging from one to six. The two‐branch pattern was the most frequent (42.7%), followed by the three‐branch pattern (34%) and the one‐branch pattern (7.3%). The remaining 16% of cases showed patterns of four, five, or six branches. When two or more branches were present, a connection between them was observed in 64% of cases. Five different types of origin of the various branches were observed along the course of the recurrent nerve in relation to the cricothyroid joint: type a, vertical segment below the cricothyroid joint (7.5%); type b) vertical segment behind the cricothyroid joint (40.5%); type c) vertical segment just above the cricothyroid joint (16%); type ) from the genu, in common with the arytenoid branch, above the cricothyroid joint and just below the cricoarytenoid joint (34%); and type e) oblique segment (2%).Conclusion Despite the variability of the innervation of the posterior cricoarytenoid muscle and its strong connection with the interarytenoid nerve, this should not preclude successful reinnervation.