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<title>Permanent Orthopedic Hand Job in Modesto near Sacramento &#x26; San Jose California with California Physician Opportunities</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_california/page_2.html</link>
<description><![CDATA[OM-1101            Orthopedics Hand Surgeon 60 minutes from the San Francisco Bay or Sacramento.     Centrally located for all major Northern California hot spots Bay Area, Santa Cruz, Yosemite and Lake ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_texas/page_3.html">
<title>Permanent Orthopedic Hand Job in Texas Metro Big XII Academics, Set Your Schedule, No State Tax, #3365 Texas with Timeline Recruiting</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_texas/page_3.html</link>
<description><![CDATA[     This position features several benefits not found anywhere else! You have the opportunity to set your own schedule! Keep your skills sharp while working alongside esteemed colleagues where you will ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_oklahoma/page_1.html">
<title>Permanent Orthopedic Hand Job in Oklahoma City, 1:5 Paid Hand Call, 1-Year Partnership Track w/ No Buy-In, #3151 Oklahoma with Timeline Recruiting</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_oklahoma/page_1.html</link>
<description><![CDATA[     Be welcomed by this friendly, down-to-earth metropolis  the site of the largest urban makeover in national history. More than $2 billion has been invested in new development, including one of the ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_michigan/page_1.html">
<title>Permanent Orthopedic Hand Job in 100% Hand, Dertoit Area Academics, No Call, #2982 Michigan with Timeline Recruiting</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_michigan/page_1.html</link>
<description><![CDATA[     Build and develop a new Orthopaedic Hand Department at the largest medical school in the country within a designated National Cancer Institute center. This opportunity will allow you to see interesting ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_kentucky/page_2.html">
<title>Permanent Orthopedic Hand Job in Georgetown Kentucky with Job Job Recruiting</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_kentucky/page_2.html</link>
<description><![CDATA[ Physician - Orthopaedic Surgery - Hand Surgery   Successful group in suburban Lexington, KY seeks to expand!  Group of two orthopedic surgeons specialized in sports med and spine seek to add a 3rd specialized ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_virginia/page_1.html">
<title>Permanent Orthopedic Hand Job in Danville Virginia with Job Job Recruiting</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_virginia/page_1.html</link>
<description><![CDATA[ Physician - Orthopaedic Surgery - Hand Surgery   Danville; Single Specialty Group - Opportunity involves joining 5 orthopedic surgeons & 3 PA's.  Single Specialty Group  The opportunity involves joining ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_arizona/page_1.html">
<title>Permanent Orthopedic Hand Job in Metro Arizona with Excel Recruiting Services</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_arizona/page_1.html</link>
<description><![CDATA[ Job ID# 200656 - Join a top notch, well-respected single specialty Orthopedic practice that handles all specialties within the practice. General orthopedics, Sports Medicine, Arthroscopic Knee and Shoulder ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_texas/page_2.html">
<title>Permanent Orthopedic Hand Job in Dallas area Texas with TX Client of South West Health Care Recruiters</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_texas/page_2.html</link>
<description><![CDATA[On behalf of a client located in the Dallas area of Texas, we are seeking a BE/BC ORTHOPEDIC SURGEON with additional fellowship training in Hand surgery - will also consider someone with Foot/Ankle (BC ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_texas/page_1.html">
<title>Permanent Orthopedic Hand Job in East Texas Texas with Nationwide Physician Recruitment</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_texas/page_1.html</link>
<description><![CDATA[ Excellent opportunity to join a large healthcare system in Texas.  Beautiful recreational area, with a pop. of 100K and an easy drive to Dallas.  Offering $475K plus production. Paid malpractice, relocation, ]]></description>
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<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://www.forbes.com/feeds/hscout/2009/07/02/hscout628535.html&#x26;usg=AFQjCNFTtAuWFlH39jeZuP8vC1nREq7uNw">
<title>Cystic Fibrosis Treatment May Cause Hearing Loss - Forbes</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://www.forbes.com/feeds/hscout/2009/07/02/hscout628535.html&#x26;usg=AFQjCNFTtAuWFlH39jeZuP8vC1nREq7uNw</link>
<description><![CDATA[Cystic Fibrosis Treatment May Cause Hearing LossForbes... which leads to hearing loss, according to information in a news release from the American Academy of Otolaryngology -- Head and Neck Surgery. ...Link Between Common Antibacterial Treatment And Sensorineural ...Medical News Today (press release)all 8 news articles&nbsp;&raquo;]]></description>
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<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://archotol.ama-assn.org/cgi/content/full/135/1/94?home&#x26;usg=AFQjCNH6zjoA51jI4ro3g5W-wUtf5cdlPA">
<title>Call for Photographs Arch Otolaryngol Head Neck Surg. 2009;135(1):94. - Archives of Otolaryngology</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://archotol.ama-assn.org/cgi/content/full/135/1/94?home&#x26;usg=AFQjCNH6zjoA51jI4ro3g5W-wUtf5cdlPA</link>
<description><![CDATA[Call for Photographs Arch Otolaryngol Head Neck Surg. 2009;135(1):94.Archives of OtolaryngologyArchives of Otolaryngology–Head &amp; Neck Surgery is always seeking interesting cover photographs. Since many of our readers are excellent amateur ...and more&nbsp;&raquo;]]></description>
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<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://www.wsoctv.com/health/19941081/detail.html&#x26;usg=AFQjCNFsIIf8ygQDR9UYL08XAnfvbx-PXw">
<title>Ear Infections in Children - WSOCtv.com</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://www.wsoctv.com/health/19941081/detail.html&#x26;usg=AFQjCNFsIIf8ygQDR9UYL08XAnfvbx-PXw</link>
<description><![CDATA[Ear Infections in ChildrenWSOCtv.comAccording to the American Academy of Otolaryngology – Head and Neck Surgery, almost all children get at least one ear infection. ...and more&nbsp;&raquo;]]></description>
</item>

<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://www.dailykos.com/storyonly/2009/7/3/749485/-Deep-Brain-Stimulation-SurgeryPart-3.Two-Years-Ago-Today!&#x26;usg=AFQjCNHTBnTucIPUi1l77QiXTJVJiQILEQ">
<title>Deep Brain Stimulation Surgery -- Part 3. Two Years Ago Today! - Daily Kos</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://www.dailykos.com/storyonly/2009/7/3/749485/-Deep-Brain-Stimulation-SurgeryPart-3.Two-Years-Ago-Today!&#x26;usg=AFQjCNHTBnTucIPUi1l77QiXTJVJiQILEQ</link>
<description><![CDATA[Deep Brain Stimulation Surgery -- Part 3. Two Years Ago Today!Daily KosBut that&#39;s just me. Whenever I have surgery, I always seem to present the anesthesiologist with a bit of worry. For one thing, I have a huge neck. ...and more&nbsp;&raquo;]]></description>
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<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://archfaci.ama-assn.org/cgi/content/short/9/3/174?home&#x26;usg=AFQjCNHfWAoNKhraZBS2I4Q62kJakhfPXg">
<title>The Healing Effects of Autologous Platelet Gel on Acute Human Skin ... - Archives of Facial Plastic Surgery</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://archfaci.ama-assn.org/cgi/content/short/9/3/174?home&#x26;usg=AFQjCNHfWAoNKhraZBS2I4Q62kJakhfPXg</link>
<description><![CDATA[The Healing Effects of Autologous Platelet Gel on Acute Human Skin ...Archives of Facial Plastic SurgeryAuthor Affiliations: Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, University of Minnesota ...and more&nbsp;&raquo;]]></description>
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<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://www.thedenverchannel.com/health/19943013/detail.html&#x26;usg=AFQjCNG4DsnZxtdXq3mInasAQhBWze2oRg">
<title>Shutting Down Tremors - TheDenverChannel.com</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://www.thedenverchannel.com/health/19943013/detail.html&#x26;usg=AFQjCNG4DsnZxtdXq3mInasAQhBWze2oRg</link>
<description><![CDATA[Shutting Down TremorsTheDenverChannel.comBACKGROUND: Essential tremor is a progressive neurological disorder where the arms, hands head and neck shake during voluntary movements such as eating and ...and more&nbsp;&raquo;]]></description>
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<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://archfaci.ama-assn.org/cgi/content/full/10/6/408?home&#x26;usg=AFQjCNG6ZHSxGnwrqMYvjYRuo-Yl7Dy8cQ">
<title>Our Journal, Our Literature, Our Culture, Our Voice - Archives of Facial Plastic Surgery</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://archfaci.ama-assn.org/cgi/content/full/10/6/408?home&#x26;usg=AFQjCNG6ZHSxGnwrqMYvjYRuo-Yl7Dy8cQ</link>
<description><![CDATA[Our Journal, Our Literature, Our Culture, Our VoiceArchives of Facial Plastic SurgeryCorrespondence: Dr Reiter, Department of Otolaryngology–Head and Neck Surgery, Thomas Jefferson University Hospital, 925 Chestnut St, Sixth Floor, ...and more&nbsp;&raquo;]]></description>
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<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://www.sciencedaily.com/releases/2009/07/090703111301.htm&#x26;usg=AFQjCNEuR2s2_4huL8nODHWvPoh8ufZvqg">
<title>Oscar The Bobcat &#x2013; Hit By A Car &#x2013; Is On The Road To Recovery After ... - Science Daily (press release)</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://www.sciencedaily.com/releases/2009/07/090703111301.htm&#x26;usg=AFQjCNEuR2s2_4huL8nODHWvPoh8ufZvqg</link>
<description><![CDATA[Oscar The Bobcat – Hit By A Car – Is On The Road To Recovery After ...Science Daily (press release)The animal underwent three hours of orthopedic surgery on June 19. Cornell surgeons Dr. Stuart Bliss and Dr. Heather Knapp-Hoch removed the head and neck of ...and more&nbsp;&raquo;]]></description>
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<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://www.cancerpage.com/news/article.asp?id=13503&#x26;usg=AFQjCNEAJgq2CD4JgbFLtznOjZU0iyLVDw">
<title>Pre-op Smoking Cessation Improves Head and Neck Surgery Outcomes - Cancerpage.com</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http://www.cancerpage.com/news/article.asp?id=13503&#x26;usg=AFQjCNEAJgq2CD4JgbFLtznOjZU0iyLVDw</link>
<description><![CDATA[Pre-op Smoking Cessation Improves Head and Neck Surgery OutcomesCancerpage.comUnfortunately, patients with a diagnosis of a head and neck cancer usually don&#39;t have the luxury of taking 2 months to stop smoking before surgery is ...and more&nbsp;&raquo;]]></description>
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<item rdf:about="http://news.google.com/news/url?a=406379&#x26;fd=R&#x26;sa=T&#x26;url=http://www.postbulletin.com/newsmanager/templates/localnews_story.asp?z=5&#x26;usg=AFQjCNH1YgadVnvJ2MO0YLW0-FRzrEXF7w">
<title>Dr. James K. Masson -- Rochester - Post-Bulletin</title>
<link>http://news.google.com/news/url?a=406379&#x26;fd=R&#x26;sa=T&#x26;url=http://www.postbulletin.com/newsmanager/templates/localnews_story.asp?z=5&#x26;usg=AFQjCNH1YgadVnvJ2MO0YLW0-FRzrEXF7w</link>
<description><![CDATA[Dr. James K. Masson -- RochesterPost-BulletinHis father was head of a section of general surgery at Mayo Clinic from 1915 to 1949, and chief of the surgical staff from 1935 to 1949. ...and more&nbsp;&raquo;]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21176">
<title>Role of salivary function in patients with globus pharyngeus</title>
<link>http://dx.doi.org/10.1002%2Fhed.21176</link>
<description><![CDATA[Background.Our aim was to investigate the prevalence and the clinical role of salivary hypofunction in patients with globus sensation.Methods.We conducted a prospective observational study in 340 patients with globus pharyngeus. A standard questionnaire and 99mTc-pertechnate salivary scintigraphy were used to evaluate salivary hypofunction, with a full examination from the nasal cavity to the larynx (N = 303). We also investigated the effect of xerostomia management on globus symptoms (N = 252).Results.The symptom scores for xerostomia were higher in patients with severe globus (p < .05). Objective salivary hypofunction was noted in 57.4% of the patients, based on the reference values from control groups. Globus symptoms were more severe in the subgroup with salivary hypofunction (p = .0447). Conservative management of xerostomia significantly reduced the severity of globus at 1 and 3 months (p = .0002) regardless of salivary function.Conclusions.Salivary hypofunction seems to be an aggravating factor in globus pharyngeus, but not a direct cause. Conservative management of xerostomia improves globus symptoms. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21173">
<title>Planned neck dissection for patients with complete response to chemoradiotherapy: A concept approaching obsolescence</title>
<link>http://dx.doi.org/10.1002%2Fhed.21173</link>
<description><![CDATA[The question of efficacy of "planned" neck dissection following complete response to chemoradiation of head and neck cancer is discussed. There is general agreement that preemptive neck dissection in patients who present initially with low volume (N1) neck disease is not necessary. However, routine performance of planned neck dissection for patients who present initially with high volume ([ge]N2) disease remains controversial. The authors reviewed a large number of studies reported in the recent literature and discuss how they affect this debate.Twenty-four of the reviewed studies indicate a benefit in regional control obtained by "planned" neck dissection among patients who had bulky neck disease pretreatment. All these studies are retrospective, they do not assess treatment response prior to surgery, although they do show very good regional control rates. Twenty-six studies demonstrate no benefit from "planned" neck dissection after complete clinical response. The reasons for these different conclusions include the development of more effective chemoradiation regimens which have improved the initial locoregional control rates of patients undergoing primary chemoradiation treatment, and improvements in diagnostic technology which have increased ability to detect low volume persistent tumor in the post treatment period. When neck dissection is necessary for persistent or recurrent disease, recent studies have shown that selective or superselective neck dissection may produce results therapeutically equivalent to those obtained with more extensive procedures, with less morbidity.There is now a large body of evidence, based on long-term clinical outcomes, that patients who have achieved a complete clinical (including radiologic) response to chemoradiation have a low rate of isolated neck failure, and the continued use of planned neck dissection for these patients cannot be justified. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21172">
<title>Development of ICF core sets for head and neck cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21172</link>
<description><![CDATA[Background.Based on the International Classification of Functioning (ICF) - Disability and Health, participants from different professional and cultural backgrounds were invited to achieve consensus on a first version of ICF Core Set for head and neck cancer (HNC). It was designed to set standards for the assessment of functioning in HNC.Methods.The ICF was adopted by the World Health Organization (WHO) in 2001 and was used as the frame of reference. Preselection of potential ICF categories was based on 4 different preparatory studies: patient interviews, health professional surveys, literature review, and multicenter study applying ICF-nomenclature. After training on the ICF, the results of preparatory studies were presented to 21 invited participants to vote in a formal consensus process on both the Brief and Comprehensive ICF Core Set for HNC. Participants came from all 6 WHO world regions, covering 12 different countries. Professional backgrounds included otorhinolaryngologists, maxillofacial surgeons, medical/radiation oncologists, psychologists, physiotherapists, nurses, and social workers.Results.The Comprehensive ICF Core Set for HNC included 112 categories (8% of entire ICF) and the Brief ICF Core Set for HNC included 19 categories (1% of ICF).Conclusion.A first version of ICF Core Sets for HNC was defined. Further validation is in process. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21166">
<title>Cyclic [alpha]v[beta]6-targeting peptide selected from biopanning with clinical potential for head and neck squamous cell carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21166</link>
<description><![CDATA[Background.A cyclic peptide-displaying phage library was used for biopanning on oral squamous cell carcinoma (OSCC) cells to identify cancer-targeting peptides. This study was designed to characterize the receptor specificity of a candidate phage clone/peptide (phage/peptide-29) and to explore the clinical potential of this peptide.Methods.Immunofluorescent confocal microscopy, phage binding assay, and immunohistochemical studies were used to demonstrate the receptor specificity of phage/peptide-29. The effect of peptide-29 on the proliferation of OSCC cells was studied using 3-dimensional (3D) cell cultures.Results.Phage/peptide-29 preferentially binds integrin [alpha]v[beta]6 rather than other [alpha]v-associated integrins. Peptide-29 significantly inhibits the proliferation of OSCC cells in 3D cell cultures. On human pathological sections, phage-29 targets oral cancer cells in a [alpha]v[beta]6-dependent manner. Besides, we showed that integrin [alpha]v[beta]6 is universally (94.7%, 36/38) expressed in all major kinds of head and neck squamous cell carcinomas (HNSCC).Conclusions.Peptide-29 selected from biopanning may have clinical potential for HNSCC. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21165">
<title>Gabapentin for the treatment of pain related to radiation-induced mucositis in patients with head and neck tumors treated with intensity-modulated radiation therapy</title>
<link>http://dx.doi.org/10.1002%2Fhed.21165</link>
<description><![CDATA[Background.This retrospective study evaluates the efficacy of gabapentin for the treatment of pain syndrome related to radiation-induced mucositis in patients with head and neck tumors.Methods.Thirty cases of head and neck malignancies treated with radiotherapy were analyzed.Results.By using a median dose of 2700 mg/day of gabapentin, only 10% of patients required additional narcotic pain medications for adequate pain relief during the third and fourth week of treatment, despite grade 2 or higher mucositis present in 56% and 73% of the patients, respectively. Likewise, during the last weeks of intensity-modulated radiation therapy (IMRT), only 35% of patients required additional narcotics for pain control, despite the presence of grade 2 or higher mucositis in 80% of cases.Conclusions.Gabapentin appears promising in reducing the need for narcotic pain medication for patients with head and neck malignancies treated with IMRT and should be further evaluated prospectively in controlled clinical trials. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21177">
<title>Weekly 5-fluorouracil plus cisplatin for concurrent chemoradiotherapy in patients with locally advanced head and neck cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21177</link>
<description><![CDATA[In locally advanced head and neck cancer, concurrent chemoradiotherapy (CRT) with combined 5-fluorouracil (5-FU) and cisplatin has increased acute toxicities as well as survival. Once-weekly chemotherapeutic administration schedule may reduce severe toxicities. Thus, we investigated CRT using weekly administration of 5-FU-cisplatin in locally advanced head and neck cancer.In a single-arm, phase II study, CRT included radiation (70.0 Gy/35 fr) and weekly 5-FU (750 mg/m2) and cisplatin (20 mg/m2).Thirty-two patients completed planned radiation. Thirteen (41%) achieved complete response, and 16 (50%) partial response. Twelve patients (38%) experienced acute grade 3 toxicities. Grade 3 mucositis, which was the most common toxicity, developed in 5 (16%) patients. The survival rates at 1 and 2 years were 81% and 76%, respectively. The progression-free survival rates at 1 and 2 years were 69% and 66%, respectively.We demonstrated weekly 5-FU-cisplatin with conventional radiotherapy was efficacious and feasible with high compliance rate in locally advanced head and neck cancer. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21167">
<title>Prospective trial to evaluate staged neck dissection or elective neck radiotherapy in patients with CT-staged T1-2 N0 squamous cell carcinoma of the oral tongue</title>
<link>http://dx.doi.org/10.1002%2Fhed.21167</link>
<description><![CDATA[A prospective study was undertaken to evaluate a policy of selective, single-modality elective neck treatment in T1-2, node-negative oral tongue squamous cell carcinoma.Where the primary tumor showed 1 of the 4 key pathological criteria (greater than 7 mm of muscle invasion, less than 5 mm of resection margin, perineural or lymphovascular invasion), radiotherapy was delivered to the primary site and the at-risk undissected neck. Otherwise patients underwent ipsilateral neck dissection within 4 weeks of initial resection. Prospective quality of life assessments were performed.The study was closed after accrual of 25 patients, because the high locoregional recurrence rate met early stopping criteria. With a median follow-up of 3.4 years, the locoregional recurrence rate was 23%. The 4-year overall and disease-free survival rates were 71% and 64%, respectively.The poor disease-free survival reflects the need for better prognostic markers and more aggressive treatment in these patients. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21149">
<title>Letter to the editor</title>
<link>http://dx.doi.org/10.1002%2Fhed.21149</link>
<description><![CDATA[No abstract.]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21148">
<title>Treatment protocols of bisphosphonate-related osteonecrosis of the jaws</title>
<link>http://dx.doi.org/10.1002%2Fhed.21148</link>
<description><![CDATA[No abstract.]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21171">
<title>Three synchronous HPV-associated squamous cell carcinomas of Waldeyer&#x27;s ring: Case report and comparison with Slaughter&#x27;s model of field cancerization</title>
<link>http://dx.doi.org/10.1002%2Fhed.21171</link>
<description><![CDATA[Patients with squamous cell carcinoma (SCC) of the oropharynx have an 8% to 20% risk of a synchronous or metachronous second malignancy. The rate of synchronous lesions in human papillomavirus (HPV)-positive oropharyngeal cancers is unknown.We report the case of a 46-year-old man with 3 simultaneous primary malignancies of Waldeyer's ring: HPV-positive SCC of both tonsils and the nasopharynx, with bilateral neck metastases.The patient received induction chemotherapy followed by definitive radiotherapy and remains free of disease at 18 months.Comparison with the Slaughter model of field cancerization suggests that HPV-positive SCC of the head and neck may have a distinct mechanism for the development of multifocal disease. Therefore, the emerging population of young patients with head and neck SCC with HPV-positive cancers presents a new opportunity for understanding the molecular origins of synchronous tumors. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21169">
<title>Circumferential pharyngeal reconstruction: History, critical analysis of techniques, and current therapeutic recommendations</title>
<link>http://dx.doi.org/10.1002%2Fhed.21169</link>
<description><![CDATA[Reconstruction of circumferential pharyngeal defects following total pharyngolaryngectomy presents major challenges with respect to surgical morbidity and restoration of functional deficits, which are often made more demanding by the increasing trend to utilize primary chemoradiation protocols with surgery reserved for salvage cases. The present review evaluates the reconstructive techniques described in the literature, including historical techniques as well as more recent innovative methods. Each technique is critically appraised with particular reference to postoperative morbidity and functional rehabilitation. Treatment recommendations are made based on the available evidence. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21179">
<title>Docetaxel, cisplatin, and fluorouracil induction chemotherapy followed by accelerated fractionation/concomitant boost radiation and concurrent cisplatin in patients with advanced squamous cell head and neck cancer: A Southwest Oncology Group phase II trial (S0216)</title>
<link>http://dx.doi.org/10.1002%2Fhed.21179</link>
<description><![CDATA[In an effort to optimize nonoperative therapy in patients with locoregionally advanced head and neck squamous cell cancer, the Southwest Oncology Group conducted a phase II trial combining 3-drug taxane-containing induction chemotherapy with accelerated fractionation/concomitant boost radiation and concomitant single-agent cisplatin.Two induction courses using docetaxel (75 mg/m2 on day 1), cisplatin (100 mg/m2 on day 1), and fluorouracil (1000 mg/m2/day continuous intravenous infusion days 1-4) were given, with an interval of 21 days. Patients who were stable or responded to the chemotherapy received definitive accelerated fractionation/concomitant boost radiation with concurrent cisplatin (100 mg/m2) on days 1 and 22 of radiation.There were 74 eligible and evaluable patients enrolled between March 1, 2003, and August 15, 2004; 52 (70%) had stage IV disease. At least 1 grade 3-4 toxicity was experienced by 63 patients (85%) during induction. A total of 61 patients completed induction and began concurrent chemoradiotherapy; 50 (68%) completed all planned treatment. At least 1 grade 3-4 toxicity was noted in 53 of the 58 patients (91%) evaluated for toxicity from concurrent chemoradiotherapy. Two patients died during induction, and 2 during chemoradiation. With a median follow-up of 36 months (range, 14-50), the 2-year and 3-year overall survival estimates were 70% and 64%, with 2-year and 3-year progression-free survival estimates of 66% and 61%, respectively.Three-drug induction chemotherapy followed by accelerated fractionation/concomitant boost radiation and concurrent cisplatin is toxic but feasible within a cooperative group. In this patient cohort with advanced head and neck squamous cell cancer, overall and progression-free survivals were encouraging, justifying further study of this approach. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21194">
<title>Abstracts</title>
<link>http://dx.doi.org/10.1002%2Fhed.21194</link>
<description><![CDATA[No abstract.]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21186">
<title>Complications in Head and Neck Surgery, 2nd Edition</title>
<link>http://dx.doi.org/10.1002%2Fhed.21186</link>
<description><![CDATA[No abstract.]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21170">
<title>Temporalis muscle flap for reconstruction of skull base defects</title>
<link>http://dx.doi.org/10.1002%2Fhed.21170</link>
<description><![CDATA[The temporalis muscle flap (TMF) is a valuable reconstructive technique utilized in a variety of challenging defects. However, its use for repair of skull base defects is less commonly reported.A retrospective chart review was conducted for 35 patients who underwent reconstruction of skull base defects between March 1999 and July 2006 at a tertiary referral hospital. Patients with skull base defects after trauma or extirpative surgery underwent reconstruction with a TMF. The measured outcomes were as follows: defect size/location, need for additional flaps, bone necrosis, hardware exposure, dehiscence, cerebrospinal fluid (CSF) leak, and meningitis.Forty-two patients underwent reconstruction with a TMF, and 35/42 patient records were available for review. No flap failures, 1 transient CSF leak, 3 hardware exposures distant from the temporalis recipient site, and 3 hydroxyapatite cement infections or foreign body reaction were observed.The TMF represents a versatile reconstructive technique employed with minimal morbidity and a low complication rate to repair defects of the skull base. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21130">
<title>Brachytherapy boost for T1/T2 nasopharyngeal carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21130</link>
<description><![CDATA[The aim of this study was to review our experience and demonstrate the safety of intracavitary brachytherapy (ICB) in patients with nasopharyngeal carcinoma (NPC).Hundred seventy-eight patients with early T1-2b disease underwent radical external beam radiation therapy (EBRT) followed by ICB boost. The primary tumor received 66 Gy of EBRT over 33 fractions using 6 or 10 MV photons. ICB insertions were performed 1 week later, delivering 10 Gy in 2 fractions over 8 days. Kaplan-Meier survival analyses were used to calculate the actuarial 5-year overall survival (OS), cause-specific survival, local control, and disease-free survival (DFS).Five-year local control rates were 91.6%. OS, DFS, and cause-specific survival were estimated to be 85.25%, 81.7%, and 87.9%, respectively. Median follow-up was 86 months. There were no documented serious complications noted with ICB.ICB boost supplementing radical EBRT is an excellent method of enhancing local control for patients with NPC with early T1-2b disease. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21102">
<title>Quality of life analysis in patients with anterior skull base neoplasms</title>
<link>http://dx.doi.org/10.1002%2Fhed.21102</link>
<description><![CDATA[Significant morbidity is associated with management of anterior skull base neoplasms. The aim of this study was to evaluate the posttreatment patient's quality of life (QOL).A retrospective chart review identified 27 patients. QOL tools included the Functional Assessment of Cancer Therapy-Head & Neck, Centre for Epidemiologic Studies Depression Scale (CES-D), Atkinson Life Happiness Rating (ALHR), and Midface Dysfunction Scale (MDS).Postoperative radiotherapy and chemotherapy was required in 16 and 2 patients, respectively. The median FACT, ALHR, and CES-D scores were 118 ± 21, 9 ± 2, and 17 ± 8, respectively. Smell and nasal crusting disturbance was reported by 69% and 61%, respectively. CES-D > 16 and patients with recurrent disease correlated with a lower Total-FACT score. Adjuvant radiotherapy correlated with a lower FACT-H&N score. Patient sex, marital-status, pathology, surgical technique, or complication rate did not correlate with worse QOL.Anterior skull base neoplasms survivors have an overall acceptable QOL. Most complaints relate to MDS. Recurrence, adjuvant radiotherapy, and MDS had lower QOL scores. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21168">
<title>Feasibility of standard mechanical ventilation with low FiO2 and small endotracheal tubes during laser microlaryngeal surgery</title>
<link>http://dx.doi.org/10.1002%2Fhed.21168</link>
<description><![CDATA[No technique can be considered as a gold standard for ventilation during direct laser CO2 laryngeal microsurgery. We evaluated the feasibility of standard ventilation with laser-safe endotracheal tubes (ETTs) and inspired O2 fraction (FiO2) = 0.21 during direct microlaryngoscopy.During total intravenous anesthesia, standard mechanical normoventilation was set with FiO2 = 0.21 and 50 mm Hg peak inspiratory pressure limit. If SpO2 was 2 minutes, FiO2 was increased to 0.3; after 4 minutes it was increased to 0.4; after another 4 minutes, positive end-expiratory pressure (PEEP) could be set at 5 cm H2O; and after another 4 minutes, surgery was stopped if SpO2 remained <90%.We studied 111 consecutive direct microlaryngoscopies on different patients. Four patients (3.6%) suffered minor intraoperative desaturation. Barotrauma was not observed, PEEP was never applied, and surgery was never stopped. Body mass index was independently predictive of the occurrence of intraoperative desaturation.Standard mechanical ventilation with FiO2 = 0.21 through laser-safe ETTs is feasible during direct microlaryngoscopy. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21160">
<title>Primary schwannoma in a cervical lymph node</title>
<link>http://dx.doi.org/10.1002%2Fhed.21160</link>
<description><![CDATA[Spindle cell neoplasms within lymph nodes are rare and include benign and malignant tumors and primary and metastatic tumors such as palisaded myofibroblastoma, leiomyoma, leiomyosarcoma, reticular cell neoplasms, and vascular sarcomas. Ancillary studies may help distinguish these neoplasms.A 77-year-old white woman was seen with a painless, slowly growing mass of the left neck. Her clinical history was noncontributory. An excisional biopsy was performed without complication. There has been no recurrence, to date, of the lesion.Gross examination, microscopic examination, immunohistochemistry, and ultrastructural studies were consistent with the diagnosis of schwannoma arising within a lymph node.We report the first case of intranodal schwannoma arising in a cervical lymph node. The recognition of intranodal schwannoma is important because it is cured with excision, whereas some of the other diagnostic considerations for a spindle cell lesion within a lymph node may require radiation or chemotherapy. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21159">
<title>Salvage surgery after concomitant chemoradiation in head and neck squamous cell carcinomas - Stratification for postsalvage survival</title>
<link>http://dx.doi.org/10.1002%2Fhed.21159</link>
<description><![CDATA[Salvage surgery after concomitant chemoradiation therapy (CCRT) for patients with head and neck squamous cell carcinomas (HNSCC) is challenging because of its associated morbidity/mortality and the poor prognoses of these patients.The outcome analysis of prospectively collected data from 93 patients with HNSCC with local and/or regional shows treatment failures but without distant metastasis after CCRT.Thirty-eight patients underwent salvage surgery, whereas 55 underwent palliative treatment, with 2-year overall survival rates of 43.4% and 0%, respectively. Initial stage IV tumors (p = .017) and concurrent local and regional failures (p = .003) were independent predictors for decreased survival after salvage surgery. Two-year overall survival rates for patients with 2, 1, or none of these predictive factors were 0%, 49%, and 83%, respectively (p = .0005).Salvage surgery after CCRT has acceptable outcomes. Initial stage IV tumors and concurrent local and regional failures were independent predictors that can stratify patients into distinct prognostic groups for postsalvage survival. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21146">
<title>Expression of membrane type 1 matrix metalloproteinase in medullary thyroid carcinoma: Prognostic implications</title>
<link>http://dx.doi.org/10.1002%2Fhed.21146</link>
<description><![CDATA[Clinical and pathologic examinations cannot always provide a prognosis for patients with medullary thyroid carcinoma. Membrane type 1 matrix metalloproteinase (MT1-MMP) can act directly on carcinogenesis and takes part in 1 of the processes of metalloproteinase 2 activation, an enzyme related to prognostic impairment of patients with such tumor.Thirty-five patients who were submitted to surgery were followed up for an average of 74 months. Postoperative and final medical conditions were characterized for comparison with MT1-MMP immunostainings, performed in surgical paraffin blocks. A value of p < .05 was considered statistically significant.Proposed index (association of proportion and intensity of immunostaining) and proportion of immunostained cells in primary specimens were correlated with cure or persistence after initial operations (p = .0216 and p = .0098, respectively).MT1-MMP immunostaining in primary tumor specimens is a new and complementary prognostic predictor in patients with medullary thyroid carcinomas. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21164">
<title>Late esophageal toxicity after radiation therapy for head and neck cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21164</link>
<description><![CDATA[The aim of this study was to determine the incidence of esophageal toxicity after radiation therapy for head and neck cancer.The records of 211 patients treated by radiation therapy for head and neck cancer were reviewed to identify those with dysphagia lasting more than 90 days after therapy. Late toxicity criteria established by the Radiation Therapy Oncology Group were used to score the symptoms.The incidence of grade 3+ esophageal toxicity at 3 and 6 months was 30% and 19%, respectively. The rate of gastrotomy-tube dependence at 3 and 6 months was 20% and 11%, respectively. Hypopharyngeal and unknown primary site (p = .01, for both), T4 disease (p = .01), and the use of concurrent chemotherapy (p = .001) were associated with grade 3+ esophageal toxicity and stricture formation.A significant proportion of patients exhibit symptoms of esophageal toxicity after radiation therapy for head and neck cancer. Therefore, preventive strategies need further investigation. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21162">
<title>Neuroendocrine neoplasms of the larynx: An overview</title>
<link>http://dx.doi.org/10.1002%2Fhed.21162</link>
<description><![CDATA[Neuroendocrine neoplasms of the larynx are rare but are the most common nonsquamous tumors of this organ. In the past, there has been considerable confusion about the nature and classification of these neoplasms, but the current consensus is that there are 4 different types of laryngeal neuroendocrine tumors composed of paraganglioma, typical carcinoid, atypical carcinoid tumor, and small cell neuroendocrine carcinoma. Carcinoids and small cell neuroendocrine carcinomas are epithelial neoplasms, whereas paragangliomas are of neural origin. Diagnosis is based primarily on light microscopy and confirmed by immunohistochemistry and electron microscopy. Precise diagnosis is essential because the natural history, treatment, and prognosis vary widely for the different neoplastic categories.Typical carcinoids are very rare and are treated by wide local excision, usually partial laryngectomy, without elective neck dissection. Atypical carcinoid tumors are more common and more aggressive. They are treated by partial or total laryngectomy with elective or therapeutic neck dissection. Adjuvant chemo/radiotherapy may be of benefit in some cases. Small cell neuroendocrine carcinomas are highly aggressive and should be considered disseminated at initial diagnosis. The treatment is by irradiation and chemotherapy as surgery has proven to be of a little benefit. Paragangliomas are treated by local excision or partial laryngectomy.It is difficult to determine the valid survival statistics for typical carcinoids because of their rarity and confusion in the literature with their atypical counterparts. They have a greater tendency to metastasize, and thus a worse prognosis than was previously believed. Atypical carcinoid tumors have a 5-year survival rate of approximately 50%, which decreases with time. The prognosis of small cell neuroendocrine carcinoma of the larynx is dismal, with 5-year survival rates of 5%. The biological behavior of laryngeal paraganglioma is generally benign and the prognosis is excellent. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21161">
<title>Severe radiation therapy-related soft tissue toxicity in a patient with porphyria cutanea tarda: A literature review</title>
<link>http://dx.doi.org/10.1002%2Fhed.21161</link>
<description><![CDATA[Some porphyrias are associated with cutaneous phototoxicity due to photoactivation of porphyrins, but whether ionizing radiation can have an additive effect is not clear. We report a case of severe radiation therapy-related toxicity in a patient with porphyria cutanea tarda and review the literature.A 50-year-old man with porphyria cutanea was treated for lower lip squamous cell carcinoma with definitive radiation therapy. During radiation therapy, acute toxicity was of an expected onset and severity. Six months after treatment completion, he developed skin hypopigmentation, soft tissue fibrosis, and areas of painful denuded skin and crusting within the previous treatment field.Reports of 7 patients with porphyria receiving radiation therapy to at least 9 separate sites were reviewed, with only 1 previous report suggestive of increased radiation therapy-related toxicity.Based on this and 1 other report, caution is warranted when considering radiation therapy in patients with active porphyria. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21158">
<title>Importance of comorbidity in hypopharyngeal cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21158</link>
<description><![CDATA[Comorbidity has an impact on survival in laryngeal cancer in several reports. However, the importance of comorbidity in hypopharyngeal cancer (HPC) has not been reported.A retrospective medical record review of 156 patients with HPC treated between 1995 and 2005 was performed. Comorbid illness was measured by the Adult Comorbidity Evaluation-27. A Cox proportional hazards model was used to determine the factors related to overall survival.Comorbidity was absent in 55 (35.2%) of the patients, mild in 39 (25%), moderate in 28 (17.9%), and severe in 34 (21.8%). There were statistically significant differences between the survival rates in accord with age, stage, subsite, and comorbidity (45.1% for none or mild vs 27.7% for moderate or severe; p = .0073). Age, stage, and comorbidity were identified as independent prognostic factors in the multivariate analysis.Comorbidity, along with the clinical stage, should be considered in treatment planning for patients with HPC. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21156">
<title>Differentiated thyroid cancer associated with intestinal polyposis syndromes: A review</title>
<link>http://dx.doi.org/10.1002%2Fhed.21156</link>
<description><![CDATA[Intestinal polyposis syndromes, such as familial adenomatous polyposis (FAP) and Cowden's syndrome, are often associated with extraintestinal manifestations, and while many of these manifestations are benign, malignant extraintestinal manifestations, such as differentiated thyroid cancers, do occur. Although differentiated thyroid cancers (ie, papillary and follicular thyroid carcinomas) are associated with multiple syndromes, they are most commonly associated with intestinal polyposis syndromes. In the general population, the probability of developing thyroid cancer by age 65 years is only .5%. However, 1% to 2% of patients with FAP develop papillary thyroid carcinoma, the most common extraintestinal malignancy in patients with FAP. Also, up to 10% of patients with Cowden's syndrome will develop follicular thyroid carcinoma. The purpose of this review was to provide an overview of FAP, Cowden's syndrome, and Peutz-Jeghers syndrome, to discuss in detail the associations between intestinal polyposis syndromes and differentiated thyroid cancers, and to provide suggestions for screening and managing these diseases. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21157">
<title>Adopting the operating microscope in thyroid surgery: Safety, efficiency, and ergonomics</title>
<link>http://dx.doi.org/10.1002%2Fhed.21157</link>
<description><![CDATA[Our aim was to assess the safety and efficiency of operating microscope use by surgeons in thyroid surgery to reduce static neck flexion.A retrospective case review comparing thyroidectomies performed using an operating microscope to those using surgical loupes was done. Operative times and incidence of complications were compared between total thyroidectomy procedures done with either microscope or loupes.The use of microscope in 51 thyroidectomies (including 20 for malignancy with central compartment node dissection [CND] and 9 for substernal goiter [SG]) was compared with 65 cases (15 with CND and 11 with SG) done previously using loupes. Surgical times using the microscope were longer (p = .0001), but the increase was significant only in the subset of patients who underwent thyroidectomy with CND. There was no difference in complications between the groups.The use of an operating microscope during thyroidectomy is safe with modest increases in surgical time. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21153">
<title>Frequent expression of Niban in head and neck squamous cell carcinoma and squamous dysplasia</title>
<link>http://dx.doi.org/10.1002%2Fhed.21153</link>
<description><![CDATA[Niban was initially identified in the Eker rat, a model of renal carcinogenesis. We examined Niban expression in head and neck squamous cell carcinoma (HNSCC) and head and neck dysplastic lesions.Using a polyclonal rabbit anti-human Niban antibody, 43 cases of HNSCC and 30 cases of head and neck squamous dysplasia were immuonohistochemically stained for Niban. Ancillary genetic studies were also performed.Forty-two of 43 HNSCCs (97.6%) and 20 of 30 (66.6%) dysplastic lesions were positively stained for Niban. The staining was generally less intense in cases of dysplasia than HNSCC. Three of 8 normal mucosal samples from drinker/smokers also showed weak Niban expression. Normal head and neck squamous epithelium from nondrinker/nonsmokers did not stained for Niban. Reverse transcription polymerase chain reaction results matched the immuonohistochemical results.The expression of Niban frequently begins in the early stages of head and neck squamous carcinoma and remains upregulated throughout the carcinogenic process. Niban may be a good molecular marker of HNSCC. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21145">
<title>Spurious hypercalcitoninemia in patients with nodular thyroid disease induced by heterophilic antibodies</title>
<link>http://dx.doi.org/10.1002%2Fhed.21145</link>
<description><![CDATA[BackgroundSerum calcitonin is the most useful tumor marker for the diagnosis and follow-up of medullary thyroid carcinoma (MTC). Spurious hypercalcitoninemia caused by heterophilic antibody interference (HAI) is rarely found in patients without MTC.MethodsWe studied 2 patients with hypercalcitoninemia and thyroid nodules, but no evidence of MTC on fine-needle aspiration cytology. We performed calcium stimulation tests, measured serum calcitonin with another calcitonin kit, performed dilution tests, and remeasured serum calcitonin after applying heterophilic blocking tubes.ResultsIn a 31-year-old woman with no response to the calcium stimulation test, serum calcitonin was <5 pg/mL using another kit. After we applied heterophilic blocking tubes, the serum calcitonin level decreased to normal range. We concluded that patient had spurious hypercalcitoninemia. In a 63-year-old woman, all tests revealed that the patient had true hypercalcitoninemia. The patient underwent total thyroidectomy that revealed MTC.ConclusionsWe suggest that patients suspected for spurious hypercalcitoninemia should undergo further investigation due to HAI. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21144">
<title>Transaxillary subfascial endoscopic approach for internal jugular phlebectasia in a child</title>
<link>http://dx.doi.org/10.1002%2Fhed.21144</link>
<description><![CDATA[Surgical intervention for internal jugular phlebectasia is occasionally necessary in cases of phlebitis, thrombus formation, rupture of the lesion, and some cosmetic deformity. However, the resultant neck scar can be of suboptimal cosmesis, with consequent psychological distress, particularly for children.We described a 3-port transaxillary endoscopic technique performed under the fascia of the pectoralis major for excision of the dilated right internal jugular vein in an 8-year-old girl.The preservation of the upper tributaries of the right internal jugular vein was helpful in draining the cerebral blood to the collaterals and in preventing postoperative craniofacial swelling immediately. Six months later, there were no signs of recurrence of other jugular veins, and the patient showed a correct hemodynamic compensation.This technique offered an effective way to surgically manage internal jugular phlebectasia while avoiding the potential for poor cosmesis from any neck scar. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21135">
<title>Prefabricated bony radial forearm flap for secondary mandible reconstruction after radiochemotherapy</title>
<link>http://dx.doi.org/10.1002%2Fhed.21135</link>
<description><![CDATA[Primary reconstruction of the mandible is the golden standard of surgical treatment after ablative tumor surgery. Many different microvascular bone grafts are used to reduce wound healing complications at the severely compromised recipient site. The loss of primary grafts due to radiotherapy or osteoradionecrosis can make secondary mandibular reconstruction necessary. To address this problem, we developed the technique of the prefabrication of a radial forearm flap with cancellous bone. The aims were to establish these techniques into the clinical routine and to create a safe and reliable flap with low donor site morbidity.In patients who had undergone ablative tumor surgery radiochemotherapy, and primary reconstruction, prefabricated bony radial forearm flaps (PBRFFs) were applied for secondary reconstruction of the mandible. Cylinders of cancellous bone taken from the iliac crest were implanted in the lower forearm to allow the necessary vascularization. After a healing period of 4 weeks, the PBRFF was elevated and grafted into the mandibular defect.All grafts healed uneventfully. However, 1 case required revision of the venous anastomosis after 2 days. The transplants improved the contour of the lower face enabling a good correction of the facial asymmetry. During the follow-up of up to 4 years, the radiographic controls showed good bony consolidation between the graft and the stumps of the mandible as well as formation of cortical bone around the cancellous bone cylinders.These results demonstrate that the PBRFF is a safe and reliable graft which provides alternate solution in which other microvascular bone grafts have already failed. In the future, the iliac bone graft may be replaced with scaffold seeded with stem cells for further reduction of donor site morbidity. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21092">
<title>Proton radiation therapy for primary sphenoid sinus malignancies: Treatment outcome and prognostic factors</title>
<link>http://dx.doi.org/10.1002%2Fhed.21092</link>
<description><![CDATA[The purpose of this study was to determine treatment outcome and prognostic factors in patients with locally advanced primary sphenoid sinus malignancy treated with proton radiation therapy.Between 1991 and 2005, 20 patients with primary sphenoid sinus malignancy received proton beam to a median dose of 76 Gray equivalent.With a median follow-up of 27 months, the 2-year local, regional, and freedom from distant metastasis rates were 86%, 86%, and 50%, respectively. The disease-free and overall-survival rates at 2 years were 31% and 53%, respectively. In multivariate analysis, oropharyngeal involvement (p = .005) and anterior cranial fossa invasion (p = .02) were predictive for poor disease-free survival rate. Brain invasion was predictive for decreased overall-survival rate (p = .05).Proton radiation therapy results in excellent local control in patients with advanced primary sphenoid sinus malignancy. Brain invasion, involvement of the oropharynx and anterior cranial fossa are important prognostic factors. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21155">
<title>Oral sensation and function: A comparison of patients with innervated radial forearm free flap reconstruction to healthy matched controls</title>
<link>http://dx.doi.org/10.1002%2Fhed.21155</link>
<description><![CDATA[Limited evidence exists for the use of innervated radial forearm free flap (RFFF) reconstruction of hemiglossectomy defects. This study reports on sensation, mastication, and speech outcomes for patients with innervated RFFF reconstruction of the anterior two-thirds of the tongue.Sensation, mastication, and speech intelligibility were assessed in 8 patients and age- and sex-matched controls.Sensation of intact tongue tissue after reconstruction of the hemitongue did not differ from controls. Although some sensory ability was restored to patients' reconstructed tongue, differences existed between the patient group and controls. However, whole mouth sensations resulted in similar sensory ability as controls. Whereas patients demonstrated adequate masticatory and speech ability, differences existed between patients and controls.Although some sensory ability is preserved in patients who have had tongue reconstruction with an innervated RFFF, functional outcomes such as masticatory ability and speech intelligibility may be affected in some patients. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21147">
<title>PET/CT in the assessment of previously treated skull base malignancies</title>
<link>http://dx.doi.org/10.1002%2Fhed.21147</link>
<description><![CDATA[Altered anatomy, radiotherapy, hardware, and reconstructive materials distort the posttreatment ventral skull base. The diagnostic characteristics of positron emission tomography/CT (PET/CT) studies in those with suspected recurrent malignancy were assessed.A retrospective review was undertaken of patients with head and neck cancer who had PET/CT for ventral skull base disease.Thirty-four PET/CTs were performed for suspected recurrent malignancy in the skull base (mean age, 59.6 ± 10.7 years; female 38%). The group comprised mainly minor salivary (35.3%), squamous (32.3%), and neuroectodermal (23.6%) tumors. Mean clinical follow-up after PET/CT was 256 ± 173 days. Sensitivity was 100% but specificity was 40%. Standard uptake values (SUVs) for true positives were higher than for those without disease (p = .03).PET/CT is a highly sensitive test for malignant disease. The mucosal lining of the reconstructed skull base is a common source for inflammatory pathologies that may lead to false-positive PET/CT. Defining SUV thresholds for malignancy may improve specificity. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21134">
<title>Predictors of facial palsy after surgery for benign parotid disease: Multivariate analysis of 626 operations</title>
<link>http://dx.doi.org/10.1002%2Fhed.21134</link>
<description><![CDATA[The objective was to identify the risk factors for, and incidence of, facial palsy following conservative parotidectomy.Conservative parotidectomies for benign diseases (N = 626) were studied retrospectively. The risk factors for postoperative facial palsy were determined by univariate and multivariate analyses of variables related to patient demographics, comorbid illnesses, and characteristics of the operation.The rate of transient facial palsies was 23.16% following parotidectomy. Significant risk factors for transient facial palsy were diabetic mellitus (odds ratio [OR] 1.727 [95% CI: 1.062-2.810]) and extended surgery (OR 3.049 [95% CI: 2.058-4.515]). Only the type of surgery was found to have a statistically significant causal relation with permanent facial palsy (p = .017).Comorbid diabetes, and more extensive as opposed to partial superficial parotidectomy, may be associated with transient facial palsy following operation for benign parotid disease. The incidence of permanent facial palsy may be higher when a more extensive parotidectomy is performed. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21150">
<title>Botulinum toxin: A noninvasive option for the symptomatic treatment of salivary gland stenosis - A case report</title>
<link>http://dx.doi.org/10.1002%2Fhed.21150</link>
<description><![CDATA[A man diagnosed with Stensen's duct stenosis exhibited recurrent parotid swelling, invariably during meals. Previous parotid duct dilations and percutaneous radiotherapy were ineffective. Botulinum toxin (BTX) injections were injected into the affected gland to regulate salivary flow and reduce parotid swelling.BTX (22.5 units) was injected into the affected gland. A second treatment with 30 units BTX was carried out 7 weeks later. Two further injections followed after 4 months, respectively. The results were scored by the patient and evaluated in an examination.The patient reported the disappearance of parotid swelling after 2 weeks of injections. This effect was maintained for 5 weeks after the first treatment and for 4 months after the following 2 treatments. There were no side effects.Here we introduce BTX as a therapeutic option for the treatment of salivary duct stenosis when other therapies are ineffective and before opting for gland extirpation. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21141">
<title>Patterns of failure among patients with squamous cell carcinoma of the head and neck who obtain a complete response to chemoradiotherapy</title>
<link>http://dx.doi.org/10.1002%2Fhed.21141</link>
<description><![CDATA[The role of adjuvant neck dissection in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) who obtain complete clinical and radiologic response following definitive chemoradiation treatment is controversial.Patterns of failure among 120 patients with locally advanced SCCHN, all with node-positive disease, treated with concurrent chemoradiation, were analyzed.Ninety-one of the patients achieved a complete response and were observed without undergoing neck dissection. Isolated failure in the neck occurred in 2 patients. The most common site of failure was metastatic disease (17 patients). Six patients had recurrence at the primary only, and 1 experienced failure in the neck and at the primary. Partial responders with resectable disease underwent neck dissection following chemoradiation. This group had worse local control and overall survival compared with complete responders.We recommend observation after definitive chemoradiation for complete responders. Further research is needed to improve outcomes among partial responders. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21138">
<title>Infiltrating macrophage count: A significant predictor for the progression and prognosis of oral squamous cell carcinomas in Taiwan</title>
<link>http://dx.doi.org/10.1002%2Fhed.21138</link>
<description><![CDATA[Infiltrating macrophage count (IMC) is found to correlate with the progression and prognosis of many human cancers.This study used immunohistochemistry to measure the IMC (macrophages/high-power field [HPF]) in 92 specimens of oral squamous cell carcinoma (OSCC).A significantly increased IMC was found in OSCCs with larger tumor size, positive lymph node metastasis, more advanced clinical stages, or recurrence (all ps 196 macrophages/HPF had a significantly shorter disease-free (p = .001, log-rank test) or overall survival (p 196 macrophages/HPF was an independent predictor for poor disease-free (p = .005) and overall survival of patients with OSCC (p = .015).The IMC can predict the progression and prognosis of OSCCs in Taiwan. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21140">
<title>Exploring the link between microorganisms and oral cancer: A systematic review of the literature</title>
<link>http://dx.doi.org/10.1002%2Fhed.21140</link>
<description><![CDATA[The majority of cases of oral cancer have been related to tobacco use and heavy alcohol consumption. However, the incidence of oral cavity carcinoma appears to be increasing in many parts of the world in a manner that it is difficult to explain with traditional risk factors alone. Meanwhile, interest in the possible relationships between microorganisms and the different stages of cancer development has been rising and numerous mechanisms by which bacteria and yeast may initiate or promote carcinogenesis are currently under investigation. In particular, a persuasive body of evidence suggests a possible etiological role involving the metabolism and production of carcinogenic products, such as acetaldehyde. Other suggested mechanisms include the induction of chronic inflammation and direct interference with eukaryotic cell cycle and signaling pathways. This review aims to summarize the known associations between microbial infection and cancer and draw attention to how they may relate to oral carcinoma. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21139">
<title>Surgical anatomy of the external branch of the superior laryngeal nerve in Chinese adults and its clinical applications</title>
<link>http://dx.doi.org/10.1002%2Fhed.21139</link>
<description><![CDATA[Background.The purpose of this study was to determine the anatomic features of the external branch of the superior laryngeal nerve (EBSLN) in Chinese adults.Methods.We analyzed the anatomic distribution of the 86 EBSLNs in 43 cadavers.Results.The incidences of the EBSLN in the thyroid area were 94.2% and 91.3% on the right and left sides, respectively. In accord with the Cernea classification, type 1 was 16.2%, type2a was 39.5%, and type 2 was 38.3%. There were no significant differences between the right and the left side. The high-risk position of the EBSLN was 77.8%.Conclusions.The inferior cornu of the thyroid cartilage was a reliable landmark in identifying the external branch of superior laryngeal nerve. Racial variations between the white and the Chinese should be taken into consideration for an explanation of the differences. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21124">
<title>Detection of synchronous lung tumors in patients presenting with squamous cell carcinoma of the head and neck</title>
<link>http://dx.doi.org/10.1002%2Fhed.21124</link>
<description><![CDATA[Background.Screening for synchronous pulmonary tumors in patients presenting with squamous cell carcinoma of the head and neck (SCCHN) is important, because detection may alter subsequent management.Methods.We conducted a retrospective review, comparing effectiveness of pulmonary screening using thoracic CT or chest X-ray, in 1882 patients presenting with SCCHN.Results.The overall rate of synchronous pulmonary tumors was 4.3%. The number needed to scan, ie, the number of thoracic CTs required to detect 1 pulmonary tumor, is reported for recurrent primary tumors, primary disease load (T and N classification), and individual primary sites. The incidence of pulmonary metastases is related to locoregional disease load while the incidence of bronchogenic carcinoma is sporadic.Conclusion.Although it is possible to propose a pragmatic screening protocol for pulmonary metastases, this is not possible for bronchogenic carcinomas. Therefore, we recommend that thoracic CT is used in all cases to screen for coexistent pulmonary pathology. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21142">
<title>Papillary microcarcimoma in comparison with larger papillary thyroid carcinoma in BRAFV600E mutation, clinicopathological features, and immunohistochemical findings</title>
<link>http://dx.doi.org/10.1002%2Fhed.21142</link>
<description><![CDATA[Background.Papillary thyroid microcarcinoma (PMC; [le]1 cm) is thought to take a benign course during the lifetime. However, recent studies showed high recurrence rates for PMC.Methods.We analyzed the clinicopathological features, long-term prognosis, and some molecular characteristics including BRAFV600E mutation by retrospectively reviewing the records of 1150 patients with papillary thyroid carcinoma (PTC), 278 with PMC, and 868 with PTC >1 cm.Results.The prevalence of extrathyroidal invasion (52.2%) and initial nodal metastasis (34.9%) in patients with PMC was surprisingly high and almost as high as that for patients with PTC (72.4% and 51.8%, respectively). The rate of recurrent or persistent disease did not differ between patients with PMC and PTC (recurrent or persistent disease, 6.1% vs 14.1%; 53.4- vs 84.2-month follow-up; n = 98 vs 647; corrected p = .112). The frequency of BRAFV600E mutation was similar in patients with PMC and PTC (65.6% vs 67.2%). Immunohistochemical staining showed no different expression pattern according to the tumor size.Conclusion.These results suggest that PMC is not an occult cancer and it can act like larger PTC. Therefore, PMC should not be underestimated in practice. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21132">
<title>Squamous cell carcinoma of the nasal vestibule 1993-2002: A nationwide retrospective study from DAHANCA</title>
<link>http://dx.doi.org/10.1002%2Fhed.21132</link>
<description><![CDATA[Background.A retrospective nationwide study of cancer of the nasal vestibule was conducted to evaluate classification systems and prognostic factors for treatment outcome.Methods.Patients treated between 1993 and 2002 at head and neck oncology centers in Denmark were included.Results.The 5-year results were locoregional control 67%, overall survival 50%, cancer-specific survival 74%. Cancer-specific survival according to Wang classification was 83%, 63%, and 39% for T1, T2, T3, respectively (p < .000). Regarding T1 tumors, 5-year locoregional control for surgery, surgery + radiotherapy (RT), or RT was 94%, 87%, or 61%, respectively (p < .000). Fifty-four Gray in 18 fractions was found comparable with 66 Gy in 33 fractions regarding T1 tumors.Conclusion.This national survey is the largest series of nasal vestibule cancer ever published. Wang classification is more prognostic and easier to use than the Union Internationale Contre le Cancer 2002. Surgery or hypofractionated RT can be used for T1 lesions, whereas larger lesions should be treated with combined approach. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21129">
<title>Incidence and patterns of regional metastasis in early oral squamous cell cancers: Feasibility of submandibular gland preservation</title>
<link>http://dx.doi.org/10.1002%2Fhed.21129</link>
<description><![CDATA[Background.We aimed to study the incidence of metastasis to the submandibular gland (SMG) and to establish the oncologic basis of SMG preservation in early-stage cancer of the oral cavity (OSCC).Methods.This was a retrospective study of 261 patients with OSCC treated primarily with surgery at a tertiary medical center. One hundred thirty-two early-stage (T1-2, N0) OSCCs were further analyzed.Results.The mean age was 59 years with male-to-female sex ratio of 1.4:1. Two hundred sixty-one neck dissections were performed with SMG removal in 253 patients. One patient with an advanced floor of mouth cancer had obvious infiltration of the SMG. Only 2.5% (3 of 116) patients with early-stage OSCC had level I metastasis; none had SMG metastases.Conclusion.SMG preservation in early cancers (T1-2, N0) of the oral cavity should be feasible unless there is evidence of direct invasion of the gland or close proximity of the cancer to it. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21154">
<title>Laryngeal reconstruction following CO2 laser surgery for glottic cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21154</link>
<description><![CDATA[CO2 laser has become a common surgical technique in the management of glottic cancer. The patients treated with this modality may benefit from additional phonosurgical techniques used to improve postoperative vocal outcome.The aim of this article was to review those phonosurgical techniques described for glottic reconstruction after CO2 laser excision of glottic cancer. The indications for using each technique are discussed, with particular attention paid to functional outcomes following these reconstructive efforts. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21151">
<title>Value of fine-needle aspiration biopsy of salivary gland lesions</title>
<link>http://dx.doi.org/10.1002%2Fhed.21151</link>
<description><![CDATA[The aim of this study was to assess the utility of fine-needle aspiration biopsy (FNAB) in the diagnosis and treatment planning of the lesions of the salivary gland.Eight hundred seventy-nine aspiration biopsies of the lesion of the salivary gland over a 10-year period, from 1997 to 2006, were reviewed with special reference to its value in the clinical treatment of patients.Cytologic as well as histologic diagnoses of 382 patients were available. In these diagnoses, the sensitivity of malignancy was 83% and specificity was 99%. The positive predictive value was 98%, and the negative predictive value was 97%. The overall accuracy was 93%. The correct subtyping of the benign lesions was 97%, and the exact type-specific concordance of the malignant lesions was 71%.Considerable benefit to the patient may result from the cautious use of FNAB of lesions of the salivary gland. The close co-operation between pathologist and surgeon can improve individual treatment. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21133">
<title>Parotid mass in a woman with multiple cutaneous cylindromas</title>
<link>http://dx.doi.org/10.1002%2Fhed.21133</link>
<description><![CDATA[Familial autosomal dominant cylindromatosis (FADC) is a rare disease characterized by multiple cutaneous cylindromas, trichoepitheliomas, and spiradenomas. We present a case of a woman with scalp lesions and a parotid mass.Biopsy of a skin nodule demonstrated cylindroma, and fine-needle aspiration of the parotid mass suggested membranous basal cell adenoma, which was confirmed following superficial parotidectomy. The study includes case report and review of the literature.Eighteen cases of cylindromatosis with coexistent salivary gland membranous basal cell adenoma were reported. Seventeen cases involved the parotid gland; there are 2 reports of malignant transformation.FADC should be considered in anyone with coexistent dermal and salivary gland neoplasms. Membranous basal cell adenoma may be mistaken for adenoid cystic carcinoma on cytologic or histologic examination. Total parotidectomy with facial nerve preservation or superficial parotidectomy with close follow-up is recommended, as multifocality and malignant transformation exist. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21131">
<title>Treatment and follow-up of oral dysplasia  -  A systematic review and meta-analysis</title>
<link>http://dx.doi.org/10.1002%2Fhed.21131</link>
<description><![CDATA[The aim of this study was to inform an evidence-based management policy for oral dysplastic lesions.Systematic review was performed with meta-analysis. Studies reporting follow-up of patients with histologically confirmed oral dysplasia were included. Outcome measures included malignant transformation rate (MTR) and time to malignant transformation (TMT). Subgroup analysis was performed by histologic grade, clinical risk factors, and treatment modality. Heterogeneity was assessed.Fourteen nonrandomized studies, reporting on 992 patients, were included. There was considerable heterogeneity between studies: mean overall MTR = 12.1% (confidence interval: 8.1%, 17.9%) and mean TMT = 4.3 years. Histologic grade significantly affected mean MTR (p < .008). Lesions that were not excised demonstrated considerably higher MTR than those that were excised (p = .003).Oral dysplasia showed a significant rate of transformation to cancer, which was related to grade and was decreased significantly but not eliminated by excision. This suggested the need for excision and continued surveillance. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21137">
<title>Inhibition of cell proliferation and glucose uptake in human laryngeal carcinoma cells by antisense oligonucleotides against glucose transporter-1</title>
<link>http://dx.doi.org/10.1002%2Fhed.21137</link>
<description><![CDATA[Malignant cells show increased glucose uptake in vitro and in vivo, which is thought to be mediated by glucose transporters. In this study, we investigated the effect of plasmid-derived antisense RNA against the Glut-l gene on proliferation and glucose uptake in laryngeal carcinoma Hep-2 cells.The expression plasmids pcDNA3.1(+)-Glut-1 and pcDNA3.1(+)-anti Glut-1 were constructed. The MTT method was used to assess cell growth inhibition. The expression of Glut-1 mRNA and protein was detected by reverse transcriptase-polymerase chain reaction and Western blotting, respectively.After transfection, Glut-1 AS clearly inhibited glucose uptake and cell growth in Hep-2 cells, and we observed a decrease in the expression of Glut-1 mRNA and protein in Hep-2 cells.Glut-1 AS decreases glucose uptake and inhibits the proliferation of Hep-2 cells. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21127">
<title>Leiomyosarcoma of the larynx as a local relapse of squamous cell carcinoma - Report of an unusual case</title>
<link>http://dx.doi.org/10.1002%2Fhed.21127</link>
<description><![CDATA[The authors report on leiomyosarcoma after previously treated squamous cell carcinoma (SCC) at the glottis.Primary tumor and relapses were investigated morphologically, immunohistochemically, and with molecular methods.The SCC was typical, but few cells showed a spindle-shaped pattern. The relapse tumor was a spindle-shaped and epitheloid tumor with the morphological and immunohistochemical appearance of leiomyosarcoma (sm-actin+, desmin+, caldesmon+, vimentin+, keratin-).The comparative genomic hybridization (CGH) revealed some gains and losses in the leiomyosarcoma. Because of altered material, the investigation failed in the primary. A fluorescence in situ hybridization (5p) focally detected 3 chromosmomal copies, corresponding to gains on 5p in CGH of leiomyosarcoma.Leiomyosarcoma after SCC is very uncommon. A connection between both seems likely in this case. Transdifferentiation, also seen in other tumors or carcinosarcomas, could be based on aberrant differentiation of a pluripotent stem cell. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21114">
<title>Nodal ratio as an independent predictor of survival in squamous cell carcinoma of the oral cavity</title>
<link>http://dx.doi.org/10.1002%2Fhed.21114</link>
<description><![CDATA[The association between nodal ratio and survival in oral cavity carcinomas has recently been proposed, but no prospective evaluations exist.We sought to determine, using an institutional database, whether nodal ratio impacts survival in node-positive oral cavity squamous cell carcinoma.Between 1994 and 2004, 143 new diagnoses of N1-2 squamous cell carcinoma of the oral cavity were identified. The mean number of nodes identified was 41.6, and the mean nodal ratio was 9%. Nodal ratio was strongly statistically associated with overall and disease-specific survival in both univariate and multivariate analyses. No other prognostic indicator maintained that degree of statistical significance. Patients could be stratified into low (0% to 6%), moderate (6% to 13%), and high-risk (>13%) groups based on nodal ratio.In squamous cell carcinoma of the oral cavity, an increased nodal ratio is a strong predictor of decreased survival. Risk of death can be stratified by nodal ratio. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21128">
<title>Voice profile after type I or II laser chordectomies for T1a glottic carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21128</link>
<description><![CDATA[Can a "typical" voice in terms of auditory perception be defined after type I or II chordectomy? Do other parameters in a multidimensional voice protocol correlate to this perceptual profile?Voice evaluation using a multidimensional voice protocol including perceptual (GRBAS; grade, roughness, breathiness, asthenia, strain scale), acoustic, aerodynamic, stroboscopic analyses, and self-assessment (Voice Handicap Index [VHI]) in a cohort of 37 consecutive patients with T1a midcord glottic carcinoma.Sixty-five percent of patients had dysphonia, dominated by mild breathiness (mean grade 1.4). Voice Handicap was minimal (mean VHI 19). Acoustic and aerodynamic parameters were only mildly deviant. The correlations between perceptual analysis and the other parameters were weak.The typical laser treated voice (type I or II resections) is characterized by mild breathiness in perceptual analysis. Correlations with other parameters, including patients' self assessment, are weak. Therefore, these outcomes do not form 1 integrated voice profile. This may have consequences for clinical decision-making. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21125">
<title>Barriers to early detection and treatment of head and neck squamous cell carcinoma in African American men</title>
<link>http://dx.doi.org/10.1002%2Fhed.21125</link>
<description><![CDATA[African Amercians afflicted with head and neck squamous cell carcinoma (HNSCC) have a strikingly worse survival than do whites. One apparent cause is an advanced stage of presentation in African Americans. This study was designed to identify barriers to early treatment among African American men.Twenty-four African American male HNSCC survivors completed structured interviews. Interviewers elicited the participants' experiences from symptom recognition to receiving definitive care.Most participants were seen with advanced-stage HNSCC. Overall, 10% experienced barriers to obtaining early medical care, though 30% were hesitant to seek care due to perceived barriers. Definitive treatment began for 81% within 3 months of initial care seeking.Once participants sought care, most of them received definitive treatment within a reasonable time frame. To explain the advanced stage at presentation, either tumor growth rate was extremely rapid or participants sought care when the tumor was quite advanced. The themes suggested by this elicitation study require further validation. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21122">
<title>Significance of promoter hypermethylation of p16 gene for margin assessment in carcinoma tongue</title>
<link>http://dx.doi.org/10.1002%2Fhed.21122</link>
<description><![CDATA[BackgroundLoss of p16 expression by promoter hypermethylation has been reported as an early event in the development of oral cancer. The aim of our study was to explore the prognostic implications of presence of promoter hypermethylation of p16 gene in surgical margins in carcinoma tongue.MethodsA prospective analysis of 38 patients with resectable carcinoma tongue was carried out. DNA from tumor and the surgical margins was assessed by methylation-specific polymerase chain reaction. Follow-up duration was 17 to 37 months.ResultsAbout 86.8% of tumors showed promoter hypermethylation of p16 gene. Out of 30 patients with histologically free margins, 43.3% showed positivity on molecular assessment. Patients with positive molecular margins had a 6.3-fold increased risk of having local recurrence as compared to patients with negative margins.ConclusionPromoter hypermethylation of p16 gene may serve as a useful molecular marker for predicting local recurrence in carcinoma tongue. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21120">
<title>Concurrent chemotherapy with intensity-modulated radiation therapy for locally advanced squamous cell carcinoma of the larynx and oropharynx: A retrospective single-institution analysis</title>
<link>http://dx.doi.org/10.1002%2Fhed.21120</link>
<description><![CDATA[We present outcome data from concurrent chemotherapy and intensity-modulated radiation therapy (IMRT) for squamous cell carcinoma (SCC) of the larynx and oropharyx.Eighty patients with laryngeal (n = 15) or oropharyngeal (n = 65) SCC underwent concurrent IMRT and chemotherapy (cisplatin or carboplatin/paclitaxel).The 3-year overall survival (OS) and disease-free survival (DFS) were 81.2% and 78.3%, respectively, with a median follow-up of 31.2 months. There was a statistically significant correlation between OS and DFS with N classification (p = .0001), but not with disease site or T classification. Toxicities compared favorably with prior reports using conventional radiation therapy.This retrospective analysis reveals a very good outcome and an acceptable toxicity profile for patients with locally advanced SCC of the oropharynx and larynx treated with chemotherapy and IMRT concurrently. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21126">
<title>Prognostic significance of molecular markers in oral squamous cell carcinoma: A multivariate analysis</title>
<link>http://dx.doi.org/10.1002%2Fhed.21126</link>
<description><![CDATA[Multiple marker accumulation impacts tumor progression and biologic phenotypes affect clinical outcome of patients with head and neck cancer. Hence, this study investigated a battery of molecular markers that may help to reflect biologic aggressiveness and predict prognosis.Epidermal growth factor receptor (EGFR), Stat3, H-ras, c-myc, p53, cyclin D1, p16, Rb, Ki-67, and Bcl-2 were localized immunohistochemically in 135 oral squamous cell carcinoma patients to assess prognostic value.In univariate analysis of total patients, p53, Stat3, and p16 predicted both relapse-free survival (RFS) and overall survival (OS). In Cox multivariate analysis, after adjusting for tumor size, nodal status, and lymphatic permeation, p53 was independently associated with RFS and OS, and p16 with RFS only. In only early-stage patients, in univariate analysis, nuclear Stat3 was significant for RFS and OS.Immunostaining of p53, p16, and Stat3 might serve as potential adjuncts in pathologic evaluation of oral tumors to predict risk of relapse. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21121">
<title>Immunohistochemical expression of interleukin-4, -6, -8, and -12 in inflammatory cells in surrounding invasive front of oral squamous cell carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21121</link>
<description><![CDATA[Cytokines play important roles in the diverse interactions between tumor microenvironment and malignant cells. This study evaluated the association of interleukin (IL)-4, -6, -8, and -12 expressions and clinicopathologic parameters of 35 primary oral squamous cell carcinomas (OSCCs).Patients were staged according to the TNM clinical staging. Malignancy grading of invasive front was evaluated in hematoxylin-eosin (H&E)-stained slides. Immunohistochemical technique was performed on frozen tissue sections. Association between clinicopathologic parameters and IL expression were analyzed using nonparametric Kruskal-Wallis ([alpha] = 0,05) and Mann-Whitney U tests, with Bonferroni correction. Correlations between interleukins were analyzed by the Spearman coefficient.Expression of ILs was verified in all samples; however, this finding was not related to clinicopathologic parameters. It was not the observed correlation between ILs.Expression of IL-4, -6, -8, and -12 in the invasive front of OSCC is not involved with the clinicopathologic parameters of the disease. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21088">
<title>Local recurrences and second primary tumors from squamous cell carcinoma of the oral cavity: A retrospective analytic study of 500 patients</title>
<link>http://dx.doi.org/10.1002%2Fhed.21088</link>
<description><![CDATA[Background.The purpose of this study was to evaluate the incidence of local recurrences (LRs) and second primary tumors (SPTs) from squamous cell carcinoma (SCC) of the oral cavity primarily treated with surgery and to further study their relationship with several primary tumor clinical and pathological features.Methods.Five hundred of 522 patients with SCC of the oral cavity primarily treated with surgery were retrospectively analyzed for the appearance of LRs and SPTs within the oral cavity. All patients with SPTs fulfilled the Warren & Gates criteria. Several clinical features were analyzed. Histological study included TNM classification, tumor size, tumor thickness, surgical margins, perineural infiltration, peritumoral inflammation, and bone involvement. In the univariant analysis, the possible association between different clinical and pathological features and the presence of LRs or SPTs was analyzed by means of the chi-square test for categorical data and the Student's t test for parametric data. The appearance of LRs and SPTs was also studied by binary logistic regression as time-dependant phenomena, in the univariant analysis. Logistic regression was also used for the multivariant analysis between the selected variables. The Kaplan-Meier method was used to estimate the probability of SPT- or LR-free survival.Results.The mean duration of the follow-up period was 52.27 ± 49.52 months. At the end of this time, 53.82% of the patients were alive without evidence of disease, whereas 31.48% had specifically died of disease. Twenty-eight (5.6%) patients developed an SPT within the oral cavity, whereas 95 (19%) patients developed an LR during the whole follow-up period. The 5-year disease-specific survival rate for the whole series was 67.2%, in contrast to 34.9% in the group of patients with SPT and/or LR. In relation to the univariant analysis, T classification, TNM staging, pT classification, surgical margins, bone involvement, and postoperative radiotherapy (RT) were found to be predictive for LR. In relation to the multivariant analysis, only postoperative RT and bone involvement were predictive for the development of LR.Conclusion.The identification of preoperative and postoperative clinical and pathological features that prelude a higher risk for the appearance of LRs and/or SPTs may be of potential interest in determining which patients should benefit of a closer regular follow-up. When considering together the whole clinical and pathological features, only postoperative RT and bone involvement were predictive for the development of LRs. Because of the poor survival rate of the affected patients, we strongly recommend aggressive surgical treatment following the appearance of an SPT or LR. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21123">
<title>Initial clinical experience with helical tomotherapy for head and neck cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21123</link>
<description><![CDATA[Background.To report a single-institutional experience with the use of helical tomotherapy (HT)-based intensity-modulated radiotherapy (IMRT) for head and neck cancer.Methods.Seventy-seven consecutive patients were treated with HT for squamous cell carcinoma of the head and neck to a median dose of 66 Gy (range, 60 to 72 Gy). Megavoltage CT scans were obtained as part of an image-guided registration protocol for patient alignment before each treatment. Concurrent chemotherapy was administered to 48 patients (62%).Results.The 2-year estimates of overall survival, local-regional control, and disease-free survival were 82%, 77%, and 71%, respectively. Spatial evaluation of local-regional failures revealed that 16 of the 18 patients who progressed in the primary site or neck failed in the high-dose planning target volume (PTV).Conclusions.HT appears to achieve clinical outcomes comparable to contemporary series reporting on IMRT for head and neck cancer. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21119">
<title>Elevated parathyroid hormone levels after parathyroidectomy for primary hyperparathyroidism</title>
<link>http://dx.doi.org/10.1002%2Fhed.21119</link>
<description><![CDATA[Background.Curative parathyroidectomy is associated with elevated levels of parathyroid hormone (PTH) with eucalcemia. This study sought to determine the frequency, clinical significance, and risk factors of this finding.Methods.Seventy-six consecutive patients surgically treated for primary hyperparathyroidism due to a single parathyroid adenoma in 2006 to 2007 were monitored for 1 month postoperatively; those with elevated PTH levels (>70 pg/mL) were monitored for 18 months.Results.Nineteen patients (25%) had high postoperative PTH levels with normal calcium levels. Compared with the remaining patients, this group had a significantly higher average preoperative PTH level (224.89 vs 156.86 pg/mL) and a lesser intraoperative decrease in PTH.Conclusions.About 25% of eucalcemic patients may have elevated PTH levels after parathyroidectomy. A high preoperative PTH level (>225 pg/mL) may predict a persistently high postoperative level. Evaluation of blood and urine calcium, bone density, and cardiac function should be considered in affected patients. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21118">
<title>Image-guided surgery in an occult neck metastasis</title>
<link>http://dx.doi.org/10.1002%2Fhed.21118</link>
<description><![CDATA[Background.We report a case of a squamous cell carcinoma of the right tonsillar region with 5 metastatic lymph nodes and a retropharyngeal metastasis, the latter detected in the preoperative MRI scan.Methods and Results.The treatment consisted of excision of the tumor in the oral cavity and the bilateral neck dissection. Despite careful exploration, a retropharyngeal metastasis was not identifiable during this procedure. This failure encouraged us to use navigation-guided surgery in a second step. The difficulty in using navigation in soft tissue of the neck is the fixation of the neck. Therefore, a thermoplastic head mask, normally indicated in radiation therapy, was used for both the preoperative CT and navigation-guided surgery. The retropharyngeal metastasis was successfully excised with this method.Conclusion.This is the first reported attempt to use navigation-guided surgery in the soft tissue of the neck. It reveals new opportunities for navigation in the future. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21113">
<title>Predictors of outcome for advanced-stage supraglottic laryngeal cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21113</link>
<description><![CDATA[Background.The objective of this study was to report our experience in the management of patients with advanced-stage supraglottic laryngeal carcinoma and to identify factors predictive of outcome.Methods.In total, 181 patients with advanced-stage supraglottic laryngeal carcinoma were treated at Memorial Sloan-Kettering Cancer Center between 1984 and 1998. Sixty-nine (38%) patients were treated by surgery ± postoperative radiotherapy (SRT), 93 (52%) by chemoradiotherapy (CTRT), and 19 (10%) by radiotherapy alone (RT). Survival outcomes were calculated using the Kaplan-Meier method. Predictors of outcome were identified using multivariate analysis.Results.The-5 year overall survival (OS) and disease-specific survival (DSS) were 53% and 71%, respectively. Patients treated with SRT and CTRT had comparable outcomes. The main independent predictors of OS and DSS were age greater than 60 years and stage of the neck at presentation.Conclusion.Regardless of index treatment, age over 60 years and clinical stage of the neck at presentation were the main independent predictors of OS and DSS. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21105">
<title>Analysis of free flap viability based on recipient vein selection</title>
<link>http://dx.doi.org/10.1002%2Fhed.21105</link>
<description><![CDATA[Background.Venous anastomotic failure is the primary reason for microvascular free tissue transfer failure. Donor and recipient veins can be oriented in the same longitudinal axis (end-to-end anastomosis), or the donor vein can be anastomosed to the internal jugular vein in an end-to-side configuration. No consensus on the optimal anastomosis configuration exists. We sought to evaluate whether type of venous anastomosis impacts flap survival rate.Methods.Data were collected on all patients undergoing microvascular free flap reconstruction of head and neck defects at the University of Washington between August 1993 and April 2007. Flaps with a single venous anastomosis were analyzed. Flaps were stratified into those with end-to-end and end-to-side anastomoses. Survival rates were compared between groups using bivariate and multivariate techniques.Results.Inclusion criteria were met by 786 free flaps; 87% performed in an end-to-end and 13% in an end-to-side configuration. Flap re-exploration and failure rate were 4.3% and 1.1%, respectively. In multivariate analysis, there was no difference in odds of flap re-exploration (OR .70, 95% CI .23-2.18) or flap failure whether or not an end-to-end or end-to-side anastomosis was performed (OR 2.09, 95% CI .38-11.5).Conclusions.In this large cohort of patients, we found no difference in the odds of flap re-exploration or failure based on venous anastomotic configuration. Reconstructive surgeons should have both anastomotic techniques in their repertoire to optimize the success of every flap. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21086">
<title>Comparison of two prognostic scores for patients with parotid carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21086</link>
<description><![CDATA[Background.Salivary glands present a wide diversity in histopathologic types and biologic behaviors, thus complicating the search for prognostic factors.Methods.We compared 2 prognostic scores that were previously published for patients with parotid carcinoma in a retrospective series of 175 patients treated in a single institution.Results.Cox multivariate analysis indicated clinical skin invasion, facial nerve function, and perineural growth as the most significant recurrent disease-related prognostic factors. According to the Vander Poorten score, 148 patients were divided into 4 groups, with the 5-year disease-free survival of 76%, 81%, 69%, and 35%, respectively. In the Carrillo's score, the patients were divided into 3 groups: low-risk, intermediate-risk, and high-risk, with the 5-year disease-free survival of 84%, 73%, and 34%, respectively.Conclusion.Carrillo's score showed more distinct survival curves, and determination of groups with a more favorable prognosis was difficult for both scores. Therefore, both scores were not totally reproducible for our group of patients. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21111">
<title>Management of squamous cell carcinoma of the base of tongue with chemoradiation and brachytherapy</title>
<link>http://dx.doi.org/10.1002%2Fhed.21111</link>
<description><![CDATA[Treatment of base of tongue (BOT) squamous cell carcinoma (SCC) has traditionally been associated with poor prognosis and significant morbidity. We report a program consisting of concurrent chemoradiation followed by brachytherapy for these patients.We reviewed all patients in our institution with previously untreated BOT SCC (1996-2004) who received this treatment program.In 88 patients (median age, 60.2 years; 37 T1/T2; 51 T3/T4), cervical lymph node metastases were present in 71 patients (80.7%). Six patients had residual/subsequent cervical metastases requiring 7 neck dissections. Local recurrence occurred in 16 patients (18.2%) and distant metastases occurred in 9 patients (10.2%). Median follow-up time was 3.1 years (range, 0.5-7.8 years). Three-year overall survival was 80.9% (95% CI: 69.6% to 88.3%). Locoregional control rate was 79.9% and disease-specific survival was 69.5% at 3 years.Concurrent chemoradiotherapy followed with brachytherapy is a safe and effective method of treatment of SCC of the BOT. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21112">
<title>Accessory nerve function after level 2b-preserving selective neck dissection</title>
<link>http://dx.doi.org/10.1002%2Fhed.21112</link>
<description><![CDATA[The aim of this prospective study was to evaluate the relationship between accessory nerve functions and level 2b-preserving selective neck dissection.Forty-one necks of 30 patients with laryngeal cancer who underwent unilateral or bilateral level 2b-preserving neck dissections, between February 2003 and July 2005, were evaluated. Neck and shoulder movements and muscle strengths were examined and electroneuromyography (ENMG) was performed preoperatively at the postoperative 21st day and 6th month. Pathological anatomical findings at the postoperative 6th month were also evaluated.All shoulder movements and muscle strengths were preserved. Neck extension, rotation movements, and flexion strengths were restricted. ENMG values were affected moderately in the early postoperative period and improved slightly in the late postoperative period. None of the patients developed shoulder syndrome or adhesive capsulitis.Preserving level 2b during selective neck dissection decreases trauma to the accessory nerve and improves functional results. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21103">
<title>Sequence dependence of cell growth inhibition by EGFR-tyrosine kinase inhibitor ZD1839, docetaxel, and cisplatin in head and neck cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21103</link>
<description><![CDATA[This study was to explore whether the efficacy of the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor ZD1839 (Z, Iressa, gefitinib) plus chemotherapeutic agents docetaxel (D) and cisplatin (P) may benefit from sequencing of the combination.Three head and neck cancer cell lines were used to study the effect of various combinations of and relative sequencing of D, P, and Z in cell growth inhibition. A population pharmacokinetic stimulation study was conducted on Z in silico and used together with the growth inhibition data to derive principles for future in vivo use of this drug combination.The inhibitory effects of Z on combinations of D and P were sequence dependent. Treatment simultaneously with DPZ or with DP followed by Z (DP[rarr]Z) showed synergistic effects in all 3 cell lines. However, sequencing with Z followed by DP (Z[rarr]DP), gave an antagonistic effect, suggesting that D and P should be administered when the effect of Z is low. The induction of apoptosis was also sequence dependent. The in silico pharmacokinetic study suggested the feasibility of deriving a 5-day-on/2-day-off regimen for Z, in which D and P administration commences when levels of Z are low, allowing levels of Z to accumulate sufficiently during the remainder of the cycle.These data suggests that it is feasible to design clinical trials with these settings to maximize the efficacy of this combined drug regimen. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21117">
<title>No reduction in complication rate by stay in the intensive care unit for patients undergoing surgery for head and neck cancer and microvascular reconstruction</title>
<link>http://dx.doi.org/10.1002%2Fhed.21117</link>
<description><![CDATA[Background.The aim of this prospective cohort study was to determine whether an immediate postoperative period of deep sedation and artificial respiration in an intensive care unit (ICU) leads to fewer complications and a reduced failure rate of microvascular flaps compared with a situation in which patients are allowed to breathe spontaneously without sedation in a recovery room.Methods.Each group comprised 50 patients. General medical complications and flap donor and recipient site complications were documented.Results.Significantly, more patients had problems with weaning from ventilation in the ICU group (p = .022). More cases of respiratory insufficiency (p = .240) and pneumonia (p = .081) occurred in the ICU group compared with the recovery room group without statistically significant differences. The number of flaps lost was comparable in both groups (p = .646).Conclusions.Admission to an ICU did not reduce complications after microvascular reconstruction and, therefore, has only to be considered for selected cases. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21116">
<title>Shoulder morbidity after pectoralis major flap reconstruction for head and neck cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21116</link>
<description><![CDATA[Background.The effect of pectoralis major flap (PMF) harvest on shoulder function, allowing for the effects of neck dissection, has not previously been objectively measured.Methods.Twenty-two patients who underwent PMF reconstruction were studied. The control group comprised 35 patients with neck dissection (without PMF). Neck dissections in both groups were classified into 3 grades; grade 1: no neck dissection/selective neck dissection; grade 2: modified radical neck dissection; grade 3: radical neck dissection/extended radical neck dissection. Objective shoulder assessments were carried out using Constant score.Results.Constant score deteriorated with grade of neck dissection (p < .005). The median Constant score for PMF group and neck dissection only group were 82 and 90, respectively (p = .40). Subgroup analysis within neck dissection grade did not show any significant difference, but the effect of PMF was noted to be greatest in grade 2 patients (p = .064).Conclusions.There is minimal or low shoulder morbidity, additional to neck dissection, caused by PMF reconstruction in head and neck surgery. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21115">
<title>Comparative study on chronic tissue damage after cordectomies using either CO2 laser or microdissection electrodes</title>
<link>http://dx.doi.org/10.1002%2Fhed.21115</link>
<description><![CDATA[This study compared the chronic damage to laryngeal soft tissues produced by microdissection electrodes and a CO2 laser after cordectomies.We included patients who were operated on to treat T1 glottic carcinomas and needed a second laryngeal surgery. We examined specimens from 6 patients each operated on with a CO2 laser or microdissection electrodes. The specimens were processed using Masson trichrome. We studied the grade and level of collagenization and analyzed relationships with age, interval between surgical procedures, and device.Control samples showed low collagenization. Second samples showed moderate collagenization, which was similar regardless of whether microdissection electrodes or a CO2 laser was used. A relationship was observed between the level of collagenization and interval between surgeries, irrespective of the surgical procedure used.The chronic vocal fold tissue damage produced by a CO2 laser and microdissection electrodes was similar. In our series, the vocal fold scar was completed between weeks 12 and 20. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21110">
<title>Acupuncture for radiation-induced xerostomia in patients with cancer: A pilot study</title>
<link>http://dx.doi.org/10.1002%2Fhed.21110</link>
<description><![CDATA[This pilot study evaluated if acupuncture can alleviate radiation-induced xerostomia among patients with cancer. Secondary objectives were to assess the effects of acupuncture on salivary flow and quality of life (QOL).Nineteen patients received acupuncture twice a week for 4 weeks.Xerostomia inventory (XI) and patient benefit questionnaire (PBQ) scores were significantly better after acupuncture on weeks 4 and 8 than at baseline (XI: p = .0004 and .0001; PBQ: p = .0004 and .0011, respectively). For QOL at weeks 4 and 8, there was a significant difference for questions related to head/neck cancer (p = .04 and .006, respectively). At week 8, there was a significant difference in physical well-being (p = .04). At weeks 5 and 8, there were significant differences in the total score (p = .04 and .03, respectively).Acupuncture was effective for radiation-induced xerostomia in this small pilot study. Further research is needed. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21109">
<title>Mechanisms of resistance to EGFR inhibitors in head and neck cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21109</link>
<description><![CDATA[Epidermal growth factor receptor (EGFR), a receptor tyrosine kinase that activates multiple signaling pathways, including phosphatidylinositol-3-kinase/v-AKT murine thymoma viral oncogene homolog protein (Akt), has long been a target of novel therapies. Despite universal EGFR expression in head and neck squamous cell carcinoma (HNSCC), the majority of patients do not respond to EGFR inhibitors. This review focuses on mechanisms of resistance to these agents in HNSCC, and how these may be unique when compared with other malignancies such as non-small cell lung and colorectal cancers. Published studies and abstracts reveal that there are likely several mechanisms underlying resistance, suggesting that different strategies will be required to improve efficacy of EGFR inhibitors in HNSCC. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21104">
<title>Primary laryngeal lymphoma: Report of three cases and review of the literature</title>
<link>http://dx.doi.org/10.1002%2Fhed.21104</link>
<description><![CDATA[Extranodal lymphomas limited to the larynx are rare, accounting for less than 1% of all laryngeal neoplasms. The aim of this study was to report the experience of our department in the management of these aggressive lesions, as they require special diagnostic and therapeutic attention.The case records of 3 patients with the diagnosis of lymphoma involving the larynx were retrospectively reviewed.The histopathological diagnosis revealed 1 case of marginal zone lymphoma mucosa-associated lymphoid tissue type, 1 case of T-lymphoblastic lymphoma, and 1 case of a rare coexistence of in situ squamous cell carcinoma with an isolated intravascular (angioimmunoblastic) lymphoma of peripheral T-cell origin. Details of the presentation, diagnostic procedures, treatment, and outcome of these patients were presented.Primary laryngeal lymphoma is a rare entity. Early symptoms are subtle and nonspecific, and confirmation of the diagnosis is often difficult. Because of the rarity of this tumor type, the optimal management remains controversial and it seems that should be managed not as a distinct disease entity but as an unusual presentation of non-Hodgkin lymphoma, according to the recent treatment trends. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21100">
<title>Impact of reconstructive microsurgery in patients with advanced oral cavity cancers</title>
<link>http://dx.doi.org/10.1002%2Fhed.21100</link>
<description><![CDATA[Background.Our goal was to determine the impact of reconstructive microsurgery on the treatment of advanced oral cavity cancers.Methods.We reviewed 484 patients undergoing resection of T3-4 oral cavity squamous cell cancers from 1980 to 2004. To examine how reconstructive microsurgery affects outcomes, we compared 135 patients treated prior to the introduction of free tissue transfer and 349 patients treated after the introduction of free tissue transfer.Results.Cancers treated after the introduction of free flaps included a significantly higher proportion of T4 compared to T3 lesions and significantly more advanced N classification lesions. Although cancers were more advanced, survival and recurrence rates were maintained and the rate of positive pathologic margins decreased significantly. In addition, fistula and tracheostomy dependence rates decreased and rates of intelligible speech increased.Conclusion.Reconstructive microsurgery contributes to improved oncologic outcomes in addition to better function and lower morbidity in oral cavity cancer treatment. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21099">
<title>Increased APN/CD13 and acid aminopeptidase activities in head and neck squamous cell carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21099</link>
<description><![CDATA[Background.Involvement of peptidases in carcinogenic processes of several tumor types has been investigated in recent years. Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers worldwide and accounts for more than 90% of all head and neck cancers. Increased understanding of its pathophysiology has led to implication of several proteinases, specially matrix metalloproteinases, in its genesis, growth, and dissemination. However, very little is known about involvement of peptidases in this neoplasm.Methods.Seventeen HNSCC tissue samples were selected for the study. Tumor and normal tissue samples were frozen for enzymatic study. The catalytic activity for a pool of peptidases (PSA, APN/CD13, APB, APA, Asp-AP, CAP, DPPIV/CD26, NEP/CD10, and PGI) was measured fluorometrically.Results.The activity of 2 cell surface aminopeptidases (APN/CD13 and APA) and a cytosolic aminopeptidase (Asp-AP) was significantly increased in HNSCC tissues.Conclusions.These data show the involvement of cell surface and cytosolic peptidases in the mechanisms underlying HNSCC. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21098">
<title>Early oral feeding after salvage laryngectomy</title>
<link>http://dx.doi.org/10.1002%2Fhed.21098</link>
<description><![CDATA[Background.Our aim was to determine the feasibility and safety of initiating early oral feeding in patients who underwent salvage laryngectomy on postoperative day 5 and to review the rate of pharyngocutaneous fistula formation.Methods.A retrospective review of 29 patients who underwent salvage laryngectomy was completed. Patients included in the study had radiation therapy ± chemotherapy for laryngeal squamous cell carcinoma with subsequent total laryngectomy. Patients were excluded from analysis if they were reliant on a gastrostomy tube preoperatively, had a concurrent complete glossectomy, or developed a fistula before beginning oral feedings. Early oral feeding was initiated on postoperative day 5.Results.Twenty patients met complete inclusion criteria. Pharyngocutaneous fistula occurred in 10% (2/20) of the patients. Patients without postoperative complications on an average remained in the hospital for 7 days.Conclusions.The risk of fistula formation is not increased and the duration of hospital stay may be shortened in patients who were given early postoperative feeds. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21097">
<title>Significance of stromal desmoplasia and myofibroblast appearance at the invasive front in squamous cell carcinoma of the oral cavity</title>
<link>http://dx.doi.org/10.1002%2Fhed.21097</link>
<description><![CDATA[Background.Tumor invasion involves complex interactions between tumor and stromal cells. We examined the extent of connective tissue in the tumor stroma and whether myofibroblasts play a role in assisting cancer invasion and metastasis.Methods.Biopsy materials from 84 patients with oral squamous cell carcinoma (SCC) were used. We compared data from intrastromal collagen fibers using Azan staining, immunohistochemical identification of myofibroblasts by cytoskeletal markers, [alpha]-smooth muscle actin, vimentin, desmin, and clinicopathological parameters. Clinical outcome was compared by 5-year survival rate.Results.There were high levels of stromal collagen fibers in invasive tumors. Myofibroblast appearance increased with increasing tumor invasiveness. Lymph node metastasis occurred more frequently in the myofibroblast-positive group, and the survival rate was significantly poorer in this group.Conclusions.Fibrous stroma in SCC appeared to have a desmoplastic response. However, an independent invasive mechanism may regulate the stroma, with tumor desmoplasia occurring in highly developed, invasive tumors. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21095">
<title>Spontaneous regression of Merkel cell carcinoma of the nose</title>
<link>http://dx.doi.org/10.1002%2Fhed.21095</link>
<description><![CDATA[Background.Merkel Cell Carcinoma (MCC) is a rare neurendocrine tumor of cutaneous origin.Methods and Results.A 79-year-old woman was seen with a neck lump and a lesion in the left nasal vestibule. Biopsy of the lesion revealed a primary neurendocrine MCC of the skin of the nasal vestibule with metastases to the cervical lymph nodes. The patient decided against any further active treatment. Follow-up of patient for 30 months showed spontaneous regression of the lesions without any active treatment.Conclusions.Although spontaneous resolution of MCC has been described for other head neck sites, there has not been any published case of nasal MCC regression. We present this rare case of nasal MCC with neck metastases and its regression. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21094">
<title>Contribution of genetic polymorphisms of stromal cell-derived factor-1 and its receptor, CXCR4, to the susceptibility and clinicopathologic development of oral cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21094</link>
<description><![CDATA[Background.The aim of this study was to evaluate the relations of SDF-1 and its receptor, CXCR4, gene variants on oral cancer risk.Methods.PCR-RFLP was used to measure SDF-1-3[prime]A and CXCR4 gene polymorphisms in 284 controls and 113 patients with oral cancer.Results.After being adjusted for age, individuals with A/G heterozygotes of SDF-1 had a higher risk of 1.86-fold to develop oral cancer when compared with those with G/G wild type homozygotes. Furthermore, patients with oral cancer with at least 1 mutant T allele of CXCR4 gene had a risk of 2.66-fold to progress to stage III or IV.Conclusions.SDF-1-3[prime]A gene polymorphism may be considered as a factor of increased susceptibility to oral cancer, and at least 1 mutated T allele of CXCR4 gene is associated with the development of stage III or IV and the induction of lymph-node metastasis of oral cancer disease in Taiwanese. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21091">
<title>Endoscopic nasopharyngectomy with potassium-titanyl-phosphate (KTP) laser for early locally recurrent nasopharyngeal carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21091</link>
<description><![CDATA[Background.Although early recurrent nasopharyngeal carcinoma (NPC) can be treated with surgery alone, conventional nasopharyngectomy still results in serious complications. Endoscopic nasopharyngectomy has been introduced, but data on the treatment outcomes of this technique are lacking.Methods.From March 2004 to December 2007, 28 patients with rT1 or rT2a NPC underwent potassium-titanyl-phosphate (KTP) laser nasopharyngectomy by endoscopic techniques with curative intent.Results.Twenty-five patients underwent surgery alone. Only 3 patients received postoperative adjuvant therapy. The 2-year local disease-free and 2-year overall survival rates for the 12 patients with rT1 tumor and for the 16 patients with rT2a tumor were 100% and 41.7% (p = .007); and 90.9% and 38.5% (p = .03), respectively. Only 3 patients had obvious osteonecrosis at the nasopharynx, and 1 patient developed hypoglossal nerve dysfuction.Conclusions.Endoscopic KTP laser nasopharyngectomy is a simple, safe, and successful procedure for treating rT1 NPC, though its benefits are less clear for rT2a. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21085">
<title>Endoscopic horizontal partial laryngectomy by CO2 laser in the management of supraglottic squamous cell carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21085</link>
<description><![CDATA[Background.The objective of this study was to evaluate the results of endoscopic horizontal supraglottic laryngectomy (EHSL) by CO2 laser.Methods.Between 1996 and 2005, 78 patients underwent a horizontal supraglottic laryngectomy operation (HSL) with an external approach and 70 underwent laser EHSL, as treatment for supraglottic laryngeal squamous cell carcinoma (LSCC). We evaluated oncological endpoints, comparing the external and the endoscopic approach.Results.Among patients primarily treated by EHSL, the 5-year disease-specific survival (DSS) was 89% (vs 80% in the external approach group). Statistical analysis did not reveal significant differences between the 2 groups as for survival nor for organ preservation. The most significant clinical predictor for DSS is neck relapse (p < .0001).Conclusions.This study confirms the effectiveness of laser EHSL in which oncological outcome is similar to the external approach and functional results are probably better. Neck management in this setting is fundamental to warrant the best survival. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21068">
<title>Extranodal nasal-type natural killer/T-cell lymphoma masquerading as recalcitrant sinusitis</title>
<link>http://dx.doi.org/10.1002%2Fhed.21068</link>
<description><![CDATA[Background.Extranodal nasal-type natural killer (NK)/T-cell lymphoma is a very uncommon disease process often mimicking refractory sinusitis. The diagnosis may be discovered after an extensive exclusion process. Careful immunohistochemical evaluation is crucial to differentiate NK/T-cell lymphoma from other malignancies.Methods and Results.We describe a 46-year-old white man presenting with a 4-month history of refractory sinusitis and new onset visual field loss in his right eye, right facial tingling, and pain. Examination revealed right periorbital edema and scleritis, and necrotic appearing turbinates with purulence and fibrinous debris. CT/MRI delineated extensive paranasal sinus involvement. Immunohistopathology demonstrated extranodal nasal-type NK/T-cell lymphoma. Additional radiography revealed widespread involvement.Conclusion.Severe recalcitrant sinusitis with orbital involvement may be the initial presentation of NK/T-cell lymphoma. Ulcerative or necrotic lesions in the midline of the head and neck should raise concern for this disease. In addition to radiographic and laboratory testing, large biopsies should be taken for immunohistochemical analysis to achieve diagnosis and guide further management. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21093">
<title>Radial forearm-palmaris longus tenocutaneous free flap; implication in the repair of the moderate-sized postoncologic soft palate defect</title>
<link>http://dx.doi.org/10.1002%2Fhed.21093</link>
<description><![CDATA[Background.Moderate resection of the soft palate results in suboptimal outcomes in terms of postoperative velopharyngeal function. We propose the radial forearm tenocutaneous free flap incorporating the palmaris longus tendon for reconstruction of the levator sling in these cases.Methods.Twenty-six patients underwent reconstruction with this method. Group I defect involved up to one-fourth of the soft palate. Group II defect involved up to one-half of the soft palate whether or not including the uvula. Group III defect involved more than three-fourths of the soft palate. Postoperative function was assessed by means of speech intelligibility, swallowing performance, nasalance score, and nasoendoscopy.Results.Groups I and II showed normal results for speech intelligibility and swallowing function at 44 months. In group III, both parameters proved to be suboptimal.Conclusions.Moderate-sized soft palatal resection cases (group II) benefited most from this particular method of dynamic reconstruction using the radial forearm tenocutaneous free flap. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21090">
<title>Genetic polymorphisms in the tobacco smoke carcinogens detoxifying enzyme UGT1A7 and the risk of head and neck cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21090</link>
<description><![CDATA[Background.UGT1A7 is an enzyme involved in the metabolism of (pre)carcinogens present in tobacco smoke. We investigated whether genetic polymorphisms in UGT1A7, with predicted altered enzyme activity, may have a risk-modifying effect on head and neck carcinogenesis.Methods.Blood samples from 427 patients with oral, pharyngeal, and laryngeal carcinoma and 420 healthy control subjects were investigated for UGT1A7 polymorphisms. Based on these polymorphisms, patients and controls were divided according to predicted enzyme activity (low, intermediate, high).Results.Logistic regression analysis showed a significant increased distribution of predicted high activity UGT1A7 polymorphisms among the patients (OR:1.44; 95% CI: 1.07-1.93). Stratified analyses demonstrated that high activity UGT1A7 polymorphisms were even more significantly present in patients with laryngeal cancer, older patients, heavy smokers, and heavy drinkers when compared with the control subjects.Conclusions.Predicted high activity UGT1A7 polymorphisms were significantly associated with an increased risk of head and neck cancer. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21087">
<title>Clinical and molecular features of mucosa-associated lymphoid tissue (MALT) lymphomas of salivary glands</title>
<link>http://dx.doi.org/10.1002%2Fhed.21087</link>
<description><![CDATA[Background.To analyze clinical features and to discuss the modality of investigation and treatment of a series of mucosa-associated lymphoid tissue (MALT) lymphomas. To investigate the prevalence of aberrant promoter methylation, responsible for gene inactivation, in a selected panel of genes potentially involved in the pathogenesis of B-cell malignancies as O6-methylguanine-DNA methyltransferase (MGMT), p73, death-associated protein kinase (DAP-k).Methods.Nine patients with primary MALT lymphoma of the salivary glands were retrospectively reviewed. MGMT, p73, DAP-k apoptotic pathways were tested.Results.Methylation of DAP-k was common (5/8; 63%). Histological examination ensured diagnostic confirmation, whereas fine-needle aspiration cytology was not definitively diagnostic.Conclusion.Histological assessment is the gold standard in the diagnosis of salivary gland lesions. Parotidectomy represents a safe and reliable diagnostic tool leading to a definite diagnosis of MALT lymphomas in all cases and curative without other treatment in early-stage MALT lymphoma. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21067">
<title>EGFR protein overexpression and mutation in areca quid-associated oral cavity squamous cell carcinoma in Taiwan</title>
<link>http://dx.doi.org/10.1002%2Fhed.21067</link>
<description><![CDATA[Background.Epidermal growth factor receptor (EGFR)-targeted therapy has been extensively assessed in human cancer treatment. We appraised the possible role of tyrosine kinase inhibitors (TKIs) in areca quid (AQ)-associated oral cavity squamous cell carcinomas (OSCCs) by examining EGFR protein overexpression and its tyrosine kinase domain mutations.Methods.EGFR overexpression was evaluated by immunohistochemical staining, and tyrosine kinase mutations was determined by direct sequencing of DNAs from 172 OSCC tumors.Results.Overexpression of EGFR was found in 27.9% (48 of 172) of the OSCCs and was associated with lymph node metastasis (p = .013) and extracapsular spread (p = .022). Only 1 (0.58%) OSCC displayed somatic EGFR mutation but in a silent form (T725T, ACG[rarr]ACA).Conclusion.EGFR-targeted therapy might have some potential in AQ-associated OSCCs for their EGFR frequently overexpressed, although EGFR mutations were rare. However, the feasibility of TKIs in AQ-associated OSCCs needs further clinical testing. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21089">
<title>Three-dimensional visualization of skin lymphatic drainage patterns of the head and neck</title>
<link>http://dx.doi.org/10.1002%2Fhed.21089</link>
<description><![CDATA[Lymphatic drainage from skin on the head and neck is complex. We sought to provide improved visualization and analysis of the patterns of head and neck skin lymphatic drainage using aggregated lymphoscintigraphy data.Lymphoscintigraphy data from 929 patients with cutaneous melanoma on the head and neck collected at the Sydney Melanoma Unit have been mapped onto a 3-dimensional computer model of the skin and lymph nodes.Novel heat maps and interactive software have been created, which show subtle differences in lymphatic drainage patterns when compared with those that are previously reported. Posterior head and neck node fields largely drained posterior regions of the head and neck, whereas anterolateral skin regions were generally drained by the other head and neck node fields.The heat maps and interactive software tool provide novel visualization of head and neck lymphatic drainage patterns, which has both educational and clinical utility. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21084">
<title>Factors associated with quality of life in outpatients with head and neck cancer 6 months after diagnosis</title>
<link>http://dx.doi.org/10.1002%2Fhed.21084</link>
<description><![CDATA[Identifying patients with head and neck cancer at greatest risk of poor health-related quality of life (HRQOL) will facilitate screening for such patients and targeted interventions.This was a cross-sectional, self-administered survey with medical record review among 65 out-patients with head and neck cancer >6 months from diagnosis and off treatment.Most were men (80%) and white (95%), with a mean age of 60 ± 13 years. The most prevalent cancer type was squamous cell (88%), site was pharyngeal (40%), and stage was III or IV (80%). Lower total HRQOL was independently associated with gastrostomy (p < .001) and history of radiation therapy (p < .05)(R2 = 0.27). Certain HRQOL subscales were also independently associated with depression, body mass index, age, and education.Several factors can be used to identify patients with head and neck cancer at risk for persistent reductions in HRQOL requiring intervention. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21083">
<title>Modified ileocolic free flap: Viable choice for reconstruction of total laryngopharyngectomy with total glossectomy</title>
<link>http://dx.doi.org/10.1002%2Fhed.21083</link>
<description><![CDATA[Reconstruction following total laryngopharyngectomy and total glossectomy is quite challenging. Many free flaps are not options for reconstruction of this particular defect because of the large area that requires reconstruction and the size discrepancies of the oral and esophageal stomas. We propose a modified ileocolic free flap for reconstruction of these defects.We conducted a retrospective chart review.Two patients underwent a modified ileocolic free flap following total laryngopharyngectomy and total glossectomy. One of these patients was able to tolerate thin liquids by mouth, and 1 patient developed severe trismus limiting oral intake. There were no significant flap-related complications aside from fistula in 3 patients that healed with conservative management.The modified ileocolic free flap is a viable option for reconstruction following total laryngopharyngectomy and total glossectomy. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21079">
<title>Approach and safety of comprehensive central compartment dissection in patients with recurrent papillary thyroid carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21079</link>
<description><![CDATA[Despite the generally favorable prognosis of patients with papillary thyroid cancers, 10-year recurrence rates for patients with stage I to III disease is greater than 20%, with central compartment recurrences common among these recurrent sites.This study is a retrospective analysis of consecutive patients treated by a single surgeon over an 18-month period of time terminating in 2003.Sixty-three patients underwent a comprehensive dissection of levels VI and VII for papillary thyroid carcinoma during this period. There was a female predominance of 2:1, with 48% of patients being greater than 45 years of age. The median number of lymph nodes identified was 16 (range, 3-52), with 7 (1-20) lymph nodes pathologically involved. Permanent hypoparathyroidism was present on presentation in 13% of patients and developed in an additional 5% following surgery. Although recurrent laryngeal paralysis was present on presentation among 8 (13%) of patients, no patients experienced paralysis of documented functioning recurrent laryngeal nerves or necessitated tracheotomy. Postoperative thyroglobulin levels were reduced to nondetectable in 71% of the informative cases. Over 60% of patients were discharged on their first postoperative day.Bilateral paratracheal and superior mediastinal dissection is an oncologically safe procedure exhibiting minimal morbidity when performed among experienced individuals despite multiple prior surgical procedures or existing vocal cord paralysis. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21066">
<title>Hypothyroidism in older patients with head and neck cancer after treatment with radiation: A population-based study</title>
<link>http://dx.doi.org/10.1002%2Fhed.21066</link>
<description><![CDATA[In patients with head and neck cancer, radiation treatment (RT) is a risk factor for hypothyroidism. However, the specific magnitude of risk after RT in older patients is not known.We identified 5916 patients (age > 65 years) from SEER-Medicare diagnosed with head and neck cancer from 1992 to 2002. Proportional hazards models compared hypothyroidism risk after any RT versus surgery alone.In patients treated with RT, 5-year incidence of hypothyroidism was 20% and 10-year incidence was 59%; in patients treated with surgery alone, incidence was 7% and 39% (p < .001). Patients treated with RT had increased adjusted risk (hazard ratio [HR] = 2.14; 95% confidence interval [CI] = 1.74-2.62), persisting for up to 10 years of follow-up (HR = 1.85, 95% CI = 1.39-2.44 from 5 to 10 years).In older patients with head and neck cancer, RT is associated with elevated hypothyroidism risk. As onset may be delayed for years, patients may require lifelong thyroid function screening after treatment. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21050">
<title>Head and neck squamous cell carcinoma in FAMMM syndrome</title>
<link>http://dx.doi.org/10.1002%2Fhed.21050</link>
<description><![CDATA[Germline mutations at the INK4a/p16 locus are implicated in several human cancer syndromes, including familial atypical multiple mole melanoma (FAMMM) syndrome, FAMMM-pancreatic cancer (FAMMM-PC) syndrome, and in familial head and neck cancer syndrome.We present an individual with a family history of melanoma and pancreatic cancer who had multiple dysplastic nevi, squamous cell carcinoma of the tongue at age 22, multiple melanomas, a second squamous cell cancer of the tongue at age 40, and ultimately a pancreatic cancer.We demonstrate a germline mutation in INK4a and loss of heterozygosity at this locus in his HNSCC tissue.This report suggests that INK4a germline mutations associated with FAMMM/FAMMM-PC can also be associated with HNSCC. We conclude that HNSCC in young individuals should prompt clinicians to obtain a family history and consider that the patient may have a germline p16 defect that could predispose them to other cancers, including melanoma and pancreatic cancer. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21082">
<title>Role of vitamin D deficiency in continued hyperparathyroidism following parathyroidectomy</title>
<link>http://dx.doi.org/10.1002%2Fhed.21082</link>
<description><![CDATA[The aim of this study was to investigate vitamin D deficiency as an etiology for patients with elevated parathormone (PTH) levels after parathyroidectomy.Fifity-five patients were identified who had undergone parathyroidectomy between January 2003 and November 2006 with complete records that included measurements of preoperative and postoperative PTH, vitamin D, calcium, ionized calcium, and sestamibi localization results.Thirteen patients (24%) had elevated PTH at 1 week postoperatively. Sixty-two percent of these patients (N = 8, 15% overall) had vitamin D deficiency. Thirty-one percent (N = 4, 7% overall) had persistent biochemical evidence of primary hyperparathyroidism. Three of the 4 had a subsequent positive sestamibi parathyroid localization of an additional adenoma (5.5% series incidence of double adenomas).Given the known prevalence of vitamin D deficiency, consideration should be given to preoperative vitamin D testing to avoid confusion about the etiology of persistently elevated PTH following surgery. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21078">
<title>Accelerated fractionation head and neck intensity-modulated radiation therapy and concurrent chemotherapy in the community setting: Safety and efficacy considerations</title>
<link>http://dx.doi.org/10.1002%2Fhed.21078</link>
<description><![CDATA[This article reviews our community cancer center's experience treating head and neck cancer primarily with accelerated fractionation intensity-modulated radiation therapy (IMRT), with or without concurrent chemotherapy, focusing on acute toxicity and efficacy.Fifty-two patients treated with IMRT at the Penrose Cancer Center between 2002 and 2007 constitute the cohort. The majority (75%) received an accelerated, altered fractionation regimen, typically concomitant boost to 7200 cGy. Concurrent chemotherapy was delivered to 32 (62%). The median follow-up was 24 months.The 2-year actuarial rates of local control, regional control, and distant metastasis-free survival were 100%, 91%, and 94%, respectively. Relapse-free survival and overall survival at 2 years were 89% and 91%, respectively. Overall, 32 of 52 patients (62%) experienced at least 1 type of grade 3 or 4 acute toxicity.Accelerated fractionation IMRT, with or without chemotherapy, can be given safely and effectively in a community cancer center setting. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21077">
<title>Anatomical variations of the superior thyroid and superior laryngeal arteries</title>
<link>http://dx.doi.org/10.1002%2Fhed.21077</link>
<description><![CDATA[There are known to be variations in the origins of the superior thyroid artery (STA), an important surgical landmark, and 1 of its branches, the superior laryngeal artery (SLA).Three hundred thirty human embalmed heminecks were dissected. The results of previous studies were reviewed, and a meta-analysis is presented.Four different origins for the STA were found. The most frequent was type I, from the carotid bifurcation (49%). Four different origins were also found for the SLA being the most frequent the type I in which the artery arose from STA (78%). The mean external diameters of STA and SLA were 0.26 and 0.20 cm, respectively, with no statistically significant differences by side or sex.Variations in the origin of STA and SLA from the carotid arterial tree and the similarity of their diameters mean that there is a significant possibility of their misidentified during surgery. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21076">
<title>Intensity-modulated radiation therapy with simultaneous integrated boost technique following neoadjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21076</link>
<description><![CDATA[Our aim was to evaluate the feasibility and efficacy of intensity-modulated radiation therapy (IMRT) with simultaneous integrated boost (SIB) technique following neoadjuvant chemotherapy for locoregionally advanced nasopharyngeal cancer (NPC).Between April 2004 and December 2006, 25 patients with stage IIB to IVB NPC underwent 3 cycles of neoadjuvant chemotherapy followed by IMRT using SIB technique. Neoadjuvant chemotherapeutic regimens were 5-fluorouracil and cisplatin in 11 patients; docetaxel, 5-fluorouracil, and cisplatin in 8; and paclitaxel and cisplatin in 6. Dose prescription of IMRT was as follows: 67.5 Gy at 2.25 Gy/fraction to postchemotherapy gross tumor, 54 to 60 Gy at 1.8 to 2 Gy/fraction to subclinical disease, and 48 Gy at 1.6 Gy/fraction to elective neck. Seventeen patients received weekly cisplatin during the course of radiation therapy as well.With a median follow-up of 29 months for survivors (range, 14-39), the 3-year local progression-free, regional progression-free, and distant metastasis-free survival rates were 89.6%, 87.2%, and 80.4%, respectively. Treatment was well tolerated despite the grade 3 mucositis (16%) and/or pharyngitis (16%). With follow-up, the frequency of xerostomia decreased. At 3 months after IMRT, the proportions of Radiation Therapy Oncology Group grades 0, 1, and 2 xerostomia were 13%, 38%, and 50%, respectively. At 24 months, the corresponding figures were 36%, 46%, and 18%, respectively.IMRT with SIB technique for locoregionally advanced NPC was feasible and effective regarding locoregional control and development of xerostomia, even after neoadjuvant chemotherapy. Definition of gross tumor volume by postchemotherapy extent of disease was also feasible. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21075">
<title>Warthin tumor presenting as a fungal abscess in an immunocompetent host: Case report and review of the literature</title>
<link>http://dx.doi.org/10.1002%2Fhed.21075</link>
<description><![CDATA[Fungal abscesses of the parotid gland are rare, and cases arising within parotid neoplasms have not been described previously. This report conveys our experience managing such an entity, which is further distinguished by its occurrence in an immunocompetent host.A 59-year-old man experienced multiple recurrences of a parotid fungal abscess requiring repeated drainage procedures. Definitive excision ultimately demonstrated Candida glabrata infecting a Warthin tumor.This case is the first report of a parotid neoplasm presenting as a fungal abscess. It contributes to the scant literature on fungal abscesses of the parotid, which previously has only been described in debilitated hosts and without an associated neoplasm. The case also expands the spectrum of disease associated with C. glabrata. Warthin tumor may be an occult etiology for a parotid fungal abscess, and definitive diagnosis and therapy may require parotidectomy. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21074">
<title>Pseudogout of the temporomandibular joint: Immediate reconstruction with total joint arthroplasty</title>
<link>http://dx.doi.org/10.1002%2Fhed.21074</link>
<description><![CDATA[Pseudogout of the temporomandibular joint (TMJ) is a rare disorder with <40 reported cases in the English-language literature. It is usually treated with surgical resection and condylectomy alone.We report the case of a 68-year-old woman presenting with a preauricular mass resulting from calcium pyrophosphate deposition (pseudogout) in the TMJ, who underwent surgical resection with immediate reconstruction.Open surgical resection to completely remove the mass confirmed substantial erosion of the condyle and disc, necessitating condylectomy and discectomy. The joint was thereafter immediately reconstructed by total joint arthroplasty using a Christensen TMJ implant sized to the patient's anatomy. The patient was able to resume a regular diet and demonstrated marked improvement in her interincisal opening.Immediate reconstruction of the TMJ with total joint arthroplasty is a safe and effective measure following removal of this (and potentially other) TMJ lesions. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21072">
<title>Impact of treating facilities&#x27; volume on survival for early-stage laryngeal cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21072</link>
<description><![CDATA[Treatment at a high-volume facility has been associated with better outcomes in a variety of conditions. The relationship between volume and survival from laryngeal cancer has not been examined previously.A total of 11,446 early-stage laryngeal cancer patients (1996-1998) who reported to the National Cancer Database (NCDB) were analyzed. Proportional hazards regression was used to assess the relationship between survival and treatment volume controlling for other factors associated with survival.Treatment at low-volume facilities was associated with a significantly increased likelihood of death (hazard ratio 1.20, 95% CI 1.04-1.38). Surgical resection, as compared with radiation treatment, was associated with lower mortality (HR 0.74, 95% CI 0.69-0.80).This study is the first to assess the relationship between survival and treatment volume in laryngeal cancer. Treatment at a high-volume facility is associated with better survival. Surgical treatment rather than radiation was also associated with better survival, although we could not control for confounders that may bias treatment selection. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21071">
<title>Detection of survivin and p53 in human oral cancer: Correlation with clinicopathologic findings</title>
<link>http://dx.doi.org/10.1002%2Fhed.21071</link>
<description><![CDATA[Survivin, an inhibitor of apoptosis, is overexpressed in cancer. It has been implicated in both prevention of apoptosis and cell cycle regulation. We investigated the distribution of antiapoptotic protein survivin in 29 oral squamous cell carcinoma (OSCC) and 16 oral premalignant lesions. It has been suggested that wild-type p53 represses survivin expression. Therefore, we investigated the status of p53 in relation to survivin to determine the potential involvement in oral tumorigenesis.Oral cancer tissues were freshly obtained at the time of surgery and classified as per general rules of head and neck cancer (TNM classification). Immunohistochemistry and reverse transcriptase-polymerase chain reaction were conducted to study the expression of survivin and p53. The Fisher's exact test was employed to determine the association of survivin and p53 with clinicopathologic parameters of the subjects being studied.Positive staining for survivin was found in 72% OSCC and 44% oral premalignant lesions with no immunoreactions in the corresponding normal tissues. For p53, 59% OSCC, 38% premalignant lesions, and 14% normal tissues were positive. Importantly, about half of the p53-positive OSCC and premalignant tissues also showed survivin positivity (28% OSCC and 18% premalignant lesions). Further, it is observed that the number of survivin positive cells was significantly higher in the p53-positive group. Survivin is expressed in a varying proportion of cells, and in majority of patients it was localized in cytoplasm, whereas p53 is strictly restricted to the nucleus. The survivin expression levels in both primary OSCC and premalignant lesions were significantly higher than in normal oral tissues (OSCC, p < .0008; premalignant lesions, p < .04). No significant correlations between survivin and p53 expression with clinicopathologic parameters were found.Frequent overexpression of apoptosis regulators, survivin and p53, in OSCC as well as in oral premalignant lesions were found. Overexpression of these 2 markers in premalignant lesions suggest a role in early stages of oral carcinogenesis. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21070">
<title>Growth inhibition of head and neck carcinomas by D-allose</title>
<link>http://dx.doi.org/10.1002%2Fhed.21070</link>
<description><![CDATA[An inhibitory effect of D-allose, a rare sugar, on several cancer cell lines has been reported. This study aimed to investigate the growth inhibition of head and neck squamous cell carcinoma cells by D-allose.We treated 3 head and neck carcinoma cell lines with D-allose, D-fructose, D-psicose, and D-glucose. Cell growth assays as well as analyses of messenger RNA (mRNA) expression, cell cycle, apoptosis, and uptake of 14C-glucose were performed.D-allose had inhibitory effects on all 3 cell lines and tended to upregulate mRNA expression of glucose transporters, p21 and p53, and downregulate mRNA expression of cyclin A2, cyclin B1, and CDC2. We observed that D-allose tended to interfere with the intracellular uptake of D-glucose and induced apoptosis.Our results indicate that D-allose inhibits the growth of head and neck squamous cell carcinoma cells. D-allose has a considerable potential as a new anticancer agent in those patients. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21062">
<title>Efficacy and safety of treating T4 oral cavity tumors with primary chemoradiotherapy</title>
<link>http://dx.doi.org/10.1002%2Fhed.21062</link>
<description><![CDATA[Patients with T4 oral cavity (OC) tumors are often treated with surgery followed by adjuvant chemoradiotherapy (CRT).We performed a retrospective review of 4 multi-institutional phase II studies estimating long-term toxicity, locoregional control (LC), progression-free survival (PFS), and overall survival (OS) of primary CRT.Thirty-nine subjects were identified; 16 (42%) with bony involvement. Median radiotherapy dose delivered to primary tumor was 74 Gy. Five-year OS, PFS, and LC rates were 56%, 51%, and 75%, respectively. Sixty-nine percent of subjects with bony involvement never relapsed. Seven subjects developed osteoradionecrosis. Bone involvement with primary tumor did not appear to be associated with increased risk of death, relapse, or long-term complication.These data suggest that primary CRT is an effective treatment approach in patients with T4 OC tumors including those with bony involvement producing LC, survival, and complication rates comparable to historical series. Prospective clinical trials should evaluate primary surgical versus CRT treatment in these patients. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21054">
<title>Novel treatment of first bite syndrome using botulinum toxin type A</title>
<link>http://dx.doi.org/10.1002%2Fhed.21054</link>
<description><![CDATA[First bite syndrome is the development of pain in the parotid region after the first bite of each meal and can be seen after surgery of the parapharyngeal space. The purpose of this study is to evaluate the efficacy of intraglandular injection of botulinum toxin type A (BTA) in patients with first bite syndrome.Five patients with first bite syndrome developed after head and neck surgery were treated by injection of BTA into parotid gland. All patients completed a 4-item quality-of-life survey with a 10-point response scale designed to measure outcome of intraglandular injection of BTA.The first bite syndrome without or with sialogogue and degree of interference with daily activity with or without eating or drinking improved significantly at 1 and 3 month after injection (p < .05).The BTA injection into affected parotid gland produces a decrease in the severity of first bite syndrome and improves the patient's quality of life. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21053">
<title>Exercise preferences among patients with head and neck cancer: Prevalence and associations with quality of life, symptom severity, depression, and rural residence</title>
<link>http://dx.doi.org/10.1002%2Fhed.21053</link>
<description><![CDATA[Our aim was to determine exercise preferences among patients with head and neck cancer and their associations with quality of life, symptom severity, depression, and rural residence.This study involved a cross-sectional chart review and self-administered survey, with 90 outpatients with head and neck cancer (response rate = 83%).The majority were <65 years old (65%), male (78%), and white (96%) with stage [ge]III (81%). Lack of preference was the most frequent option for counseling source (66%), counseling delivery (47%), and exercise variability (52%). Popular specific preferences included outdoors (49%), morning (47%), and alone (50%). Significant adjusted associations occurred for patients' interest with lower functional well-being, alone with higher functional well-being, and morning with higher total quality of life and emotional, social, and functional well-being. No significant associations occurred with symptoms, depression, or rural residence.Patients with head and neck cancer may be open to a variety of exercise options. Quality of life may influence interest and preference for exercising alone or in the morning. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21029">
<title>Synchronous papillary carcinoma in thyroglossal duct cyst and thyroid gland: Case report and review of literature</title>
<link>http://dx.doi.org/10.1002%2Fhed.21029</link>
<description><![CDATA[We report a rare case of synchronous occurrence of thyroglossal duct cyst carcinoma and thyroid carcinoma and discuss its management in detail.A 59-year-old woman was clinically diagnosed to have a thyroglossal duct cyst and a solitary nodule. Fine-needle aspiration cytology revealed a papillary carcinoma in the thyroglossal duct cyst and a colloid in the thyroid nodule. Sistrunk's procedure along with a total thyroidectomy was performed followed by postoperative radioiodine ablation.Histopathologic examination revealed thyroglossal duct cyst carcinoma and bilateral foci of papillary carcinoma in the thyroid gland. She has remained free of disease on follow-up.Most cancers arising in thyroglossal duct cysts are of low risk, and Sistrunk's procedure is an adequate treatment for such cancers. However, for synchronously occurring cancers of the thyroglossal duct cyst and thyroid gland, or high-risk thyroglossal duct cyst cancers, more aggressive treatment comprising total thyroidectomy, Sistrunk's procedure, and radioiodine therapy is indicated. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21069">
<title>Perception of head and neck cancer quality of life within the medical world: A multicultural study</title>
<link>http://dx.doi.org/10.1002%2Fhed.21069</link>
<description><![CDATA[Physician's perception of quality of life of patients with cancer is unclear. No reports have evaluated its influence on patient management.Five hundred otolaryngologists completed a questionnaire regarding the quality of life of patients with head and neck cancer.Seventy-eight percent of responders thought that quality of life must be considered when choosing treatment, even if this meant decreased survival. Seventy-five percent thought it justified to withhold curative treatment if this would lead to impaired quality of life. Pain and breathing were the most important symptoms to consider. The perception was worse for physicians practicing in Latin culture, working in private practice, or with no personal acquaintance with a head and neck cancer victim and was better after radiotherapy than after surgery and chemotherapy.Quality of life is important for physicians and is considered as essential as survival by many physicians. The perception of patient's quality of life influences the treatment choice. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21073">
<title>Impact of nodal ratio on survival in squamous cell carcinoma of the oral cavity</title>
<link>http://dx.doi.org/10.1002%2Fhed.21073</link>
<description><![CDATA[The association between nodal ratio and survival has not been assessed in squamous cell carcinomas of the head and neck.This is a population-based analysis, using the Surveillance, Epidemiology, and End-Results database, to determine whether nodal ratio impacts survival in patients with oral cavity squamous cell carcinoma.Between 1988 and 2005, 2955 new diagnoses of N1 or N2 squamous cell carcinoma of the oral cavity were identified. The mean nodal ratio was 16.9%. Nodal ratio was found to be strongly statistically associated with overall survival in both univariate and multivariate analyses. Patients could be stratified into low- (0% to 6%), moderate- (6% to 12.5%), and high-risk (>12.5%) groups based on nodal ratio.In patients with squamous cell carcinoma of the oral cavity, an increased nodal ratio is a strong predictor of decreased survival. Risk of death can be stratified based on nodal ratio. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21052">
<title>Fluorescence in situ hybridization gene amplification analysis of EGFR and HER2 in patients with malignant salivary gland tumors treated with lapatinib</title>
<link>http://dx.doi.org/10.1002%2Fhed.21052</link>
<description><![CDATA[Background.Gene amplification status of the epidermal growth factor receptor (EGFR) and the human epidermal growth factor receptor 2 (HER2) were analyzed and correlated with clinical outcome in patients with progressive malignant salivary glands tumors (MSGT) treated with the dual EGFR/Her2 tyrosine kinase inhibitor lapatinib.Methods.Fluorescence in situ hybridization (FISH) analysis for both EGFR and HER2 gene amplification was performed successfully in the archival tumor specimens of 20 patients with adenoid cystic carcinomas (ACC) and 17 patients with non-ACC, all treated with lapatinib.Results.For ACC, no EGFR or HER2 amplifications were detected. For non-ACC, no EGFR gene amplifications were detected but 3 patients (18%) were HER2 amplified and all had stained 3+ for both EGFR and HER2 by immunohistochemistry (IHC) in their archival specimens. Two of these patients had time-to-progression (TTP) durations of 8.3 months and 18.4 months, respectively. Interestingly, patients with low and high HER2/chromosome-specific centromeric enumeration probe (CEP) 17 ratio had a prolonged TTP than those with moderate ratios for both ACC and non-AAC subtypes.Conclusions.HER2 to CEP17 FISH ratio may predict which patients with MSGT have an increased likelihood to benefit from lapatinib. The finding of HER2:CEP17 ratio as a predictive marker of efficacy to lapatinib warrants further investigation. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21032">
<title>Arteriovenous malformation of the scalp with cerebral steal</title>
<link>http://dx.doi.org/10.1002%2Fhed.21032</link>
<description><![CDATA[Arteriovenous malformation of the scalp resulting from blunt trauma to the head is an unusual occurrence and is rarely associated with neurological sequelae. This case details an arteriovenous malformation with a cerebral steal phenomenon.A 21-year-old man presented with an enlarging, pulsatile mass in the right facial/temporal area without known cause. CT and angiography were consistent with a large arteriovenous malformation involving the external carotid system, causing a secondary cerebral steal that resulted in neurological symptoms including seizure. Surgical resection of the mass was undertaken.The patient had an uncomplicated preoperative course with complete resolution of all neurologic symptoms.Cerebral steal is an uncommon consequence of traumatic extracranial arteriovenous malformation. The current literature is reviewed, and the diagnostic approach as well as therapeutic options are discussed. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21064">
<title>Rehabilitation of swallowing with polydimethylsiloxane injections in patients who underwent partial laryngectomy</title>
<link>http://dx.doi.org/10.1002%2Fhed.21064</link>
<description><![CDATA[Background.We conducted this longitudinal prospective study to illustrate a surgical technique for swallowing rehabilitation of patients after partial laryngectomy.Methods.Nine patients with persistent swallowing impairment after partial laryngectomy were included in the study. Evaluation of swallowing was performed by fiberoptic endoscopic evaluation of swallowing (FEES), and was quantified using 2 scales: a dysphagia score and a modified penetration-aspiration scale. The site of bolus inhalation was identified. Polydimethylsiloxane (PDMS) was injected into the neoglottis to fill these passages, and to obtain a certain continence of the organ.Results.Mean follow-up was 25 months (range, 5-39). All patients showed an improvement both in the dysphagia score and in the modified penetration-aspiration scale. Average improvement was 2.6 points in the dysphagia score (p = .0042) and 2.1 points in the modified penetration-aspiration scale (p = .0043).Conclusion.PDMS injection can be considered as an option in surgical rehabilitation of swallowing in patients who underwent partial laryngectomy. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21063">
<title>Arteriovenous malformation in the parotid region presenting as pulsatile tinnitus: A case report</title>
<link>http://dx.doi.org/10.1002%2Fhed.21063</link>
<description><![CDATA[Background.Pulsatile tinnitus is a unique symptom in the general population and often leads patients to medical attention.Methods and Results.We report a patient who had an arteriovenous malformation of superficial temporal artery in the parotid region causing pulsatile tinnitus and insomnia. Magnetic resonance angiography and carotid angiography were useful tools for the detection of this vascular malformation. Successful treatment of this lesion was achieved by endovascular embolization.Conclusion.This case illustrates a thorough diagnostic work-up with a high index of suspicion and a proper treatment option is rewarding when dealing with such a rare disease. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21059">
<title>Pseudogout mimicking an infratemporal fossa tumor</title>
<link>http://dx.doi.org/10.1002%2Fhed.21059</link>
<description><![CDATA[Background.The infratemporal fossa is a well-concealed, complex anatomical space. Neoplasms arising in this area are heterogenous in nature and have an insidious onset and usually present late.Methods and Results.We present a case of a 71-year-old woman who presented with worsening facial pain, trismus, and a large mass in her infratemporal fossa with minimal associated temporomandibular joint destruction. She underwent a surgical excision of the mass, which revealed a pseudogout deposit.Conclusion.The clinical and radiological features of patients with tophaceous pseudogout frequently mimic those of a benign or malignant neoplasm of the infratemporal fossa, often resulting in more radical surgery. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21057">
<title>Cetuximab in hemodialysis: A case report</title>
<link>http://dx.doi.org/10.1002%2Fhed.21057</link>
<description><![CDATA[Background.Concurrent chemoradiotherapy with cisplatin is the standard therapy for patients with unresectable locally advanced head and neck squamous cell carcinoma. However, cisplatin administration in patients on hemodialysis is complicated by the need to perform hemodialysis immediately after the infusion. Concurrent chemoradiation with cetuximab has been approved in definitive treatment of locally advanced head and neck cancer. Although cetuximab is not excreted via the kidneys, its use in patients on hemodialysis has not been reported.Methods and Results.We present the case of a 65-year-old man undergoing hemodialysis, with stage IVA squamous cell carcinoma of the hypopharynx. Given the logistics of performing hemodialysis immediately postcisplatin, he received concurrent chemoradiotherapy with cetuximab. He tolerated treatment well with minor side effects.Conclusion.Cetuximab can be safely used in patients with renal impairment. This is the first reported case of the use of cetuximab in a patient undergoing hemodialysis. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21055">
<title>Cotton-swab cryotherapy for oral leukoplakia</title>
<link>http://dx.doi.org/10.1002%2Fhed.21055</link>
<description><![CDATA[Background.Oral leukoplakia (OL) is a common oral precancerous lesion. Cotton-swab cryotherapy (CSC) is commonly used for treating skin lesions but is rarely used for treating OL lesions.Methods.Sixty OL lesions were treated by CSC once every 2 weeks until complete regression (CR) of the lesion had been achieved.Results.CR was achieved in all 60 OL lesions after an average of 6.3 treatments with cryotherapy. The number of CSC treatments required to achieve CR was significantly fewer for OL lesions on oral mucosal sites other than the tongue, those <2 cm2, those with epithelial dysplasia, and those with a surface keratin thickness of <55 [mu]m. Multivariate analyses showed that only the location and area of the OL lesions were independent factors influencing the number of CSC treatments required to achieve CR.Conclusion.For OL lesions with a mean surface area of [le]1.8 cm2, CR can be achieved with fewer than 7 CSC treatments on average. CSC is a simple, safe, easy, conservative, and acceptable treatment modality for OL lesions. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21047">
<title>A new, simple maxillary-sparing tongue depressor for external mandibular radiotherapy: A case report</title>
<link>http://dx.doi.org/10.1002%2Fhed.21047</link>
<description><![CDATA[Background.In external radiotherapy, the use of leaded intraoral devices to shield adjacent tissues is well described, but stabilization of the mandible is often realized with standard bite blocks, which do not allow a good stabilization of the mandible.Methods and Results.A 40-year-old patient presenting with a local recurrence of a tumor of the floor of the mouth underwent external radiotherapy. To shield the maxilla during mandibular irradiation and to ensure mandible and tongue immobility during external radiotherapy, a custom-made device was realized. The apparatus consists of a polymethylmethacrylate resin plate and 2 wedges. Only 2 steps are needed.Conclusion.The realization is simple and cheap, the apparatus is comfortable, and modifications are easy. It can be used in all patients, except in patients with totally mandibular edentulous with severe bone resorption. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21019">
<title>Bisphosphonate-associated osteonecrosis of the jaws: The limits of a conservative approach</title>
<link>http://dx.doi.org/10.1002%2Fhed.21019</link>
<description><![CDATA[An increasing number of cases of osteonecrosis of the jaws (ONJ) in patients treated with bisphosphonates has been reported in the literature. ONJ significantly affects the patients' quality of life and its management is still extremely difficult.A woman with ONJ secondary to therapy with zoledronic acid came to our attention for recurrent oral infections and orocutaneous fistula unresponsive to antibiotic therapy combined with minor surgical debridements. The patient underwent major surgery to remove the fistula and clean the necrotic bone and soft tissues; a lobed skin platysma flap was used to close the defect. The treatment outcome was good.When ONJ fails to respond to antibiotic therapy and surgical debridements, a more invasive surgical approach may be necessary to guarantee a better quality of life for the patient. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21015">
<title>Management of an arteriovenous fistula with two nidus between the inferior alveolar artery and the external jugular vein</title>
<link>http://dx.doi.org/10.1002%2Fhed.21015</link>
<description><![CDATA[Cervical arteriovenous fistulas are rare forms of head and neck tumors.We describe the case of a patient with an extensive fistula between the right inferior alveolar artery and the external jugular vein. The disorder had been diagnosed 30 years earlier and the patient had been followed clinically and radiologically ever since. The patient developed progressive cardiac failure and surgery was required when arteriovenous fistula expansion was found after 2 failed attempts at embolization.During resection of the arteriovenous fistula, a second nidus in contact with the mandible was discovered, which excision led to severe hemorrhage and mandibulectomy was performed to obtain hemostasis.This rare case was a true surgical challenge because the patient's life was at stake. In such difficult cases, preoperative assessment is essential because of the risk of major bleeding. Finally, CT angiogram reconstructions are undeniably helpful in elaborating the surgical treatment plan. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21012">
<title>Cavernous hemangioma of infrahyoid carotid sheath and review of the literature on carotid sheath tumors</title>
<link>http://dx.doi.org/10.1002%2Fhed.21012</link>
<description><![CDATA[Carotid sheath may include a variety of lesions such as neurogenic or vascular, tumors originating from extra-adrenal chromaphil cells, squamous cell carcinomas, and lymphomas. Hemangiomas are benign congenital neoplasms, which, when located in the head and neck region, may be easily misdiagnosed due to their infrequent localization.We report an unusual case of cavernous hemangioma of the infrahyoid carotid sheath presenting as palpable mass in a 51-year-old woman with no prior medical history. A review of the literature was performed to investigate the radiological and histopathological characteristics and highlight the treatment of carotid sheath lesions.CT, MRI, and MR angiography would help to locate hemangiomas of carotid sheath, but only surgical excision and histopathology can reveal their true nature. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.20994">
<title>Playing a brass instrument after total laryngectomy: A case report</title>
<link>http://dx.doi.org/10.1002%2Fhed.20994</link>
<description><![CDATA[A brass instrument is a musical instrument in which the tone is produced by vibration of the lips as the player blows into a tubular resonator. The case of a professional brass player who continued his activity after total laryngectomy, with insertion of a voice prosthesis in a tracheoesophageal shunt, is reported.A videoendoscopic and videofluoroscopic study of the patient during brass playing was conducted.A nonvibrating, open neoglottis during brass playing was found on videoendoscopy. Videofluorography revealed an enlarged hypopharynx, a thick neoglottis while playing at lower tone; at higher pitch the tongue base was retracted, the neoglottis was thin and stretched, and the subneoglottic area was extremely enlarged.The case reported shows that the insertion of a voice prosthesis in a tracheoesophageal shunt seems to create a regulating airflow system sufficiently advanced to play a brass instrument, further reducing the disability of laryngeal speakers. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.20992">
<title>Anterolateral thigh free flap for tracheal reconstruction after parastomal recurrence</title>
<link>http://dx.doi.org/10.1002%2Fhed.20992</link>
<description><![CDATA[Stomal recurrence after total laryngectomy is 1 of the most serious issues in head and neck surgery, both because of the complexity of its management and because of its morbidity. Prior to the introduction of free-tissue transfer, mediastinal tracheostomy has been the standard reconstructive procedure with high rate of complications. The ideal reconstructive solution to these problems must provide well-vascularized soft tissues that can cover the defect after resection and also allow suturing of the tracheal remnant to skin edges without tension.We describe a case of a 56-year-old man with stomal recurrence after total laryngectomy treated by the use of a tubed anterolateral thigh (ALT) flap to elongate the shortened trachea and simultaneously cover the cervical skin defect.The ALT can be accepted as an ideal free-flap choice for stomal recurrence, because it has maximal reconstructive capacity and produces minimal donor-site morbidity. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.20990">
<title>Extramammary myofibroblastoma in the head and neck region</title>
<link>http://dx.doi.org/10.1002%2Fhed.20990</link>
<description><![CDATA[Mammary myofibroblastoma is a benign mesenchymal tumor of the breast. Extramammary location is very rare and usually occurs along the embryonic milk-line.In this article, we present a case of a woman with an infra-auricular swelling. A diagnosis could not be made on CT scans, so the mass was surgically removed. Histological examination showed spindle cells in clusters, with CD34, desmin, and actin expression. The diagnosis of extramammary myofibroblastoma was made.We describe this case because of the unusual location of this rare tumor. Furthermore, we want to highlight the possible relationship between (extra)mammary myofibroblastoma and spindle cell lipoma (SCL). SCL has a predilection site in the posterior neck. Both tumors show the same clinical behavior, a close histological resemblance, and their cells are both immunoreactive for CD34 and CD10. The loss of RB/13q14 and FKHR/13q14 loci, which is typically found in SCL cells, was also shown in this case. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.20981">
<title>Synovial sarcoma of the Eustachian tube</title>
<link>http://dx.doi.org/10.1002%2Fhed.20981</link>
<description><![CDATA[Synovial sarcoma is a rare, aggressive high-grade neoplasm with poor prognosis. Synovial sarcoma is usually encountered in the lower extremities of young adults; only a few cases have been reported in the head and neck region.We describe a case of a 44-year-old man seen with a 3-month history of progressive nasal obstruction. Nasoendoscopy revealed a pink polypoid mass filling in the entire right posterior nasal cavity. CT and MRI studies showed that a hyperintense mass on the right nasopharynx extending to the nasal cavity anteriorly and the oropharynx inferiorly. During the operation, the mass was noted as originating from the lower portion of anterior cushion of the right Eustachian tube. We endoscopically removed the tumor and part of the anterior cushion of the right Eustachian tube. Because of the large tumor size (7.0 × 3.5 cm), we took the tumor out transorally.The histopathology and genetic analysis confirmed the diagnosis of monophasic synovial sarcoma prominent myxoid pattern. The patient then underwent adjuvant irradiation to 64.8 Gy, and he was free of recurrence and distant metastasis in the 5-year follow-up.To our knowledge, this is the first case report of synovial sarcoma of the Eustachian tube. Synovial sarcoma should be included in the differential diagnosis when managing the Eustachian tube region mass. Recommended treatment is surgery and postoperative adjuvant radiotherapy. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.20998">
<title>Presence of HPV type 6 in dysplasia and carcinoma arising from recurrent respiratory papillomatosis</title>
<link>http://dx.doi.org/10.1002%2Fhed.20998</link>
<description><![CDATA[We collected rare cases of recurrent respiratory papillomatosis (RRP) undergoing malignant transformation. We sought to identify human papillomavirus (HPV) subtypes in areas of papilloma, dysplasia, and carcinoma and investigate thve pattern of protein overexpression.Three patients whose disease underwent malignant transformation from RRP to carcinoma were subjected to this study. Morphologically distinct areas in the pathology specimen of each patient were diagnosed as papilloma, dysplasia, and carcinoma. Each lesion was separately obtained by laser capture microdissection and was PCR amplified for the presence of HPV. A DNA chip was used to determine the type of HPV in each area. Immunohistochemistry for p53, Ki-67, and pRb was performed.HPV type 6 was present in all specimens tested positive. Expression of p53 and Ki-67 increased with increasing severity of dysplastic change.Although HPV type 11 is most frequently associated with malignant change of RRP, HPV type 6 may also contribute to play an equally important role in RRP carcinogenesis. © 2008 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

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