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<title>Not Disclosed :: Texas :: Locum Medical Group</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_texas/page_2.html</link>
<description><![CDATA[A premier orthopedic surgery practice south of Tyler, Texas is looking for a permanent Hand Surgeon. The ideal physician will be Board Certified, but a physician that is Board Eligible will be considered ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_texas/page_4.html">
<title>Nationwide :: Texas :: Physician Referral Network</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_texas/page_4.html</link>
<description><![CDATA[Physician Referral Network is your best source to learn about the latest practice opportunities.  We are not a recruiting firm, so we promise you'll never be pressured to look at or take a position that ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_texas/page_1.html">
<title>East Texas :: Texas :: 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>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_arizona/page_1.html">
<title>Southwest :: Arizona :: Excel Recruiting Services</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_arizona/page_1.html</link>
<description><![CDATA[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 Surgery, complete ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_california/page_1.html">
<title>Temecula :: California :: Universal Health Services, Inc.</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_california/page_1.html</link>
<description><![CDATA[Southern California Orthopedic Hand Specialist Opportunity!  Southwest Healthcare System in Temecula, CA is assisting an Orthopedic Surgery group in their recruitment of an Orthopedic Surgeon / Hand Specialist. ]]></description>
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<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_washington/page_1.html">
<title>Spokane :: Washington :: Providence Health</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_washington/page_1.html</link>
<description><![CDATA[ Spokane, Washington -- Holy Family Hospital and a well-established private practice are partnering to bring an excellent Orthopedist to serve this community in sunny eastern Washington. Seeking a BC/BE ]]></description>
</item>

<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fwww.sciencedaily.com%2Freleases%2F2009%2F11%2F091105084848.htm&#x26;usg=AFQjCNE9Edw25X7-G-VMKwldm3x_bRksjg">
<title>Green Tea Shows Promise As Chemoprevention Agent For Oral Cancer - Science Daily (press release)</title>
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<description><![CDATA[Laboratory EquipmentGreen Tea Shows Promise As Chemoprevention Agent For Oral CancerScience Daily (press release)... MD, professor in the Department of Head and Neck Surgery; J. Jack Lee, Ph.D., professor and Diane Liu, both of the Department of Biostatistics. ...Green tea shows promise as chemoprevention agent for oral cancer, MD Anderson ...Webnewswire.comall 150 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%3A%2F%2Fwww.usnews.com%2Farticles%2Fhealth%2Fhealthday%2F2009%2F11%2F04%2Fhow-safe-are-popular-reflux-drugs.html&#x26;usg=AFQjCNHVAS-dSn0PFv9Ju34lbnPm0OlXsg">
<title>How Safe Are Popular Reflux Drugs? - U.S. News &#x26; World Report</title>
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<description><![CDATA[How Safe Are Popular Reflux Drugs?U.S. News & World Report... attention to some of the potential consequences of PPI use in a commentary published in the November issue of Otolaryngology -- Head and Neck Surgery. ...Use of PPI Drugs in Reflux Disease may Lead to Unwanted Side-EffectsMedIndiaall 16 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%3A%2F%2Fwww.eurekalert.org%2Fpub_releases%2F2009-11%2Faaoo-cwo102609.php&#x26;usg=AFQjCNFfkX8Kv93opE4_hBCzDg1jEUMeZg">
<title>Commentary warns of unexpected consequences of proton pump inhibitor use in ... - EurekAlert (press release)</title>
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<description><![CDATA[Commentary warns of unexpected consequences of proton pump inhibitor use in ...EurekAlert (press release)Otolaryngology – Head and Neck Surgery is the official scientific journal of the American Academy of Otolaryngology – Head and Neck Surgery Foundation ...GERD Drugs May Cause Unexpected Side EffectseMaxHealthProton pump inhibitor use in reflux disease may lead to unexpected consequencesIndia Business Blog (blog)all 19 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%3A%2F%2Fwww.reuters.com%2Farticle%2FpressRelease%2FidUS193939%2B04-Nov-2009%2BPRN20091104&#x26;usg=AFQjCNF8ggk9b1Qj5ButXaf1X-4knpJcKQ">
<title>Twenty Surgical Groups Say Senate Health Legislation Will Threaten Patient ... - Reuters</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fwww.reuters.com%2Farticle%2FpressRelease%2FidUS193939%2B04-Nov-2009%2BPRN20091104&#x26;usg=AFQjCNF8ggk9b1Qj5ButXaf1X-4knpJcKQ</link>
<description><![CDATA[Twenty Surgical Groups Say Senate Health Legislation Will Threaten Patient ...Reuters... American Academy of Facial Plastic and Reconstructive Surgery American Academy of Ophthalmology American Academy of Otolaryngology-Head and Neck Surgery ...and more&nbsp;&raquo;]]></description>
</item>

<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fwww.medscape.com%2Fviewarticle%2F711766&#x26;usg=AFQjCNH5DJ9P5XzOvb4hbBSGIr-YyGLwtg">
<title>Three-Day Course of Antibiotics May Be Effective After Pediatric Tonsillectomy - Medscape</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fwww.medscape.com%2Fviewarticle%2F711766&#x26;usg=AFQjCNH5DJ9P5XzOvb4hbBSGIr-YyGLwtg</link>
<description><![CDATA[Three-Day Course of Antibiotics May Be Effective After Pediatric TonsillectomyMedscape... prospective, randomized, placebo-controlled trial reported in the October issue of the Archives of Otolaryngology—Head and Neck Surgery. ...]]></description>
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<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fwww.usnews.com%2Farticles%2Fhealth%2Fhealthday%2F2009%2F10%2F27%2Fadding-chemo-helps-head-neck-cancer-patients.html&#x26;usg=AFQjCNFJos4z3PL6WhsSHd_6rb8qSCdAsQ">
<title>Adding Chemo Helps Head, Neck Cancer Patients - U.S. News &#x26; World Report</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fwww.usnews.com%2Farticles%2Fhealth%2Fhealthday%2F2009%2F10%2F27%2Fadding-chemo-helps-head-neck-cancer-patients.html&#x26;usg=AFQjCNFJos4z3PL6WhsSHd_6rb8qSCdAsQ</link>
<description><![CDATA[Private MDAdding Chemo Helps Head, Neck Cancer PatientsU.S. News & World ReportBritish researchers looked at the 10-year outcomes of 966 patients with locally advanced head and neck cancer. Those who hadn&#39;t undergone surgery for their ...Study Says Combined Therapy Helps Head, Neck CancerABC NewsChemo treatments lengthen lives for head, neck cancer patientsPrivate MDAdding Chemotherapy to Radiotherapy Increases Survival for Patients With ...DG Newsall 27 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%3A%2F%2Fwww.naturalnews.com%2F027346_cancer_curcumin_cancers.html&#x26;usg=AFQjCNEJmhpZnN226OAREWRzah62MmtxnQ">
<title>Curcumin inhibits cancers of the head and neck - Natural News.com (registration)</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fwww.naturalnews.com%2F027346_cancer_curcumin_cancers.html&#x26;usg=AFQjCNEJmhpZnN226OAREWRzah62MmtxnQ</link>
<description><![CDATA[BBC NewsCurcumin inhibits cancers of the head and neckNatural News.com (registration)Now research just released at the 2009 American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) annual meeting in San Diego shows ...Turmeric can help fight cancerIndia Business Blog (blog)all 164 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%3A%2F%2Fjama.ama-assn.org%2Fcgi%2Fcontent%2Ffull%2F302%2F14%2F1596&#x26;usg=AFQjCNHyNpc9OxDEZ7NryFPEBdFU6ViiYw">
<title>Operative Otolaryngology&#x2013;Head and Neck Surgery - Journal of American Medical Association (subscription)</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fjama.ama-assn.org%2Fcgi%2Fcontent%2Ffull%2F302%2F14%2F1596&#x26;usg=AFQjCNHyNpc9OxDEZ7NryFPEBdFU6ViiYw</link>
<description><![CDATA[Operative Otolaryngology–Head and Neck SurgeryJournal of American Medical Association (subscription)The specialty of otolaryngology–head and neck surgery encompasses a large breadth of diseases and surgical procedures, including the areas of head and neck ...]]></description>
</item>

<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fwww.sciencedaily.com%2Freleases%2F2009%2F10%2F091019172335.htm&#x26;usg=AFQjCNGU4pK-FqRtMWE9Jhe5-mTvMJck1g">
<title>Three-day Course Of Antibiotics May Be Sufficient Following Tonsillectomy - Science Daily (press release)</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fwww.sciencedaily.com%2Freleases%2F2009%2F10%2F091019172335.htm&#x26;usg=AFQjCNGU4pK-FqRtMWE9Jhe5-mTvMJck1g</link>
<description><![CDATA[Three-day Course Of Antibiotics May Be Sufficient Following TonsillectomyScience Daily (press release)... and activity level, according to a report in the October issue of Archives of Otolaryngology-Head &amp; Neck Surgery, one of the JAMA/Archives journals. ...After tonsillectomy, 3 days and 7 days of antibiotics are equally effectivenews StoriesVIDEO: Residents Unfamiliar With Skin Cancer Exams, Short Antibiotic Course ...InsidermedicineShorter Antibiotic Course Effective After TonsillectomyMedPage TodayIvanhoeall 14 news articles&nbsp;&raquo;]]></description>
</item>

<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fwww.medpagetoday.com%2FEndocrinology%2FThyroid%2F16476&#x26;usg=AFQjCNHHdyh_-i4LUwZslyyccyW_1uG7mg">
<title>Thyroidectomy Safe in the Elderly - MedPage Today</title>
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<description><![CDATA[Thyroidectomy Safe in the ElderlyMedPage TodayWriting in the October issue of Archives of Otolaryngology–Head and Neck Surgery, the researchers noted that the older cohort did have higher rates of ...Thyroid Surgery Safe For Older Patients, Study FindsScience Daily (press release)Thyroid Surgery Safe in People over 65About - News & Issues (blog)all 33 news articles&nbsp;&raquo;]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21261">
<title>Altered fractionation and adjuvant chemotherapy for head and neck squamous cell carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21261</link>
<description><![CDATA[The aim of this review was to discuss the role of altered fractionation and adjuvant chemotherapy for patients treated with definitive radiotherapy (RT) for head and neck squamous cell carcinoma (HNSCC).This review explores the pertinent literature and discusses the optimal management of previously untreated patients with stage III-stage IVA and/or -B HNSCCs.Depending on the schedule, altered fractionation improves locoregional control and survival. Both hyperfractionation and concomitant boost RT improve locoregional control and are associated with improved overall survival (OS). Adjuvant chemotherapy improves OS; the greatest impact is observed after concomitant versus induction or maintenance chemotherapy. Monochemotherapy appears to be equivalent to polychemotherapy. Drugs associated with the greatest survival benefit include fluorouracil and cisplatin. Intraarterial chemotherapy offers no advantage over intravenous chemotherapy. Concomitant cetuximab and RT results in improved outcomes similar to those observed after concomitant cisplatin-based chemotherapy and RT.Altered fractionation and/or concomitant chemotherapy result in improved outcomes compared with conventionally fractionated definitive RT alone for stage III-stage IV HNSCC. The optimal combination of RT fractionation and chemotherapy remains unclear. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21307">
<title>Meeting Report - The NIDCR 2nd Salivary Gland Tumor Meeting, November 2008</title>
<link>http://dx.doi.org/10.1002%2Fhed.21307</link>
<description><![CDATA[No abstract.]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21256">
<title>Immunostaining patterns of CD31 and podoplanin in previously untreated advanced oral/oropharyngeal cancer: Prognostic implications</title>
<link>http://dx.doi.org/10.1002%2Fhed.21256</link>
<description><![CDATA[The objective of this study was to assess angiogenesis and lymphangiogenesis patterns in advanced oral/oropharyngeal cancer by immunohistochemical techniques.Forty-five patients with advanced oral/oropharyngeal cancer, treated by primary surgery between January 1996 and December 2005, were selected. All cases were followed for at least 24 months. Angiogenesis and lymphangiogenesis were evaluated with antibodies against CD31 and podoplanin, respectively. Survival outcomes were calculated by the Kaplan-Meier method, whereas univariate comparisons were obtained by log-rank, chi-square, and Mann-Whitney tests.Survival correlated with the area of peritumoral blood vessels (p = .02), whereas the number of intratumoral lymphatics (p = .02) correlated with the occurrence of nodal metastasis. The risk for distant metastasis correlated with the perimeter of intratumoral lymphatics (p = .02).Peritumoral angiogenesis presented different expression patterns between survivors and patients who died of disease. Intratumoral lymphangiogenesis was correlated with a higher risk of developing lymph node (LN) and distant metastasis. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21255">
<title>Complementary and alternative medicine use in patients presenting to a head and neck oncology clinic</title>
<link>http://dx.doi.org/10.1002%2Fhed.21255</link>
<description><![CDATA[The aim of this study was to determine the prevalence of complementary and alternative medicine (CAM) use among patients presenting to a head and neck oncology clinic prior to a diagnosis.The study was conducted by administering questionnaires to 102 patients after being seen in the Head and Neck Oncology clinic for their initial consultation. The questionnaire assessed the extent of CAM use, types of CAMs used, and their reasons for use.A total of 132 CAMs were currently being used among 56 patients. The most common CAMs in use were multivitamins (26/132) and vitamin D (21/132). Meditation and yoga were associated with the greatest perceived benefit. The majority of patients obtained their information from family and friends. Most patients were using CAMs for physical health and well-being.As CAM use among the population is widespread, it is important for clinicians to specifically address their use on initial presentation. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21252">
<title>Detection of metachronous esophageal squamous carcinoma in patients with head and neck cancer with use of transnasal esophagoscopy</title>
<link>http://dx.doi.org/10.1002%2Fhed.21252</link>
<description><![CDATA[The use of transnasal esophagoscopy was examined for detecting metachronous esophageal squamous carcinoma in patients with head and neck squamous cell carcinoma (HNSCC).In all, 398 transnasal esophagoscopies were performed in 293 previously treated patients with HNSCC between December 2007 and January 2009.Metachronous esophageal squamous carcinoma was detected in 15 (5.1%) patients. The prevalence rate was 15.9% (7/44) in patients with hypopharyngeal cancer, significantly higher than the 8.3% (2/24) with laryngeal, 7.1% (3/42) with oropharyngeal, and 1.6% (3/183) with oral cancer (p = .001). The stage distributions of esophageal squamous carcinoma were I-II in 12 (80%) and III-IV in 3 (20%) patients. Subsequently, curative strategies were performed in 13 (87%) patients.Transnasal esophagoscopy can be used as a routine survey technique in patients with HNSCC to detect metachronous esophageal squamous carcinoma, especially in those with hypopharyngeal cancer. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21279">
<title>Accelerated fractionation radiotherapy and late intensification with 2 intra-arterial cisplatin infusions for locally advanced head and neck squamous cell carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21279</link>
<description><![CDATA[This study was established to determine the maximum tolerated dose of intra-arterial cisplatin (IAC) concurrent with accelerated fractionation radiotherapy for locally advanced head and neck squamous cell carcinoma (HNSCC).We conducted a phase I study. Treatment consisted of 70 Gy/35 fractions/5.8 weeks and 2 weekly IAC infusions during the last 2 weeks.Ten patients were recruited. Two patients had stage III, 1 had stage IVa, and 7 had stage IVb disease. Three patients received IAC at 100 mg/m2, 3 at 125 mg/m2, and 4 at 150 mg/m2. Nine patients received both planned infusions. Dose-limiting toxicity occurred at 150 mg/m2 as transient grade 4 leukopenia and prolonged grade 3 acute skin reactions. The maximum tolerated dose was 125 mg/m2. Six patients survived disease-free at 39 to 67 months.It was feasible to give IAC concurrent with accelerated fractionation radiotherapy for locally advanced HNSCC. The maximum tolerated dose of cisplatin was 125 mg/m2. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21257">
<title>Anaplastic thyroid cancer: Clinical outcomes with conformal radiotherapy</title>
<link>http://dx.doi.org/10.1002%2Fhed.21257</link>
<description><![CDATA[Background.The aim of this study was to review institutional outcomes for anaplastic thyroid cancer treated with conformal 3-dimensional radiotherapy (3DRT) or intensity-modulated radiotherapy (IMRT).Methods.In all, 53 consecutive patients were analyzed. Thirty-one (58%) patients were irradiated with curative intent. Median radiation dose was 55 Gray (Gy; range, 4-70 Gy). Thirteen (25%) patients received IMRT to a median 60 Gy (range, 39.9-69.0 Gy). Thirty-nine (74%) patients received chemotherapy with radiation.Results.The Kaplan-Meier estimate of overall survival (OS) at 1 year for definitively irradiated patients was 29%. Patients without distant metastases receiving [ge]50 Gy had superior survival outcomes; 5 such patients had no evidence of disease at last follow-up. Use of IMRT versus 3DRT did not influence toxicity.Conclusions.Outcomes for anaplastic thyroid cancer treated with 3DRT or IMRT remain equivalent to historical results. Healthy patients with localized disease who tolerate full dose irradiation can potentially enjoy prolonged survival. Biologically targeted radiosensitization merits prioritized investigation. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21239">
<title>Nuclear factor-[kappa]B expression as a novel marker of radioresistance in early-stage laryngeal cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21239</link>
<description><![CDATA[Background.The aim of this study was to evaluate the significance of nuclear factor-kappa B (NF-[kappa]B) expression as a marker of radioresistance in early-stage laryngeal cancer.Methods.Thirty-five patients with local recurrence and 70 case-matched patients without local recurrence were entered in this study. NF-[kappa]B expression was compared with Bcl-2 and epidermal growth factor (EGF) receptor expression by immunohistochemistry, using pretreatment biopsy specimens. The prognostic value of NF-[kappa]B was also evaluated. Twenty-nine recurrent tumors were compared with pretreatment tumors.Results.NF-[kappa]B expression in pretreatment tumors significantly correlated with local tumor control (p = .01), but bcl-2 and EGF receptor expression did not. Only NF-[kappa]B expression showed prognostic significance for local tumor control in both univariate and multivariate analyses (p = .008 and .04, respectively). NF-[kappa]B expression was markedly enhanced in 23 of 29 (80%) recurrent tumors.Conclusion.NF-[kappa]B expression may be a novel marker of radioresistance in early-stage laryngeal cancer. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21260">
<title>Kimura&#x27;s disease in a white man</title>
<link>http://dx.doi.org/10.1002%2Fhed.21260</link>
<description><![CDATA[Kimura's disease is a rare inflammatory disease that mainly affects Asians and most often occurs in the deep lymph nodes of the head and neck. We report on a rare case of Kimura's disease in the hard palate of a white man.A 56-year-old white man was seen with a rapidly growing mass in the upper jaw. A complete tumor resection with hemimaxillectomy was performed. The tumor, which showed signs of inflammation, was located within the bone and the soft tissue.Kimura's disease was diagnosed by histopathologic examination of the resected tumor.This case demonstrates that Kimura's disease, though rare, is not limited to the Asian population. We present a case of a tumor in a white man. This adds another possibility for uncertain differential diagnoses of rapidly growing tumor masses. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21276">
<title>Comparison of biofilm formation on new Phonax and Provox 2 voice prostheses - A pilot study</title>
<link>http://dx.doi.org/10.1002%2Fhed.21276</link>
<description><![CDATA[In voice rehabilitation for laryngectomized patients, voice prosthetic biofilm formation is still an unsolved problem. Design and materials of voice prostheses have been altered by manufacturers to improve function and extend the lifetime of devices. The goal of the study was to investigate biofilm formation on Provox 2 and Phonax, recently introduced voice prostheses made of thermoplastic polyurethane.Five laryngectomized patients were equipped with both Phonax and Provox 2 voice prostheses. Microbial colonization was analyzed using standard microbiological methods. Biofilm formation and material infiltration were illustrated using scanning electron microscopy, fluorescence microscopy, and thin-section light microscopy.Although no differences in quality or quantity of microbial colonization were assessed, microscopic imaging revealed differences in material surfaces, biofilm composition, and infiltration morphologies; the polyurethane material seems to destabilize biofilm architecture by inhibition of hypheal Candida growth forms.Polyurethane material for voice prostheses seems to reduce biofilm stability and infiltrative processes. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21280">
<title>New insights in the vascular supply of the human parotid gland - Consequences for parotid gland-sparing irradiation</title>
<link>http://dx.doi.org/10.1002%2Fhed.21280</link>
<description><![CDATA[Xerostomia is caused by irradiation for head and neck cancer, depending on the dose to the parotid gland. To investigate which part of the parotid gland has to be spared with radiotherapy, detailed information about the vascular supply of the parotid gland is necessary.Arterial vessels of the head of a human cadaver were colored. A 3-dimensional reconstruction of the parotid gland and the arterial vessels was made and analyzed.Five arterial vessels were responsible for the vascular supply of the parotid gland: the posterior auricular artery, 2 branches so far unnamed, the superficial temporal artery, and the transverse facial artery. All arteries were branches off the external carotid artery, and supplied different parts of the parotid gland.This study describes the detailed vascular supply of the human parotid gland. These results may contribute to improve parotid sparing radiotherapy, thus reducing complications such as xerostomia in the future. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21259">
<title>Carcinoma arising from pharyngeal diverticula</title>
<link>http://dx.doi.org/10.1002%2Fhed.21259</link>
<description><![CDATA[Pharyngeal diverticulum or Zenker's diverticulum carcinoma is a rare malignancy with a poor prognosis. Carcinoma arising in a recurrent pharyngeal diverticulum is even rarer, with only 1 such case reported in the English-language literature. We report 2 patients with pharyngeal diverticulum carcinoma exhibiting an unusual presentation and good long-term, disease-free survival with normal speech and swallowing.A 70-year-old man with a carcinoma in a recurrent pharyngeal diverticulum excised 20 years previously and a 65-year-old man with a neck mass as the only presentation of pharyngeal diverticulum carcinoma.Our patients were treated with open resection, laryngeal preservation, and postoperative radiotherapy (PORT), resulting in long-term tumor control and disease-free survival of 5 and 15 years (longest reported), respectively.One-stage diverticulectomy with or without radiotherapy is the treatment of choice and can provide long-term control and survival. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21258">
<title>Three-dimensional photogrammetry for surgical planning of tissue expansion in hemifacial microsomia</title>
<link>http://dx.doi.org/10.1002%2Fhed.21258</link>
<description><![CDATA[We aim to illustrate the applications of 3-dimensional (3-D) photogrammetry for surgical planning and longitudinal assessment of the volumetric changes in hemifacial microsomia.A 3-D photogrammetric system was employed for planning soft tissue expansion and transplantation of a vascularized scapular flap for a patient with hemifacial microsomia. The facial deficiency was calculated by superimposing a mirror of the normal side on the preoperative image. Postsurgical volumetric changes were monitored by serial superimposition of 3-D images.A total of 31 cm3 of tissue expansion was achieved within a period of 4 weeks. A scapular free flap measuring 8 cm × 5 cm was transplanted to augment the facial deficiency. Postsurgical shrinkage of the flap was observed mainly in the first 3 months and it was minimal thereafter.3-D photogrammetry can be used as a noninvasive objective tool for assessing facial deformity, planning, and postoperative follow-up of surgical correction of facial asymmetry. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21249">
<title>Role of intratumoral lymphatic vessels in the lymph node dissemination of laryngopharyngeal squamous cell carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21249</link>
<description><![CDATA[The development of new markers for lymphatic endothelium allowed the study of intratumoral lymphatic microcirculation, as well as its association with lymph node metastasis.In all, 120 patients with laryngopharyngeal squamous cell carcinoma (LPSCC) without previous treatment were retrospectively studied. The immunohistochemical determination of PA2.26 antigen/podoplanin was used to assess intratumoral lymphatic vessels (ILVs) in the primary tumor.Multivariate analysis revealed that lymph node metastasis was associated with tumor location (p = .001), differentiation grade (p = .02), and ILV (p = .013). Hypopharyngeal and supraglottic locations, poor grade of differentiation, and ILV, respectively, increased the risk of developing lymph node metastasis 13.5-, 4.7-, 5.2-, and 3.2-fold.In our series, the presence of ILV in the primary tumor was an independent risk factor for the development of lymph node metastasis. The incorporation of ILV assessment into routine clinicopathological study might improve the evaluation of patients with LPSCC. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21251">
<title>Clinical grading of oral mucosa by curve-fitting of corrected autofluorescence using diffuse reflectance spectra</title>
<link>http://dx.doi.org/10.1002%2Fhed.21251</link>
<description><![CDATA[Laser-induced autofluorescence (LIAF) and diffuse reflectance (DR) were collectively used in this clinical study to improve early oral cancer diagnosis and tissue grading.LIAF and DR emission from oral mucosa were recorded on a fiber-optic spectrometer by illumination with a 404-nm diode laser and tungsten halogen lamp in 36 healthy volunteers and 40 lesions of 20 patients.Absorption dips in LIAF spectra at 545 and 575 nm resulting from changes in oxygenated hemoglobin were corrected using DR spectra of the same site. These corrected spectra were curve-fitted using Gaussian spectral functions to determine constituent emission peaks and their relative contribution. The Gaussian peak intensity and area ratios F500/F635 and F500/F685 were found to be useful indicators of tissue transformation. The diagnostic capability of various ratios in differentiating healthy, hyperplastic, dysplastic, and squamous cell carcinomas (SCCs) were examined using discrimination scatterplots.The LIAF/DR technique, in conjunction with curve-fitting, differentiates different grades of dysplasia and SCC in this clinical trial and proves its potential for early detection of oral cavity cancer and tissue grading. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21244">
<title>Extracapsular spread in oral squamous cell carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21244</link>
<description><![CDATA[Extracapsular spread (ECS) in the cervical lymph nodes represents the most significant adverse prognostic indicator in oral squamous cell carcinoma (OSCC).In a consecutive cohort of OSCC treated by primary surgery, ECS was seen in 25% (101) of 400 patients.ECS doubled the incidence of local recurrence and distant metastases, but tripled regional failure. The recurrences occurred sooner in ECS than in non-ECS cases (206 vs 334 days, p = .04). Patients with macroscopic ECS had a 5-year overall survival (OS) of 19% compared with 31% in microscopic ECS. MRI neck staging offered poor sensitivity, especially in microscopic ECS. Age >75 years, smoking, and heavy use of alcohol were independent predictors of ECS, which may implicate a failure of immunosurveillance by the host as much as adverse biology of the tumor.Reporting of ECS is essential in accurate prognostication, and we advocate that all patients with OSCC and ECS should be grouped as pN3 on the basis of their prognosis. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21245">
<title>Impact of comorbidity on short-term mortality and overall survival of head and neck cancer patients</title>
<link>http://dx.doi.org/10.1002%2Fhed.21245</link>
<description><![CDATA[In 2001, we presented a Cox regression model that is able to predict survival of the newly diagnosed patient with head and neck squamous cell carcinoma (HNSCC). This model is based on the TNM classification and other important clinical variables such as age at diagnosis, sex, primary tumor site, and prior malignancies. We aim to improve this model by including comorbidity as an extra prognostic variable. Accurate prediction of the prognosis of the newly diagnosed patient with head and neck cancer can assist the physician in patient counseling, clinical decision-making, and quality maintenance.All patients with HNSCC of the oral cavity, pharynx, and larynx diagnosed in the Leiden University Medical Centre between 1981 and 1998 were included. From these 1371 patients, data on primary tumor site, age at diagnosis, sex, TNM classification, and prior malignancies were already available. Comorbidity data were collected retrospectively according to the ACE27 manual. The prognostic value of each variable on overall survival was studied univariately by Kaplan-Meier curves and the log-rank test. The Cox regression model was used to investigate the impact of these variables on overall survival simultaneously. Furthermore, univariate analyses were performed to investigate the impact of comorbidity severity on short-term mortality and to investigate the impact of organ-specific-comorbidity on short-term mortality.Comorbidity was present in 36.4% of our patients. Mild decompensation was seen in 17.4%, moderate decompensation in 13.5%, and severe decompensation in 5.5%. Most frequently observed ailments were cardiovascular, respiratory, and gastrointestinal. In univariate analyses, all prognostic variables, including comorbidity, contributed significantly to overall survival. Their contribution (except sex) remained significant in the multivariate Cox model. Internal validation of this model showed a concordance index of 0.73, indicating a good predictive value. Short-term mortality was seen in 5.7% of our patients. Cardiovascular comorbidity, respiratory comorbidity, gastrointestinal comorbidity, and diabetes showed a significant relationship with short-term mortality.Comorbidity impacts overall survival of the newly diagnosed patient with HNSCC. There is a clear distinction between the impact of the 4 ACE27 severity grades. The impact of an ACE27 grade 3 is comparable to the impact of a T4 tumor or an N2 neck. Comorbidity impacts short-term mortality as well. Especially cardiovascular comorbidity, respiratory comorbidity, gastrointestinal comorbidity, and diabetes show a strong relationship. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21270">
<title>Upregulation of interleukin-1 by Epstein-Barr virus latent membrane protein 1 and its possible role in nasopharyngeal carcinoma cell growth</title>
<link>http://dx.doi.org/10.1002%2Fhed.21270</link>
<description><![CDATA[Nasopharyngeal carcinoma (NPC) is associated with Epstein-Barr virus (EBV) infection. We previously found that interleukin (IL)-1[alpha] and IL-1[beta] significantly increased in NPC tissues. This study investigated what EBV-encoded proteins were involved in such IL-1 production.IL-1[alpha] and IL-1[beta] messenger ribonucleic acids (mRNAs) were detected in the EBV latent membrane protein 1 (LMP1) transfectant (LMP135) only by reverse transcriptase-polymerase chain reaction (RT-PCR). LMP1-mediated IL-1[alpha] and IL-1[beta] production could be enhanced by tumor necrosis factor alpha (TNF-[alpha]), determined by enzyme-linked immunosorbent assay (ELISA). Moreover, IL-1[alpha] and IL-1[beta] mRNAs and proteins were increased in a dose-dependent manner in epithelial cells transiently transfected by an LMP1 plasmid. Besides, immortalized human epidermal keratinocyte (RHEK-1) epithelial cells could be enhanced to proliferate by IL-1[alpha] and IL-1[beta] determined by water-soluble tetrazolium salt (WST-1) assay.EBV LMP1 is capable of upregulating IL-1[alpha] and IL-1[beta] secretions from epithelial cells and positively modulated by TNF-[alpha]. This may consequently contribute to tumor growth in patients with NPC. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21268">
<title>Revision Surgery in Otolaryngology</title>
<link>http://dx.doi.org/10.1002%2Fhed.21268</link>
<description><![CDATA[No abstract.]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21267">
<title>The Larynx, 3rd Edition, Volumes 1 and 2</title>
<link>http://dx.doi.org/10.1002%2Fhed.21267</link>
<description><![CDATA[No abstract.]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21265">
<title>Extraesophageal Reflux</title>
<link>http://dx.doi.org/10.1002%2Fhed.21265</link>
<description><![CDATA[No abstract.]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21254">
<title>Practical Head and Neck Oncology</title>
<link>http://dx.doi.org/10.1002%2Fhed.21254</link>
<description><![CDATA[No abstract.]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21253">
<title>Atlas of Skull Base Surgery and Neurotology, 2nd Edition</title>
<link>http://dx.doi.org/10.1002%2Fhed.21253</link>
<description><![CDATA[No abstract.]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21246">
<title>Morbidity and mortality of thyroidectomy for substernal goiter</title>
<link>http://dx.doi.org/10.1002%2Fhed.21246</link>
<description><![CDATA[Our objective was to evaluate morbidity and mortality of thyroidectomy in substernal goiters and identify patients at risk for these events.The medical records of 127 patients with substernal goiters were retrospectively reviewed.The most common preoperative symptom was shortness of breath (48%). 13% of the 127 patients were asymptomatic. Preoperative imaging identified tracheal deviation in 69% and tracheal compression in 41% of the cases. Substernal goiters were resected via a cervical approach in 100% of the cases. Six patients (5%) had postoperative hoarseness, 1 had permanent vocal cord paralysis, and 19 (15%) had transient postoperative hypocalcemia. The mortality and permanent hypoparathyroidism were null. Patients with postoperative complications had larger goiters and were more likely to have tracheal compression.Thyroid resection via a cervical approach for substernal goiters is associated with low rate of morbidity and no mortality. Patients with large tumors and tracheal compression are more likely to develop postoperative complications. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21243">
<title>Targeted radionuclide therapy in head and neck cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21243</link>
<description><![CDATA[There is great potential for targeted radionuclide therapy (TRT) in the treatment of head and neck cancer. In recent years, developments in fields such as antigen screening, protein engineering, and cancer biology have facilitated the rational design of targeted pharmaceuticals, with monoclonal antibodies forming the most rapidly expanding category. TRT may be a promising way to improve targeted treatment, especially in head and neck cancer, because of the intrinsic radiosensitivity of this tumor type. TRT may also provide a good foundation on which to build rational biologic combination therapies. In the next few years the use of TRT may offer new opportunities for further improvement of the therapeutic ratio that potentially may obviate or reduce the need for conventional cytotoxics. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21230">
<title>Inhibition of invasion and migration of salivary gland adenocarcinoma cells by 5[prime]-nitro-indirubinoxime (5[prime]-NIO)</title>
<link>http://dx.doi.org/10.1002%2Fhed.21230</link>
<description><![CDATA[5[prime]-Nitro-indirubinoxime (5[prime]-NIO) is a derivative of the bis-indole indirubin that exhibits anticancer activities. The present study investigated the anti-invasive action of 5[prime]-NIO in salivary gland ductal adenocarcinoma, SGT cells.The wound-scratch, migration, and invasion assays were applied to determine the effect of 5[prime]-NIO on the migration capacity and invasiveness of SGT cells. Reverse-transcriptase-polymerase chain reaction (RT-PCR) and Western blot were performed to evaluate the impacts of 5[prime]-NIO on the expression of [beta]1 integrin and matrix metalloproteinases MMP-2 (gelatinase-A) and MMP-9 (gelatinase-B).The viability of SGT cells was decreased by 5[prime]-NIO in a dose-dependent manner, but not significant at the concentrations of 0.5 and 1 [mu]M. Under the concentrations showing little cytotoxic effect, 5[prime]-NIO exhibited a dose-dependent inhibitory effect on the invasion and migration of SGT cells. Furthermore, 5[prime]-NIO suppressed the mRNA and protein expression of [beta]1 integrin and MMP-2 and MMP-9.Taken together, these results suggest that 5[prime]-NIO, even at low concentrations, may effectively inhibit the invasion and migration of SGT cells by suppressing [beta]1 integrin-mediated signaling. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21248">
<title>Endoglin as a marker in cervical paragangliomas</title>
<link>http://dx.doi.org/10.1002%2Fhed.21248</link>
<description><![CDATA[Endoglin is expressed on endothelium and is implicated in the control of angiogenesis. This study compares the expression of endoglin with vascular endothelial growth factor (VEGF), commonly used as a marker for neoangiogenesis in cervical paragangliomas (CPG).The CPG were surgically obtained from 5 patients and compared with nontumoral lung obtained from patients subjected to pulmonary resection. Detection with specific antibodies was used to determine the expression of the proteins VEGF and endoglin. The expressions of hypoxia-inducible factor (HIF) and vascular cell adhesion molecule-1 (VCAM-1) were used to determine the degree of hypoxia and capillarization, respectively.Endoglin is located at the plasma membrane of endothelial cells. The relative expression of endoglin is significantly higher in CPG respect to lung (p < .02), whereas that of VEGF is similar.Endoglin expression in CPG is significantly superior to that of VEGF and correlates with tumor vascularization. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21242">
<title>Biochemical and clinical responses after treatment of a catecholamine-secreting glomus jugulare tumor with gamma knife radiosurgery</title>
<link>http://dx.doi.org/10.1002%2Fhed.21242</link>
<description><![CDATA[Functional glomus jugulare tumors (GJTs) are commonly managed with resection. Although primary radiation therapy of functional GJT can provide durable control of tumor growth, little is known of its ability to ablate functional capacity.We describe a case of a 47-year-old man with a symptomatic norepinephrine-hypersecreting GJT treated with definitive single-fraction gamma knife radiosurgery and pharmacologic catecholamine blockade. At a 32-month follow-up, he has experienced significant symptomatic improvement, excellent control of local tumor growth, minimal treatment-related morbidity, and near normalization of catecholamine levels.Radiosurgery was safe and effective in significantly reducing the functional capacity of a paraganglioma. Care must be taken to avoid inducing a hypertensive crisis during and following treatment, and longer follow-up will help determine whether and when pharmacologic blockade can be discontinued. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21240">
<title>UltraCision harmonic scalpel versus clamp-and-tie total thyroidectomy: A clinical trial</title>
<link>http://dx.doi.org/10.1002%2Fhed.21240</link>
<description><![CDATA[Hemostasis is important in thyroid surgery to avoid complications. Our aim was to evaluate the effectiveness of the harmonic scalpel in patients undergoing total thyroidectomy.In this study, 90 patients were randomized into group A (classic technique of tying and knots) and group B (harmonic scalpel). We recorded the following: age, sex, pathology, thyroid weight, hemostatic technique, duration of operation, change in calcemia ([Delta]Ca), change in hematocrit ([Delta]Ht), change in hemoglobin ([Delta]Hgb), change in white blood cell count ([Delta]WBC), vocal motility, operative difficulty, postoperative vocal alteration, postoperative pain, complications, blood in the drains, operating time, mass of gland excised per minute, and hospitalization.Differences (p < .05) were observed concerning duration of surgery, operative difficulty, postoperative pain, hospitalization, [Delta]WBC, and quantity of gland removed per minute. No recurrent laryngeal nerve (RLN) palsies were observed.Use of the Harmonic Scalpel in total thyroidectomy is more effective than the clamp-and-tie technique: the duration of surgery, intraoperative difficulty, postoperative pain, and hospitalization are reduced. Both techniques are equivalent concerning RLN injuries, postoperative vocal alterations, and blood loss. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21237">
<title>Nonparotid parapharyngeal oncocytoma: A case report and literature review</title>
<link>http://dx.doi.org/10.1002%2Fhed.21237</link>
<description><![CDATA[Oncocytoma is a rare, benign salivary neoplasm composed of mitochondria-rich cells called oncocytes. Although oncocytoma usually occurs in the parotid glands, it has much less commonly been reported to occur in minor salivary gland tissues. Although there have been a few reported cases of oncocytomas being found in the parapharyngeal space, most if not all cases seem to be extensions of deep lobe parotid tumors. We present a case of a 73-year-old man with a previous history of prostate cancer that had the incidental finding of an 18F-fluorodeoxyglucose (FDG) image of a highly avid parapharyngeal space lesion noted on a follow-up positron emission tomography-computed tomography (PET/CT) scan. Excision of the mass, through a transcervical approach, demonstrated it to be an isolated oncocytoma of the parapharyngeal space, noncontiguous with the parotid gland. Based on our literature search, this may be the first such reported case. A brief review of the available literature examining the known body of knowledge regarding these neoplasms is presented. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21235">
<title>Methods of monitoring buried flaps</title>
<link>http://dx.doi.org/10.1002%2Fhed.21235</link>
<description><![CDATA[No abstract.]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21233">
<title>Dendritic cells pulsed with GST-EGFR fusion protein: Effect in antitumor immunity against head and neck squamous cell carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21233</link>
<description><![CDATA[Overexpression of epidermal growth factor receptor (EGFR) is common in head and neck squamous cell carcinoma (HNSCC). Targeting EGFR is an effective approach to treat EGFR-positive HNSCC. However, the clinical benefits of the present EGFR-targeting agents are still limited in HNSCC patients.Recombinant glutathione-S-transferase (GST)-EGFR fusion protein was produced and purified. Dendritic cells (DCs) of C3H mice were pulsed with fusion protein. Mice were challenged with HNSCC cells before or after vaccination with these DCs, and the cytotoxic T-lymphocyte (CTL) response, interferon-[gamma] (IFN-[gamma]) secretion, tumor growth, and survival of mice were assessed.Significant in vitro and in vivo antitumor activities were observed for mice immunized with DCs pulsed with GST-EGFR fusion protein, compared with the control groups (p < .05).The DCs pulsed with GST-EGFR fusion protein can provide not only preventive but also therapeutic antitumor activities against HNSCC in the animal model. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21232">
<title>Laryngeal inflammatory myofibroblastic tumors: Different clinical appearance and histomorphologic presentation of one entity</title>
<link>http://dx.doi.org/10.1002%2Fhed.21232</link>
<description><![CDATA[Inflammatory myofibroblastic tumors (IMFTs) of the larynx are rare. We report the clinical presentation, histomorphology, and new molecular findings of 2 cases.Paraffin-embedded specimens were stained immunohistochemically (eg, vimentin, AE1/3, Alk-1, smooth muscle [sm-]actin, p53, Rb1, immunoglobulin G4 [IgG4]). Epstein-Barr virus-encoded RNA (EBER) in situ hybridization and HHV8-polymerase chain reaction (PCR) were done. Comparative genomic hybridization (CGH) was performed.Case 1 was that of a 56-year-old man with an infiltrating plasma-cell-rich tumor (Alk-1-, sm-actin+). Plasma cells were strongly positive for IgG4. CGH was unsuspicious. Case 2 was that of a 34-year-old woman with an exophytic tumor (Alk-1+). CGH revealed losses on 13q14-22. The few plasma cells were negative for IgG4. The proliferation (Ki67) was low in both cases.Different types of IMFTs may exist and could indicate different therapeutic strategies. Alk-1-positive cases with only scattered inflammatory cells could represent the neoplastic variant, whereas cases rich in plasma cells could be associated with IgG4 sclerosing diseases. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21238">
<title>Role of postoperative irradiation for patients with bilateral cervical nodal metastases from cutaneous melanoma: A critical assessment</title>
<link>http://dx.doi.org/10.1002%2Fhed.21238</link>
<description><![CDATA[The aim of this study was to evaluate the role of regional nodal radiation therapy (RT) for patients with bilateral cervical nodal metastases from melanoma.Between 1998 and 2008, 16 patients with bilateral cervical metastases without distant metastases were treated with postoperative RT (30 Gy in 5 fractions delivered twice weekly).Median follow-up was 5 months (range, 1-34 months). Median survival was 9 months (95% confidence interval [CI], 0-23 months). Overall survival was 68%, 50%, and 27% at 6, 12, and 24 months, respectively. Regional nodal control was 74% and 64% at 6 and 12 months, respectively. Rates of development of distant metastasis were 60%, 70%, and 90% at 6, 12, and 18 months, respectively. The actuarial rate of RT-related complications was 49% at 12 months.The limited life expectancy of patients observed with this disease combined with the high rate of RT-related complications argue against the routine use of adjuvant RT for regional nodal disease in this setting. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21234">
<title>Hyperphosphorylation of replication protein A in cisplatin-resistant and -sensitive head and neck squamous cell carcinoma cell lines</title>
<link>http://dx.doi.org/10.1002%2Fhed.21234</link>
<description><![CDATA[Resistance to chemotherapy is a major limitation in the treatment of head and neck squamous cell carcinomas (HNSCCs), accounting for high mortality rates in patients. Here, we investigated the role of replication protein A (RPA) in cisplatin and etoposide resistance.We used 6 parental HNSCC cell lines. We also generated 1 cisplatin-resistant progeny subline from a parental cisplatin-sensitive cell line, to examine cisplatin resistance and sensitivity with respect to RPA2 hyperphosphorylation and cell-cycle response.Cisplatin-resistant HNSCC cell levels of hyperphosphorylated RPA2 in response to cisplatin were 80% to 90% greater compared with cisplatin-sensitive cell lines. RPA2 hyperphosphorylation could be induced in the cisplatin-resistant HNSCC subline. The absence of RPA2 hyperphosphorylation correlated with a defect in cell-cycle progression and cell survival.Loss of RPA2 hyperphosphorylation occurs in HNSCC cells and may be a marker of cellular sensitivities to cisplatin and etoposide in HNSCC. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21209">
<title>Respiratory-swallow phase patterns and their relationship to swallowing impairment in patients treated for oropharyngeal cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21209</link>
<description><![CDATA[Unstable respiratory-swallowing coordination has been associated with disorders and disease. The goals of this study were (1) to describe respiratory-swallow patterns in patients with dysphagia consequent to treatments for cancers of the oropharynx and (2) to determine the association between respiratory-swallow patterns, airway invasion, and overall severity of swallowing impairment.This prospective, cross-sectional design compared respiratory-swallow patterns in 20 patients treated for oropharyngeal cancer and 20 healthy, age-matched control participants. Nasal airflow direction was synchronously recorded with videofluoroscopic imaging in participants who swallowed 5-mL thin liquid barium boluses.Respiratory-swallow patterns differed between groups. Most control participants initiated and completed swallowing bracketed by expiratory airflow. Swallowing in patients often interrupted inspiratory flow and was associated with penetration or aspiration of the bolus.We suggest nonexpiratory bracketed respiratory-swallowing phase patterns in patients with oropharyngeal cancer may place patients at greater risk of airway penetration or aspiration during swallowing. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21205">
<title>Unintentional parathyroidectomy and hypoparathyroidism in secondary central compartment surgery for thyroid cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21205</link>
<description><![CDATA[Unintentional parathyroidectomy is a complication of thyroid surgery. To our knowledge, no study has specifically examined the incidence of inadvertent parathyroidectomy exclusively in patients undergoing secondary central compartment surgery for recurrent or persistent thyroid cancer.The records of 40 patients who underwent 42 secondary central compartment surgeries for thyroid cancer were reviewed to determine the incidence of inadvertent parathyroidectomy.Parathyroid tissue was present on permanent pathology in 31% of SCCSs. Unintentional parathyroidectomy did not have an effect on hypoparathyroidism. Concomitant lateral neck dissection did not have an effect on the incidence of hypoparathyroidism, but did have a statistically significant effect on inadvertent parathyroidectomy.Accidental resection of parathyroid tissue is relatively common in secondary central compartment surgery compared with primary thyroid surgery, but does not appear to correlate with postoperative hypoparathyroidism. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21199">
<title>Prediction of hypocalcemia after using 1- to 6-hour postoperative parathyroid hormone and calcium levels: An analysis of pooled individual patient data from 3 observational studies</title>
<link>http://dx.doi.org/10.1002%2Fhed.21199</link>
<description><![CDATA[Parathyroid hormone (PTH) levels up to 6 hours postthyroidectomy have been shown to have excellent predictive power in determining hypocalcemia. In this study, we investigate the usefulness of combining calcium and PTH to increase the predictive power.Individual patient data were obtained from 3 studies (152 patients) that fulfilled our criteria (using PTH assay within hours postthyroidectomy to predict symptomatic hypocalcemia).Changes in combined PTH and calcium threshold levels checked 1 to 6 hours after thyroidectomy were excellent in predicting postoperative hypocalcemia. A decrease in PTH of 60%, coupled with a simultaneous decrease in calcium of 10%, 5 to 6 hours postoperatively resulted in a sensitivity and specificity of 100%. However, combined PTH and calcium threshold changes were not significantly better than using PTH threshold changes alone.Threshold changes in serum calcium and PTH, checked hours after surgery, can be used together to accurately predict whether a patient will become hypocalcemic after thyroidectomy. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21203">
<title>Primary salivary gland type carcinoma of the nasopharynx: Therapeutic outcomes and prognostic factors</title>
<link>http://dx.doi.org/10.1002%2Fhed.21203</link>
<description><![CDATA[Background.Primary salivary gland type nasopharyngeal carcinoma (SNPC) is a rare malignancy with diverse clinical behavior and different prognoses. Previous studies have reported on limited patient populations, and few long-term studies have outlined outcomes and prognostic factors. Furthermore, controversy exists as to the treatment policy of SNPC. The aim of this study was to define management approaches, therapeutic outcomes, and prognostic factors of SNPC.Methods.The medical records of 67 patients with SNPC at 1 institution between 1977 and 2005 were reviewed. Patient records were analyzed for management approaches, outcomes, and prognostic factors.Results.SNPC is a rare malignancy accounting for only 0.29% of nasopharyngeal malignancies, and the lymphatic metastases and distant metastases rates were 28.4% and 23.9%, respectively. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 41.1% and 57.1%, respectively; no significant differences were found in DFS or OS between different histological subtypes. A significant difference was found in OS between surgical treatment and nonsurgical treatment in T1-T2 patients with well-differentiated tumors. Multivariate analyses indicated that lymph node metastases, stage, and distant metastases were independent factors for DFS, whereas cranial nerve invasion, tumor residue, and distant metastases were independent factors affecting OS.Conclusions.SNPC is a malignancy with generally favorable prognosis. In T1-T2 patients with well-differentiated tumors, SNPC should be treated by combined surgical operation and radiotherapy. Cranial nerve invasion, tumor residue, and distant metastases were independent factors affecting OS. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21198">
<title>Genotyping of 73 UM-SCC head and neck squamous cell carcinoma cell lines</title>
<link>http://dx.doi.org/10.1002%2Fhed.21198</link>
<description><![CDATA[Background.We established multiple University of Michigan Squamous Cell Carcinoma (UM-SCC) cell lines. With time, these have been distributed to other labs all over the world. Recent scientific discussions have noted the need to confirm the origin and identity of cell lines in grant proposals and journal articles. We genotyped the UM-SCC cell lines in our collection to confirm their unique identity.Method.Early-passage UM-SCC cell lines were genotyped and photographed.ResultsThus far, 73 unique head and neck UM-SCC cell lines (from 65 donors, including 21 lines from 17 females) were genotyped. In 7 cases, separate cell lines were established from the same donor.Conclusions.These results will be posted on the UM Head and Neck SPORE Tissue Core website for other investigators to confirm that the UM-SCC cells used in their laboratories have the correct features. Publications using UM-SCC cell lines should confirm the genotype. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21224">
<title>Comprehensive IMRT plus weekly cisplatin for advanced head and neck cancer: The University of Wisconsin experience</title>
<link>http://dx.doi.org/10.1002%2Fhed.21224</link>
<description><![CDATA[We retrospectively examined the treatment efficacy and toxicity profile of intensity-modulated radiotherapy (IMRT) plus concurrent weekly cisplatin chemotherapy in patients with locoregionally advanced head and neck squamous cell carcinoma (HNSCC).A total of 57 patients with stage III or IV HNSCC were treated with IMRT and concurrent weekly cisplatin (dosed at 30 mg/m2) between November 2001 and May 2007. The median prescription dose to the gross tumor volume was 70 Gy (using 2.0-2.2 Gy daily fractions).In-field tumor control at 2 years was 89.1%, locoregional control was 85.5%, and overall survival was 86.9%. The median radiation dose delivered was 70 Gy. The mean dose intensity of cisplatin administered was 25.7 mg/m2/week.Comprehensive head and neck IMRT to 70 Gy delivered with weekly cisplatin chemotherapy (30 mg/m2) is feasible and generally well tolerated. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21216">
<title>HPV-positive/p16-positive/EBV-negative nasopharyngeal carcinoma in white North Americans</title>
<link>http://dx.doi.org/10.1002%2Fhed.21216</link>
<description><![CDATA[Human papillomavirus (HPV) has been detected in keratinizing nasopharyngeal carcinomas (NPCs); however, the relationship between HPV and Epstein-Barr virus (EBV) among whites with nonkeratinizing NPCs remains unclear. The HPV, p16, and EBV status was examined in current University of Michigan patients with NPC.From 2003 to 2007, 89 patients, 84 with oropharyngeal cancer (OPC) and 5 with NPC, were enrolled in an organ-sparing trial. Biopsy tissues from all 89 patients were evaluated for HPV and p16 expression. A separate HPV analysis of the 84 OPC patients is in progress. Among the patients with NPC, tumor tissue was also analyzed for EBV-encoded RNA (EBER).Five of 89 patients (5.6%) had NPC, all with nonkeratinizing histology. The 4 white patients with NPC were HPV(+) (subtype-16, subtype-18 [2 patients], and subtype-59)/p16(+)/EBER(-). One Asian patient with NPC had an HPV(-)/p16(-)/EBER(+) NPC tumor that developed distant metastases.We postulate that HPV may be the etiologic factor in some EBV-negative, nonkeratinizing NPCs among whites. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21227">
<title>Smoking and drinking in relation to depressive symptoms among persons with oral cancer or oral epithelial dysplasia</title>
<link>http://dx.doi.org/10.1002%2Fhed.21227</link>
<description><![CDATA[We examined whether smoking or drinking during or before the diagnosis-year of oral cancer or oral epithelial dysplasia (OED) was related to "subsequent depression" measured months after the oral diagnosis.Incident cases of oral cancer or OED were identified via 3 oral pathology laboratories. A telephone-administered questionnaire included questions on smoking/drinking history through the diagnosis-year and measured depressive symptoms using the Center for Epidemiologic Studies-Depression Scale (CES-D); scores of 16+ indicated clinical depression. "Subsequent depression" was defined as a CES-D score of 16+, measured at the time of assessment several months after the diagnosis of oral cancer or OED.Patients who smoked during their diagnosis-year had twice the odds of subsequent depression relative to former/never smokers. Diagnosis-year (vs never/former) drinking was not associated with depression; however, average alcohol consumption of >1.5 drinks/week was negatively associated with subsequent depression for both diagnosis-year and ex-drinkers (past reported drinking) even among heavy drinkers.Our findings suggest that subsequent depression is positively associated with diagnosis-year smoking and negatively associated with alcohol consumption of >1.5 drinks/week among both diagnosis-year and ex-drinkers. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21225">
<title>Real-time and computerized sonographic scoring system for predicting malignant cervical lymphadenopathy</title>
<link>http://dx.doi.org/10.1002%2Fhed.21225</link>
<description><![CDATA[To identify malignant cervical lymphadenopathy, we established a real-time, computerized scoring system based on sonographic findings and demographic data.One hundred eight patients with neck lymphadenopathy, receiving ultrasonography and ultrasound-guided fine-needle aspiration (US-FNA), were used to construct a predictive model. This model was validated by another independent patient cohort.A predictive scoring scale was proposed by multivariate logistic regression analysis: 0.06 × (age) + 4.76 × (S/L ratio) + 2.15 × (internal echo) + 1.80 × (vascular pattern). Cervical lymphadenopathy was regarded as malignant with a score [ge]7. The formula was programmed into a synchronized, computerized sonographic reporting system. Prospective validation of this predictive tool showed excellent sensitivity (100%), specificity (88.0%), and overall accuracy (90.1%).A real-time and practical sonographic scoring system was built and validated to provide the physician prompt and reliable probability guidance for performing US-FNA cytology in managing cervical lymphadenopathy. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21219">
<title>Visualization of anterior skull base defects with intraoperative cone-beam CT</title>
<link>http://dx.doi.org/10.1002%2Fhed.21219</link>
<description><![CDATA[The role of cone-beam CT (CBCT) in demonstrating anterior skull base defects (ASBDs), differing in size and location, was investigated. The study was designed to describe the potential advantage of CBCT in the setting of an intraoperative cerebrospinal fluid (CSF) leak.In all, 120 ASBD were evaluated in 5 cadaver heads. Orthogonal and oblique slices were reconstructed. Observer studies assessed the visibility of ASBD in each location as a function of defect size.For 1-, 2-, and 4-mm defects, the percentage that were undetectable ranged from 20% to 33%, 0% to 14%, and 0% to 5%, respectively. Confident breach detection increased with defect size and was most challenging in the lateral lamella and cribriform. CBCT permitted confident detection of ASBD as small as about 2 mm in the fovea ethmoidalis and planum. Oblique views were found to be superior to orthogonal planes.The ability to identify ASBD depended on the size and location of defect. Oblique viewing planes were optimal for ASBD visualization. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21188">
<title>Impact of neck dissection on long-term feeding tube dependence in patients with head and neck cancer treated with primary radiation or chemoradiation</title>
<link>http://dx.doi.org/10.1002%2Fhed.21188</link>
<description><![CDATA[The impact of posttreatment neck dissection on prolonged feeding tube dependence in patients with head and neck squamous cell cancer (HNSCC) treated with primary radiation or chemoradiation remains unknown.We conducted a retrospective cohort study using propensity score adjustment to investigate the effect of neck dissection on prolonged feeding tube dependence.A review of 67 patients with node-positive HNSCC (T1-4N1-3), treated with primary radiation or chemoradiation, with no evidence of tumor recurrence and follow-up of at least 24 months, was performed. Following adjustment for covariates, the relative risk (RR) of feeding tube dependence at 18 months was significantly increased in patients treated with posttreatment neck dissection (RR 4.74, 95% confidence interval [CI] 2.07-10.89). At 24 months, the relative risk of feeding tube dependence in the patients having undergone neck dissection increased further (RR 7.66, 95% CI 2.07-10.89). Of patients with feeding tubes 2 years after completing treatment, 75% remained feeding tube dependent.Neck dissection may contribute to chronic oropharyngeal dysphagia in HNSCC patients treated with primary radiation or chemoradiation. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21229">
<title>99mTc-sestamibi scanning in thyroid nodules with nondiagnostic cytology</title>
<link>http://dx.doi.org/10.1002%2Fhed.21229</link>
<description><![CDATA[Our aim in this study was to assess the relevance of 99mTc-sestaMIBI (MIBI) scan in the diagnostic evaluation of thyroid nodules with nondiagnostic cytology.In all, 74 patients with a single nodule and repeatedly nondiagnostic ultrasound-guided fine-needle aspiration cytology (US-FNAC) were enrolled. In all cases thyroid nodules were cold in 99mTc-pertechnetate (Tc) scans. Thyroid scans were also acquired 30 and 120 minutes after intravenous administration of MIBI. Nodules that concentrate MIBI were considered as positive (ie, suspicious for malignancy). Histologic findings were obtained after surgery in all patients.No differences occurred in early and late MIBI images. None of 63 patients with a negative MIBI scan had a final histologic diagnosis of malignancy (ie, no false-negative results). Two patients with a final histologic diagnosis of papillary thyroid carcinoma (PTC) and 1 with follicular thyroid carcinoma (FTC) had a positive MIBI scan. Eight patients with a final histologic diagnosis of benign lesions (3 with follicular adenomas) also had MIBI-positive scans. The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were, respectively, 100%, 88%, 89%, 27%, and 100%.A negative MIBI scan in a cold nodule accurately excludes malignancy when US-FNAC is reported as nondiagnostic. This avoids the need for more invasive diagnostic procedures (ie, surgery) and positively influences the cost-effectiveness profile. A MIBI scan may be performed by acquiring images 30 minutes after tracer administration alone. Histology is still necessary to distinguish benign from malignant disease in a MIBI-positive nodule but unnecessary surgery could have been reduced from 71 to 8 cases in our series. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21228">
<title>Benefit of measuring basal serum calcitonin to detect medullary thyroid carcinoma in a Danish population with a high prevalence of thyroid nodules</title>
<link>http://dx.doi.org/10.1002%2Fhed.21228</link>
<description><![CDATA[Routine measurement of serum calcitonin to detect medullary thyroid carcinoma (MTC) continues to be fiercely debated, although less attention has been paid to the positive predictive value (PPV) of this method.We collected data from 959 patients with nontoxic nodular goiter; thyroidectomy was performed in 307 of these patients.Thirty-nine patients had elevated serum calcitonin; 6 of these patients had MTC detected by the initial diagnostic setup. No additional patient in the cohort was registered in the Danish Thyroid Cancer Database, reflecting that all patients with MTC were classified correctly initially. The sensitivity of serum calcitonin for detection of MTC was 100%, the specificity was 95.3%, the positive predictive value was 15.4%, and the negative predictive value was 100%.Serum calcitonin has high sensitivity and specificity for detection of MTC. The low PPV might lead to unnecessary thyroid surgery. Thus, the result of serum calcitonin measurement should always be interpreted in the context of other clinical variables. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21218">
<title>Impact of demographics, tumor characteristics, and treatment factors on swallowing after (chemo)radiotherapy for head and neck cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21218</link>
<description><![CDATA[This prospective study evaluated the impact of patient demographics, tumor characteristics, and radiotherapy treatment on swallowing before and after radiotherapy or chemoradiotherapy.Eighty-one patients with head and neck cancer were examined using videofluoroscopy swallowing studies (VFSS) before treatment and again at 3 and 6 months after treatment.Swallowing was best at baseline, significantly worse 3 months posttreatment, and improved by 6 months posttreatment. Worse swallowing was associated with: living in rural areas; ex-heavy alcohol consumption; hypopharyngeal tumor site; large (particularly T4) tumors; nonconformal radiotherapy; bilateral radiation to the pharynx; and longer radiotherapy fields. Through the use of multiple regression analysis, previous swallowing was determined to be the most common predictor of swallowing outcomes, followed by T classification, alcohol history, and radiotherapy technique.The pretreatment and treatment factors that influenced swallowing in this cohort should be considered when planning treatment, in discussing potential side effects with patients, and when developing and testing future treatment techniques. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21215">
<title>Ectopic parathyroid adenoma located inside the hypoglossal nerve</title>
<link>http://dx.doi.org/10.1002%2Fhed.21215</link>
<description><![CDATA[Intraneural parathyroid adenomas are extremely rare, with only 9 cases of intravagal adenomas reported. We report the first case of an ectopic parathyroid adenoma located within the hypoglossal nerve.A 62-year-old woman presented with a palpable nodule in the right submandibular area, reduced bone mass, and elevated calcium and parathormone levels. Preoperative investigation with neck ultrasound and MRI did not provide a definitive diagnosis, whereas sestamibi scan showed slightly increased radiotracer accumulation in the same area. Intraoperatively, the right hypoglossal nerve was found to course through the lesion and, despite the attempt to salvage it, most of its fibers were transected. Histopathology confirmed the presence of a parathyroid adenoma inside the trunk of a nerve. Postoperatively, calcium and parathormone levels decreased but right hypoglossal nerve paresis was noted.This unique case emphasizes the variability of parathyroid anatomy and the difficulties faced by the surgeon when treating this disease process. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21207">
<title>Outcomes of patients with tonsillar carcinoma treated with post-tonsillectomy radiation therapy</title>
<link>http://dx.doi.org/10.1002%2Fhed.21207</link>
<description><![CDATA[Our aim was to evaluate the therapeutic outcomes of patients with squamous cell carcinoma of the tonsil that underwent tonsillectomies followed by radiotherapy.A search of the database maintained within the Department of Radiation Oncology at The University of Texas M. D. Anderson Cancer Center identified 120 patients with carcinoma of the tonsil who were irradiated between 1979 and 2004 following total gross removal of their disease by tonsillectomy.Thirty-six patients had stage III disease and 64 patients had stage IV disease. Only 12 patients received systemic chemotherapy. With median follow-up of 51 months, the 5-year local-regional control rate, recurrence-free survival rate, and overall survival rates were 97%, 92%, and 86%, respectively.Patients who undergo tonsillectomies resulting in total gross removal of their primary disease followed by radiation have excellent outcomes. Our common practice is to deliver 66 Gy to the tonsillar bed. This practice has resulted in extremely high local control rates. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21217">
<title>Postoperative radiotherapy for primary early oral tongue cancer with pathologic N1 neck</title>
<link>http://dx.doi.org/10.1002%2Fhed.21217</link>
<description><![CDATA[The benefit of postoperative radiotherapy (PORT) for early squamous cell carcinoma of the tongue (SCCOT) with pathologic N1 disease remains unclear.The medical records of all patients with pathologic T1-2/N0-1 SCCOT who underwent wide excision of the primary tumor and neck dissection between 1980 and 2002 were reviewed.There were 59 patients analyzed, including 28 patients with and 31 patients without PORT. The 5-year disease-free survival rates were 81.2% and 53% for the patients with and without PORT, respectively (p = .03). The overall 5-year survival rates were 77% and 70.5% for the patients with and without PORT, respectively (p = .36). Multivariate analyses showed that PORT had the only protective effect (p = .01) and extracapsular spread (ECS) was the only significantly adverse factor for locoregional recurrence (p = .03).Approximately one-third of the patients who received only surgery had locoregional recurrence. PORT significantly improved the disease-free survival. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21222">
<title>Commentary</title>
<link>http://dx.doi.org/10.1002%2Fhed.21222</link>
<description><![CDATA[No abstract.]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21220">
<title>Never-smokers, never-drinkers: Unique clinical subgroup of young patients with head and neck squamous cell cancers</title>
<link>http://dx.doi.org/10.1002%2Fhed.21220</link>
<description><![CDATA[Young patients represent an increasing subgroup with head and neck cancer.Patients between 18 and 39 years of age with newly diagnosed and previously untreated squamous cell cancers were identified.Seventy-eight patients met the selection criteria: 28 patients were never-smokers/never-drinkers (NSNDs), and 50 patients reported tobacco or alcohol abuse (smokers and/or drinkers [SD]). NSND patients were diagnosed at a younger median age (31.5 years vs 35.5 years, p = .007), were more likely to be female (75% vs 30%, p < .001) and white (89% vs 60%, p = .006), and were more likely to have tumors of the oral tongue (57% vs 24%, p = .003) and T1 disease (47% vs 20%, p = .01). There was no difference in 10-year relapse-free survival, but a suggestion of improved 10-year overall survival for NSND patients (71% vs 46%, p = .10).Young patients with head and neck squamous cell carcinoma (HNSCC) appear to have unique clinical profiles based on history of alcohol and tobacco abuse. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21200">
<title>CO2 laser therapy in Tis and T1 glottic cancer: Indications and results</title>
<link>http://dx.doi.org/10.1002%2Fhed.21200</link>
<description><![CDATA[Laser cordectomy for glottic cancer is still hampered by recurrence, which is more frequent upon anterior commissure (AC) involvement. Analysis of results may be a step to improve the efficacy of this therapy for early glottic cancer.In all, 81 patients who underwent surgery with CO2 laser for Tis and T1, AC0 to AC2 glottic carcinoma were followed up to 55 months.The incidence of recurrence increased significantly with T and AC classifications. The disease-free interval decreased with increasing T and AC classifications and with increasing severity of histology, but only the AC classification appeared significant. Recurrences occurred in 5 of 35 patients upon type I and type II cordectomy, in 16 of 24 patients upon type V cordectomy, and never upon type III and IV cordectomy.Type I to type IV cordectomy, when indicated, can achieve radical treatment of most T1 glottic cancer. Type V cordectomy requires that any suspicion of cartilage invasion, even microscopic, be excluded. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21175">
<title>Postoperative hypocalcemia - The difference a definition makes</title>
<link>http://dx.doi.org/10.1002%2Fhed.21175</link>
<description><![CDATA[Review of the literature reveals considerable variability in the definitions and criteria used for reporting postoperative hypocalcemia. The lack of standardization prevents a meaningful comparison of results and performance locally with the national standard. It also prevents the pooling of data when performing meta-analysis, and may affect the comparison of research results.A literature review was performed to identify the different definitions used to define hypocalcemia in post-thyroidectomy patients. We analyzed the incidence of hypocalcemia in the same cohort of 202 post thyroidectomy patients using these definitions.The reported hypocalcemia rates varied from 0% to 46% for the same cohort depending on the definition of hypocalcemia used. Only one-third of biochemically hypocalcemic patients requested calcium supplementation.This study demonstrates the need for more uniformity and standardization in the definitions used for reporting hypocalcemia rates. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21214">
<title>Postsurgery serum thyroglobulin disappearance kinetic in patients with differentiated thyroid carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21214</link>
<description><![CDATA[Knowing the postsurgery thyroglobulin (Tg) kinetic would enable its rationale for use in patients with differentiated thyroid cancer (DTC). Heterogeneous results were previously reported, then we aimed to evaluate the postsurgery Tg kinetic in a large group of patients with DTC.Enrolled were 96 patients with DTC. Serum Tg was measured first at 5 minutes, then at 24, 48, 72, 96, and 120 hours after thyroidectomy. The Tg half-life (Tg[t1/2]) was estimated in a 1-compartment model. A simplified 2-point formula (24 and 120 hours) was also used.The mean Tg(t1/2) was 28.53 to 30.22 hours in 1-compartment model and 27.39 hours when estimated by a simplified formula. A strong inter-methods relationship was found (p < .001).A reliable Tg(t1/2) estimation could be obtained by a simplified formula requiring only 2 postsurgery Tg measurements (24 and 120 hours, respectively). © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21213">
<title>Cervical hemorrhage due to spontaneous rupture of the superior thyroid artery: Case report and review of the literature</title>
<link>http://dx.doi.org/10.1002%2Fhed.21213</link>
<description><![CDATA[Beneath the different reasons for cervical masses, a spontaneous hemorrhage presents a rare and life-threatening condition.We present the rare case of a 62-year-old man who was presented with a dramatically enlarging cervical mass causing respiratory distress because of upper airway compression. An endotracheal intubation was lifesaving and avoided tracheotomy. A CT scan revealed a hematoma in the region of the left external carotid artery. An emergency angiography embolized a ruptured branch of the superior thyroid artery and surgery evacuated the hematoma. We discuss the rarity of the condition, reasons for a spontaneous rupture of the artery, and the diagnostic and treatment strategy. In addition, we review the literature on spontaneous thyroid artery hemorrhages, which, up to now, have been described only for the inferior thyroid artery.We conclude that the optimal management for cases of cervical hematoma is intubation, diagnosis, and angiography before surgery. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21212">
<title>In vivo and in vitro models of ionizing radiation to the vocal folds</title>
<link>http://dx.doi.org/10.1002%2Fhed.21212</link>
<description><![CDATA[Radiation therapy (RT) to the head and neck often results in damage to the vocal folds (VF) and surrounding structures. Characterization and treatment of these sequelae is limited, likely due to the lack of experimental models.Larynges from rats exposed to 2 fractionation schedules (40 Gy total) were analyzed histologically. In vitro, reactive oxygen species (ROS) synthesis, and transcription of select genes associated with ROS, inflammation, and fibrosis were examined in VF fibroblasts after single-dose radiation.Although radiation-induced histologic alterations are made to VF architecture, 1 fractionation schedule was accompanied by significant morbidity and mortality. In vitro, radiation increased ROS synthesis and inflammatory and profibrotic gene expression.Our data suggest that hyperfractionated RT is more tolerable. Utilizing this model, RT-induced histologic aberrations are made to the VF mucosa. In addition, a relationship between radiation, ROS, and inflammatory and fibrotic gene expression was observed in vitro. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21210">
<title>Dual priming oligonucleotide-based multiplex PCR analysis for detection of BRAFV600E mutation in FNAB samples of thyroid nodules in BRAFV600E mutation-prevalent area</title>
<link>http://dx.doi.org/10.1002%2Fhed.21210</link>
<description><![CDATA[To evaluate the diagnostic value of dual priming oligonucleotide (DPO)-based multiplex polymerase chain reaction (PCR) for the detection of BRAFV600E mutations in ultrasound-guided fine-needle aspiration biopsy (US-FNAB) of thyroid nodules.Our institutional review board approved this retrospective study, and informed consent was not required from patients. The 130 patients underwent US-FNAB to evaluate BRAF status in thyroid nodules. In FNAB washouts, DPO-based multiplex PCR, direct DNA sequencing, and PCR-restriction fragment length polymorphism (RFLP) were used to detect BRAFV600E. The diagnostic performance of these methods was calculated. We compared cytologic results by BRAF status.Diagnostic accuracy and sensitivity were highest when screening with DPO-based multiplex PCR. BRAFV600E positivity was a useful marker at thyroid nodules with "suspicious for papillary thyroid carcinoma" or "inadequate" cytological result.DPO-based multiplex PCR may be an alternative to direct DNA sequencing because of its high sensitivity, high accuracy, and simplicity. BRAFV600E may be a useful additional diagnostic marker in BRAFV600E-prevalent areas. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21204">
<title>Anterolateral thigh flap</title>
<link>http://dx.doi.org/10.1002%2Fhed.21204</link>
<description><![CDATA[The anterolateral thigh (ALT) flap is a versatile soft tissue flap. It can be harvested as a fasciocutaneous or myocutaneous flap. Vascularized fascia can be included or the pedicle may be harvested as a flow-through flap. The flap can also be harvested incorporating multiple skin islands or as a chimeric flap incorporating separate skin and muscle components. When a large flap is needed, the entire lateral thigh can be harvested by combining the ALT with either the tensor fascia lata or the anteromedial thigh flap as a conjoined flap. Morbidity is remarkably minimal despite the availability of such generous amounts of tissue. The purported difficulty with the use of this flap is because of the anatomical variations that may render this flap unreliable. This paper clarifies the vascular anatomy of the flap and elaborates an approach to flap harvest that can be used to reliably harvest the flap in spite of the anomalies that may be encountered. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21201">
<title>Esophageal stricture after radiotherapy in patients with head and neck cancer: Experience of a single institution over 2 treatment periods</title>
<link>http://dx.doi.org/10.1002%2Fhed.21201</link>
<description><![CDATA[Risk factors for development of a stricture of the upper esophagus after radiotherapy for head and neck cancer are poorly defined.This was a retrospective case-control study of patients diagnosed and treated for esophageal stricture after radiotherapy for head and neck cancer.The incidence of esophageal stricture after external beam radiation therapy (EBRT) was 3.3%. Seventy patients with stricture and 66 patients without stricture were identified. A multivariate analysis showed that there was increased risk of stricture in receiving enteral feeding during EBRT or in receiving a mean dose of >45 Gy to the upper esophagus.Enteral feeding during EBRT is strongly associated with the development of stricture of the esophagus, as is a mean dose of >45 Gy to the upper esophagus. Treatment of the stricture with Savary-Gilliard bougienage or through scope balloon dilatation is safe and successful but often has to be repeated. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21189">
<title>Extent of neck dissection required after concurrent chemoradiation for stage IV head and neck squamous cell carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21189</link>
<description><![CDATA[The management of initially bulky nodal disease after primary nonsurgical treatment for stage IV head and neck squamous cell carcinoma (HNSCC) continues to be a subject of debate.A retrospective chart review of neck management in patients after chemoradiation was performed.Of the initially positive necks analyzed, 210/329 (65%) had a complete clinical response to treatment and 161 necks underwent neck surgery. Patients were pathologically positive 13.8% and 39.6% of the time after clinical complete or partial response, respectively. Regional recurrence was more frequent in necks with partial clinical (p = .04) or pathologic responses (p < .01) and with primary site recurrences (p < .01).It is still safest at our institution to perform selective neck dissection on patients with [ge]N2 neck disease when initially observed to prevent unsalvageable regional recurrence until more accurate interval assessment tools are confirmed. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21211">
<title>Squamous cell carcinoma of base of tongue in a patient with Fanconi&#x27;s anemia treated with radiation therapy: Case report and review of literature</title>
<link>http://dx.doi.org/10.1002%2Fhed.21211</link>
<description><![CDATA[Fanconi's anemia (FA) is a rare autosomal recessive genetic disorder characterized by congenital anomalies, progressive aplastic anemia, and a predisposition for malignancies. Solid tumors in the head and neck region, especially in the tongue, are rarely observed. Management of these patients is a challenge because of hematological complications and increased toxicities.We report a case of Fanconi's anemia in a 27-year-old man with carcinoma of the base of tongue (T2N0M0) who was treated with radical radiation therapy to a dose of 70 Gy/35 fractions/51 days. We have also done in vitro radiosensitivity tests.The patient tolerated the radiation treatment well and completed it without any interruptions. In vitro studies did not show any increased radiosensitivity in this patient.Head and neck cancer in a patient with FA requires individualized treatment. The decision about opting for different modalities should be based on a balanced approach with respect to locoregional control and toxicities of the treatment. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21208">
<title>Current concepts and new horizons in conservation laryngeal surgery: An important part of multidisciplinary care</title>
<link>http://dx.doi.org/10.1002%2Fhed.21208</link>
<description><![CDATA[New surgical techniques in conservation laryngeal surgery (CLS) have emerged over the past 20 years and now offer a viable "organ-preservation" approach for patients with laryngeal cancer. We review traditional and new CLS procedures and summarize the functional and oncologic outcomes of CLS in both primary and salvage settings.We searched the literature by accessing Medline for articles from 1991 to 2007 on primary or salvage surgery (open and transoral) for laryngeal neoplasms.Our review of the literature suggests that proper selection of patients for CLS can yield long-term local control rates equal to or better than those obtained using radiation-based approaches. We believe that CLS should be directly compared with radiation or chemoradiation to further refine the indications for each kind of treatment in cases of primary and recurrent/refractory laryngeal cancer. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21206">
<title>Percutaneous sclerotherapy of massive venous malformations of the face and neck using fibrin glue combined with OK-432 and pingyangmycin</title>
<link>http://dx.doi.org/10.1002%2Fhed.21206</link>
<description><![CDATA[Surgical excision is useful only for localized and limited lesions. The purpose of this study was to evaluate the clinical curative effect of percutaneous sclerotherapy of massive venous malformations of the face and neck using fibrin glue combined with OK-432 and pingyangmycin.Eighteen patients with massive venous malformations were treated with an injection of fibrin glue combined with OK-432 and pingyangmycin.All the patients had extreme swelling postoperatively with no major complications. The follow-up period ranged from 6 to 12 months. Twelve lesions were completely involuted, 4 lesions were mostly involuted, and 2 lesions were partially involuted. All of the patients had normal liver and kidney functions. None of the patients presented with hematologic toxic effects or signs of pulmonary involvement.Percutaneous sclerotherapy using fibrin glue combined with OK-432 and pingyangmycin provided a simple, safe, and reliable alternative treatment for massive venous malformations. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21202">
<title>Correlation between lymphatic vessel density and regional metastasis in squamous cell carcinoma of the tongue</title>
<link>http://dx.doi.org/10.1002%2Fhed.21202</link>
<description><![CDATA[The aim of this study was to investigate the correlation between lymphatic vessel density in squamous cell carcinoma of the tongue and regional metastasis.Intratumoral and peritumoral lymphatic densities (ILDs and PLDs, respectively) were determined by immunohistochemical staining of lymphatic endothelial cells with podoplanin in 62 patients surgically treated for tongue cancer. Clinicopathological variables were quantified, and their correlations with regional metastasis were assessed.The rate of regional metastasis was significantly higher in patients with high ILD than that in those with low ILD (21/33, 63.6% vs 8/29, 27.5%; p = .006). Perineural invasion and lymphovascular invasion were also significantly correlated with regional metastasis. By multivariate analyses, ILD was the only variable identified to be significantly correlated with regional metastasis (p = .009). On the other hand, PLD showed no correlation with regional metastasis.ILD showed a strong correlation with regional metastasis in patients with squamous cell carcinoma of the tongue. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21196">
<title>Reoperative thyroidectomy for benign thyroid disease</title>
<link>http://dx.doi.org/10.1002%2Fhed.21196</link>
<description><![CDATA[Subtotal thyroidectomy for benign thyroid disease (BTD) may lead to delayed recurrence, thus necessitating reoperative surgery. We describe our experience with reoperative thyroidectomy for BTD and recommendations for definitive primary management.Patients undergoing thyroid surgery between 2003 and 2007 by a single surgeon were prospectively assessed. Numerous clinical parameters were evaluated, including time interval between primary and reoperative surgery and complications.In all, 321 thyroidectomies were identified: 45 were reoperative and 22 were related to BTD after primary surgery done elsewhere. Median interval between the primary and reoperative procedure was 8.5 years. No recurrences followed total thyroidectomy or total thyroid lobectomy. There were no cases of permanent or transient recurrent laryngeal nerve (RLN) injury related to reoperative surgery. There was 1 case of transient hypocalcemia.Although reoperative thyroidectomy can be performed safely in the hands of experienced surgeons, a thorough initial surgical procedure should obviate the need for exposure to this additional risk. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21195">
<title>Head and neck cancer radiosensitization by the novel poly(ADP-ribose) polymerase inhibitor GPI-15427</title>
<link>http://dx.doi.org/10.1002%2Fhed.21195</link>
<description><![CDATA[In this study, we tested the ability of a novel poly(adenosine diphosphate ribose) polymerase (PARP) inhibitor, 10-(4-methyl-piperazin-1-ylmethyl)-2H-7-oxa-1,2-diaza-benzo[de]-anthracen-3-one (GPI-15427), to enhance the effect of radiotherapy in a xenograft model of human head and neck squamous cell carcinoma (HNSCC).Human xenograft HNSCC tumors were established in female nude mice: animals were treated with orally administered GPI-15427 at varied doses prior to tumor irradiation. In vitro and in vivo apoptosis analyses and neutral single-cell gel electrophoresis (comet) assay were performed, with the "tail moment" calculated to evaluate DNA double-strand break damage.Orally administered GPI-15427 given before radiation therapy significantly reduced tumor volume, and cells demonstrated significantly elevated mean tail moments (indicative of DNA damage) and enhanced apoptosis both in vitro and in vivo, compared with radiation-alone and control groups.Use of the PARP-1 inhibitor GPI-15427 induced significant sensitization to radiotherapy, representing a promising new treatment in the management of HNSCC. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21190">
<title>Electrophysiologic facial nerve monitoring during parotidectomy</title>
<link>http://dx.doi.org/10.1002%2Fhed.21190</link>
<description><![CDATA[Facial nerve monitoring is an adjunctive method available to a surgeon during parotid surgery to assist with the functional preservation of the facial nerve. This review describes the goals, applications, technique, and benefits of electrophysiologic facial nerve monitoring during parotid surgery. A review and analysis of the relevant medical literature related to electrophysiologic facial nerve monitoring during parotid surgery are included. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21193">
<title>Oral cavity cancer in developed and in developing countries: Population-based incidence</title>
<link>http://dx.doi.org/10.1002%2Fhed.21193</link>
<description><![CDATA[The incidence of oral cavity cancer (OCC) is not well documented because it is rarely described in accord with the anatomic definition but is usually grouped with oropharyngeal subsites. We studied the incidence of OCC in developed and in developing countries.The age-standardized and age-specific incidence rates of OCC were calculated for the period 1998-2002, using the topographic definition used by the Union Internationale Contre le Cancer (UICC), based on data from CI5-IX.The highest rates are observed in Pakistan, Brazil, India, and France and were consistent with country-specific risk factors and their prevalence.In developing countries, people are exposed to a wider range of risk factors, starting at younger ages, and primary prevention measures and policies are needed. Awareness of professionals must be improved to identify people at risk and target them for prevention and to minimize the consequences of OCC. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21191">
<title>Expression of hedgehog signaling molecules in Merkel cell carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21191</link>
<description><![CDATA[The Hedgehog signaling pathway is important for human development and carcinogenesis in various malignancies.One tissue microarray with triplets of 28 samples from 25 patients with Merkel cell carcinoma (MCC) was constructed. Six samples of normal skin and 5 samples of normal oral mucosa served as controls. All samples were analyzed immunohistochemically with antibodies directed against Sonic hedgehog, Indian hedgehog, Patched, Smoothened, Gli-1, Gli-2, and Gli-3.All investigated proteins were frequently and intensely overexpressed in MCCs (Sonic hedgehog, 93%; Indian hedgehog, 84%; Patched, 86%; Smoothened, 79%; Gli-1, 79%; Gli-2, 79%; Gli-3, 86%) compared with control samples. High levels of Patched and Indian hedgehog were significantly associated with an increase in patients overall (p = .015) and recurrence-free survival (p = .011), respectively.Our results indicate that the Hedgehog signaling pathway is strongly activated in MCC and thus may play a role in carcinogenesis. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21184">
<title>18F-FDG-PET/CT versus panendoscopy for the detection of synchronous second primary tumors in patients with head and neck squamous cell carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21184</link>
<description><![CDATA[This study assesses the additional value of 18F-fluoro-2-deoxy-D-glucose positron emission tomography/CT (18F-FDG-PET/CT) with respect to synchronous primaries in patients undergoing panendoscopy for staging of head and neck squamous cell carcinoma.In all, 311 patients underwent both modalities. Cytology, histology, and/or clinical/imaging follow-up served as reference standard.The prevalence of second primary tumors detected by panendoscopy was 4.5%, compared with 6.1% detected by 18F-FDG-PET/CT. The sensitivity for panendoscopy was 74%, the specificity was 99.7%, the positive predictive value (PPV) was 93%, and the negative predictive value (NPV) was 98%. The sensitivity for 18F-FDG-PET/CT was 100%, the specificity was 95.7%, the PPV was 59%, and the NPV was 100%.18F-FDG-PET/CT is superior to panendoscopy. With a negative 18F-FDG-PET/CT, the extent of endoscopy can be reduced to the area of the primary tumor. Due to the costs, 18F-FDG-PET/CT is recommended only in advanced disease to assess potential distant disease. In early-stage cancer, panendoscopy is accurate enough to rule out secondary tumors. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21182">
<title>Anatomical landmarks for endosonography of the larynx</title>
<link>http://dx.doi.org/10.1002%2Fhed.21182</link>
<description><![CDATA[A precise knowledge of anatomy is necessary to allow a correct interpretation of sonographic images when investigating a particular region of the body. The objective of the present study was to establish anatomical landmarks for endosonography of the larynx.In an experimental study, a total of 32 normal human larynges were examined endosonographically, and the classical landmarks were correlated to horizontal whole-organ sections of the scanned specimens.All laryngeal specimens showed a similar and reproducible sonoanatomy, which could be verified consistently on corresponding histological cross sections. Anatomical structures readily identified included the laryngeal framework, the vocal ligament, the vocal muscle, the ventricular fold, the preepiglottic and paraglottic space, and the epiglottis.Due to a reproducible sonoanatomy of the larynx, endosonography might be an interesting complementary tool in the diagnostic investigation of laryngeal lesions such as medium-sized tumors, cysts, laryngoceles, and stenoses. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21143">
<title>Reliability and validity of the Vanderbilt Head and Neck Symptom Survey: A tool to assess symptom burden in patients treated with chemoradiation</title>
<link>http://dx.doi.org/10.1002%2Fhed.21143</link>
<description><![CDATA[We describe the development and validation of the Vanderbilt Head and Neck Symptom Survey (VHNSS), which was designed to screen for tumor- and treatment-specific symptoms in patients with head and neck cancer undergoing concurrent chemoradiation (CCR).Using a 2-step card sort method, we identified high-impact and high-frequency toxicities in patients with head and neck cancer treated with CCR. This resulted in a 28-item questionnaire which scores symptoms on a 0 to 10 scale (none to severe). The tool was validated using data collected from 5 supportive care studies comprising a total sample of 332 patients with head and neck cancer.Responses to the VHNSS items demonstrated a very consistent pattern (Cronbach's alpha = 0.943) with each item contributing substantially to the global index. Five symptom subscales were identified including "Nutrition," "Pain," "Voice," "Swallow," and "Mucous/Dry Mouth." Each of the cluster scores demonstrated good internal consistency. The pattern of associations between the VHNSS and established tools indicated appropriate convergence and divergence. Comparison of global and subscale scores and objective measure were also in the expected direction providing further evidence of validity.The findings provide support that the VHNSS is a valid and reliable tool to assess head and neck-specific symptom burden and function loss. Further research to evaluate this screening tool as a part of a systems approach to supportive care is warranted. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21197">
<title>Absence of Simian virus 40, BK, and JC polyomavirus DNA in squamous cell carcinoma limited to the oral cavity</title>
<link>http://dx.doi.org/10.1002%2Fhed.21197</link>
<description><![CDATA[Head and neck squamous cell carcinomas (SCCs) are among the most aggressive types of cancer. The Simian virus 40 (SV40), which is a polyomavirus known for its oncogenic potential, was found as a contaminant of oral vaccines and has been related to human pleomorphic adenoma in the parotid gland. The aim of this study was to evaluate the presence of SV40 and 2 human polyomaviruses - BK virus (BKV) and JC virus (JCV) - in a large sample of SCCs of the oral cavity.Quantitative real-time polymerase chain reaction (PCR) was used to evaluate virus load.Overall, the prevalence of SV40, BKV, and JCV in oral SCC was negligible. Matched-pair case-control analysis indicated that prevalence among the controls did not significantly differ with respect to analyzed cases.The results did not indicate a major role for SV40, BKV, and JCV in the etiology of oral SCC. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21192">
<title>Detection of cervical metastases with 11C-tyrosine pet in patients with squamous cell carcinoma of the oral cavity or oropharynx: A comparison with 18F-FDG PET</title>
<link>http://dx.doi.org/10.1002%2Fhed.21192</link>
<description><![CDATA[A disadvantage of 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography (PET) in head and neck cancer is that 18F-FDG uptake is not specific to malignant tissue. To provide an alternative, radiolabeled amino acids such as L-1-[11C]-tyrosine (11C-TYR), were introduced because these are less avidly metabolized by inflammatory cells.In this prospective study, we compared both 11C-TYR PET and 18F-FDG PET performance in detecting cervical metastases in 27 patients with a squamous cell carcinoma (SCC) of oral cavity or oropharynx.11C-TYR PET sensitivity, specificity, and accuracy for detecting nodal metastases were 33%, 100%, and 81%, respectively. With respect to 18F-FDG PET, these figures were 67%, 97%, and 89%, respectively. Neck metastases not detected by 11C-TYR PET were camouflaged by high tracer uptake by salivary glands.Because of bilateral accumulation of 11C-TYR in salivary glands, 11C-TYR PET is not suitable to replace 18F-FDG PET in staging SCC of oral cavity and oropharynx. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21185">
<title>Ex vivo gene therapy using autologous dermal fibroblasts expressing hLMP3 for rat mandibular bone regeneration</title>
<link>http://dx.doi.org/10.1002%2Fhed.21185</link>
<description><![CDATA[Implantation of autologous skin fibroblasts transduced ex vivo with a replication-defective adenoviral vector, carrying the LIM mineralization protein-3 (Ad-LMP-3), and adsorbed on a hydroxyapatite/collagen (HA/COL) scaffold.Twenty-seven Wistar rats were used. A 5- × 5-mm full-thickness defect was created in the exposed mandible. All animals were randomized into 3 experimental groups: (1) autologous dermal fibroblasts transduced with Ad-LMP-3 and adsorbed on the HA/COL; (2) nontransduced dermal fibroblasts adsorbed on the HA/COL scaffold; and (3) HA/COL scaffold without cells. Three-dimensional micro-CT (3DmicroCT or 3D[mu]CT) and histological analysis were performed.Efficient neoosteogenesis was observed in animals treated with LMP-3-expressing cells (group 1) as soon as 4 weeks after surgery. Conversely, nonsignificant bone formation was detected in control animals (groups 2 and 3) at all time points tested.These results suggest that the experimental approach based on transplantation of genetically modified autologous cells could provide an alternative treatment for cranio-maxillo-facial defects. Nonetheless, additional data from the study on larger bone defects must follow to foresee a clinical application in the near future. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21183">
<title>Malakoplakia presenting as an enlarging neck mass: Case presentation and review of the literature</title>
<link>http://dx.doi.org/10.1002%2Fhed.21183</link>
<description><![CDATA[Malakoplakia is a very rare chronic inflammatory disorder, first described in 1902. In 75% of cases, the condition affects the genitourinary tract. Five cases of malakoplakia affecting the neck were previously reported in the literature.An 83-year-old woman presented with an enlarging mass in the posterior triangle of the neck that was histologically confirmed as malakoplakia. Presenting features are often nonspecific, and the diagnosis is dependent on histological findings. The characteristic microscopic findings are of Michaelis-Gutmann (M-G) bodies that stain positive with periodic acid-Schiff reagent, von Kossa's reaction for calcium, and Perl's ferrocyanide reaction to ferric iron.Although rare, a diagnosis of malakoplakia should be considered in patients with an enlarging mass. This may mimic the presentation of malignancy, particularly in patients in whom erosion through skin occurs, and histological confirmation is advocated. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21181">
<title>Multidimensional analysis of body image concerns among newly diagnosed patients with oral cavity cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21181</link>
<description><![CDATA[Body image is a critical psychosocial issue for patients facing treatment for oral cancer, yet there is limited research conducted in this area. This study uses a multidimensional approach to body image assessment and evaluates relationships between body image, demographic, health, and psychosocial variables.Newly diagnosed patients with oral cancer completed self-report questionnaires and a structured clinical interview.Most participants identified current and/or future body image concerns primarily related to impending surgery. Adequate psychometric properties were demonstrated on a range of body image measures. Depression was the strongest and most consistent predictor of body image outcomes.Preliminary evidence supports the importance of evaluating body image concerns in oral cancer patients prior to surgical intervention. Our findings have implications for developing validated body image tools and can be used to guide psychosocial interventions targeting body image disturbance. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21163">
<title>Metastases to level IIb in squamous cell carcinoma of the oral cavity: A systematic review and meta-analysis</title>
<link>http://dx.doi.org/10.1002%2Fhed.21163</link>
<description><![CDATA[In this study, a meta-analysis of level IIb metastases in squamous cell carcinoma (SCC) of the oral cavity was conducted.Two independent reviewers screened abstracts and full text papers deemed potentially relevant. Data were pooled using a random intercept model.In this analysis, 729 abstracts and 177 full text papers were screened (Kappa statistic 0.8 and 1.0, respectively). A total of 332 patients in 9 papers were included in the analysis. Twenty patients had level IIb metastases (mean, 6%; range, 0% to 10.4%). The pooled percentage of level IIb metastases was 6.0% (95% CI: 3.5-8.6). Only 3 patients with level IIb metastases had isolated nodal disease. Eighty-five percent of those with level IIb metastases had additional nodal disease (95% CI: 64.0-94.8), with IIa being a common denominator among all.Level IIb nodal metastases are relatively uncommon in previously untreated SCC of the oral cavity (6%). Furthermore, isolated level IIb nodal disease is uncommon. However, given the quality of evidence to date, it is recommended that dissection of level IIb remain the standard of care in oral cavity squamous cell cancer. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21174">
<title>Nutrition impact symptoms: Key determinants of reduced dietary intake, weight loss, and reduced functional capacity of patients with head and neck cancer before treatment</title>
<link>http://dx.doi.org/10.1002%2Fhed.21174</link>
<description><![CDATA[Our aim was to evaluate the prevalence and relationship of symptoms with reduced dietary intake, weight, and functional capacity in patients with head and neck cancer.Three hundred forty-one patients were prospectively screened with the patient-generated subjective global assessment before treatment. Logistic analysis was used to relate symptoms to reduced dietary intake, weight, and functional capacity. Cumulative hazard analysis was performed to determine the time and risk of weight loss of each symptom. Survival analysis was performed with Cox proportional hazards model.Anorexia, dysphagia, mouth sores, and others were significant predictors of reduced dietary intake and weight. Symptom presence accelerated the time and probability of weight loss. Body mass index [le]18.5 related to overall survival (p value = .001).Symptoms present before treatment may adversely affect the dietary intake, weight, and functional capacity of patients. Symptom treatment and management is critical to weight loss prevention. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21178">
<title>Detectable BRAF mutation in serum DNA samples from patients with papillary thyroid carcinomas</title>
<link>http://dx.doi.org/10.1002%2Fhed.21178</link>
<description><![CDATA[An activating point mutation of the BRAF oncogene results in a V600E amino acid missense mutation found in a majority of papillary thyroid carcinomas (PTC).In this study, 28 matched tumor and serum samples obtained from patients with both benign and malignant thyroid disorders were analyzed for BRAF mutation using a gap-ligase chain reaction technique.The BRAF mutation was absent in tumor DNA samples obtained from patients with benign adenomas, follicular neoplasms or carcinoma, and thyroid lymphoma. In contrast, 5 of 14 PTC tumors were positive for the BRAF mutation. Moreover, 3 of 14 patients with PTC were positive for BRAF mutation in serum and tumor. Of these 3 patients, 2 had lymph node metastasis and 2 had PTC in background of the Hashimoto's thyroiditis.The detection of free circulating mutant BRAF in patients with PTC is possible and future studies are warranted to determine its clinical significance. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21152">
<title>Juvenile nasopharyngeal angiofibroma recurrence associated with exogenous testosterone therapy</title>
<link>http://dx.doi.org/10.1002%2Fhed.21152</link>
<description><![CDATA[Juvenile nasopharyngeal angiofibromas (JNAs) are rare benign lesions that express hormonal receptors. This report describes a recurrence of a JNA 20 years after excision associated with exogenous testosterone therapy.A 36-year-old man developed a sphenoid mass 20 years following resection of a JNA, shortly after initiating exogenous testosterone therapy for symptomatic low endogenous testosterone.The mass was subsequently excised and was histologically consistent with a JNA. The patient resumed his testosterone therapy postoperatively. Repeated imaging has demonstrated no recurrence after 3 years.This unique case adds further evidence to the role of testosterone in the pathogenesis of JNAs. Exogenous testosterone can cause tumor regrowth at any time, even decades following treatment. The patients with a history of JNA, even those without recurrence for years, should weigh the risk of recurrence before the use of exogenous testosterone. © 2009 Wiley Periodicals, Inc. Head Neck, 2009]]></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.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.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.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.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.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.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.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.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.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.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.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.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.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.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.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.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>

</rdf:RDF>