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<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_alabama/page_1.html">
<title>HAND SPECIALTY IN CENTRAL AL :: Alabama :: Minerva Recruiting</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_alabama/page_1.html</link>
<description><![CDATA[  Orthopedic practice located in southeast looking for hand physician.   Base plus bonus.  Will re-evaluate after one year and if physician is on track, physician could make partner within one year.  ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_kentucky/page_1.html">
<title>Minutes from Lexington :: Kentucky :: Nationwide Physician Recruitment</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_kentucky/page_1.html</link>
<description><![CDATA[ You will have an outstanding quality of life and phenomenal earning potential with this position.  This is a private practice of two orthopedic surgeons specialized in sports medicine and spine looking ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_north_carolina/page_1.html">
<title>Southern Pines :: North Carolina :: Medical Search International</title>
<link>http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_north_carolina/page_1.html</link>
<description><![CDATA[A busy practice located in a beautiful community 90 minutes East of Charlotte is seeking an Orthopedic Surgeon to joint their specialty group. The ideal candidate will be either a BC/BE Orthopod or a ]]></description>
</item>

<item rdf:about="http://www.physemp.com/physician_jobs/all_orthopedic_hand_jobs_in_texas/page_2.html">
<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>
</item>

<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fwww.philly.com%2Finquirer%2Fmagazine%2F20100208_Personal_Health__News_and_Notes.html&#x26;usg=AFQjCNG0HcfRQrnvitp9yaXZoUvtHVAy1w">
<title>Personal Health: News and Notes - Philadelphia Inquirer</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fwww.philly.com%2Finquirer%2Fmagazine%2F20100208_Personal_Health__News_and_Notes.html&#x26;usg=AFQjCNG0HcfRQrnvitp9yaXZoUvtHVAy1w</link>
<description><![CDATA[Personal Health: News and NotesPhiladelphia InquirerThat&#39;s the conclusion of a new study in the current issue of Otolaryngology - Head and Neck Surgery. The study authors gave questionnaires to 88 children ...]]></description>
</item>

<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fwww.times-standard.com%2Fothervoices%2Fci_14352875&#x26;usg=AFQjCNH-uTuMpuN_k7M0ErUPE0B70_1_wg">
<title>Males more likely than females to have noise-related hearing loss - Times-Standard</title>
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<description><![CDATA[Males more likely than females to have noise-related hearing lossTimes-StandardRecent research presented by the American Academy of Otolaryngology (Head and Neck Surgery) in San Diego concluded that males are three times more likely to ...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.nytimes.com%2F2010%2F02%2F02%2Fhealth%2Fresearch%2F02children.html&#x26;usg=AFQjCNExobBlfGhu7yDqhQXoK9PihSnxrg">
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<description><![CDATA[TheMedGuruChildren: Quality of Life With Cochlear ImplantsNew York Times1 issue of Otolaryngology — Head and Neck Surgery. Though the overall quality-of-life scores were very similar to those of the control group, ...Kids with cochlear implants more confident, finds studyTheMedGuruKids with cochlear implants rank quality of life equal to normally hearing peersOneindiaKids with cochlear implants and normal hearing ability have same quality of lifebolohealth.comIvanhoeall 24 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.theplasticsurgerychannel.com%2Fbreaking-news%2Fplastic-surgery-creates-blinking-device.html&#x26;usg=AFQjCNGIg6ErKuAHLOZXGSbwDUDXO4aGsg">
<title>Plastic Surgery Creates Blinking Device - The Plastic Surgery Channel</title>
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<description><![CDATA[The Plastic Surgery ChannelPlastic Surgery Creates Blinking DeviceThe Plastic Surgery Channel... Otolaryngology – Head and Neck Surgery, a lead researcher in the study of alternative methods for eyelid rehabilitation in permanent facial paralysis. ...&quot;Healthcare&quot; Dilemma? Plastic Surgeons Seek a PR FaceliftHuffington Post (blog)all 2 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.24-7pressrelease.com%2Fpress-release%2Frespected-surgeon-dr-dean-toriumi-discovers-new-technique-to-correct-a-droopy-nasal-tip-135516.php&#x26;usg=AFQjCNFHVbpEJMtUZk2hFT36V6JN2dyjBA">
<title>Respected Surgeon Dr. Dean Toriumi Discovers New Technique to Correct a Droopy ... - 24-7PressRelease.com (press release)</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fwww.24-7pressrelease.com%2Fpress-release%2Frespected-surgeon-dr-dean-toriumi-discovers-new-technique-to-correct-a-droopy-nasal-tip-135516.php&#x26;usg=AFQjCNFHVbpEJMtUZk2hFT36V6JN2dyjBA</link>
<description><![CDATA[24-7PressRelease.com (press release)Respected Surgeon Dr. Dean Toriumi Discovers New Technique to Correct a Droopy ...24-7PressRelease.com (press release)Dean M. Toriumi, MD is a full time faculty member of the Department of Otolaryngology - Head and Neck Surgery, and Head of the Division of Facial Plastic ...Respected Surgeon Dr. Dean Toriumi Discovers New Technique to Correct a Droopy ...India Business Blog (blog)all 3 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.sciencedaily.com%2Freleases%2F2010%2F01%2F100118161937.htm&#x26;usg=AFQjCNHVjY2myRjH4ZmLVdZ9g_ZJZpO0Nw">
<title>Complications Common, Often Linked to Trauma in Children Receiving Cochlear ... - 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%2F2010%2F01%2F100118161937.htm&#x26;usg=AFQjCNHVjY2myRjH4ZmLVdZ9g_ZJZpO0Nw</link>
<description><![CDATA[Complications Common, Often Linked to Trauma in Children Receiving Cochlear ...Science Daily (press release)... inner ear malformation, according to a report in the January issue of Archives of Otolaryngology-Head &amp; Neck Surgery, one of the JAMA/Archives journals. ...Kids with Bionic Ears Have Trouble Controlling Their VoicesMedPage TodayVoice Control Needs Time to Develop After Cochlear ImplantBusinessWeekCochlear Implantation Often Problematic for Children Studies show high rates ...ModernMedicineDaily News & Analysisall 43 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.wsoctv.com%2Fhealth%2F22332315%2Fdetail.html&#x26;usg=AFQjCNEPJQ4SpRCzNQRqe__bZV2ihlxFCw">
<title>Head and Neck Cancer - WSOCtv.com</title>
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<description><![CDATA[Head and Neck CancerWSOCtv.comAccording to the American Academy of Otolaryngology – Head and Neck Surgery, about 55000 cases of head and neck cancer will be diagnosed in the US this year ...]]></description>
</item>

<item rdf:about="http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fwww.prweb.com%2Freleases%2F2010%2F02%2Fprweb3563894.htm&#x26;usg=AFQjCNFVhTPFUcFQCQXvIjh1_AYDv9Ia-w">
<title>Dr. Jack Gunter One of 2009&#x27;s &#x27;Best Doctors in Dallas,&#x27; Rhinoplasty Surgeon ... - PR Web (press release)</title>
<link>http://news.google.com/news/url?fd=R&#x26;sa=T&#x26;url=http%3A%2F%2Fwww.prweb.com%2Freleases%2F2010%2F02%2Fprweb3563894.htm&#x26;usg=AFQjCNFVhTPFUcFQCQXvIjh1_AYDv9Ia-w</link>
<description><![CDATA[PR Web (press release)Dr. Jack Gunter One of 2009&#39;s &#39;Best Doctors in Dallas,&#39; Rhinoplasty Surgeon ...PR Web (press release)He is a member of the American Academy of Otolaryngology-Head &amp; Neck Surgery, American Society of Plastic Surgeons, the American Society for Aesthetic ...]]></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.prnewswire.com%2Fnews-releases%2Fdr-randy-miller-is-named-president-elect-of-the-florida-society-of-plastic-surgeons-83486697.html&#x26;usg=AFQjCNHARV76IQbFkzJBwgARC5Rj1ZPJmA">
<title>Dr. Randy Miller Is Named President-Elect of the Florida Society of Plastic ... - PR Newswire (press release)</title>
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<description><![CDATA[Dr. Randy Miller Is Named President-Elect of the Florida Society of Plastic ...PR Newswire (press release)He is certified by the American Board of Plastic Surgery and the American Board of Otolaryngology – Head and Neck Surgery. After earning a Bachelor of Arts ...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.nhl.com%2Fice%2Fnews.htm%3Fid%3D515915&#x26;usg=AFQjCNGCCkjFXr8BrpklwbJvYNqxMffJVg">
<title>Borer returns after neck surgery - NHL.com</title>
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<description><![CDATA[Borer returns after neck surgeryNHL.com&quot;I was sleeping on the right side of the bus ... and I fell through the air and hit my head on the (left) luggage rack. I couldn&#39;t believe it. ...and more&nbsp;&raquo;]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21348">
<title>Risk of third and fourth tumors in patients with head and neck cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21348</link>
<description><![CDATA[The objective of our study was to analyze the incidence and location of second and subsequent tumors in patients after an index head and neck carcinoma.A retrospective study was made by reviewing clinical data prospectively collected from 3631 patients with head and neck cancer. Incidence, location, and histology of the second, third, and fourth tumors was evaluated.During the follow-up, 839 second tumors, 147 third tumors, and 35 fourth tumors were diagnosed. The annual hazard ratio was 3.8% for second tumors, 5.1% for third tumors, and 7.8% for fourth tumors. The risk of second and subsequent neoplasms remained constant throughout the follow-up. There were significant differences in the risk of appearance between the second and third tumors (p < .0001), and between the third and fourth tumors (p = .005).Patients with a second tumor after an index head and neck carcinoma have an increased risk for developing subsequent tumors. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21334">
<title>Impact of positive frozen section microscopic tumor cut-through revised to negative on oral carcinoma control and survival rates</title>
<link>http://dx.doi.org/10.1002%2Fhed.21334</link>
<description><![CDATA[The objective of the study was to evaluate the prognostic and therapeutic implications of an initial positive frozen section margin that was revised until negative (microscopic tumor cut-through), and to analyze the influence of microscopic margin status on oral carcinoma control.The approach in our investigation was through a retrospective review of patients treated with primary surgery, with frozen section margin control in oral carcinoma. Inclusion criteria included availability of frozen and permanent section histology reports of resection margins and negative final resection margins.Of 547 patients studied, 175 received adjuvant radiation. Local and regional control and disease-specific survival rates were 81.6%, 78.4%, and 76.3%, respectively. Tumor cut-through and pathologic nodal (pN) stage had an independently adverse effect on local control. Tumor cut-through adversely affected cancer control and survival, but this effect diminished significantly in the absence of regional disease.Microscopic tumor cut-through revised to negative margins is a powerful prognosticator that is observed only when regional disease is also present. The value of adjuvant therapeutic regimens is questionable in patients with microscopic tumor cut-through, revised to negative margins, and with no regional disease. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21309">
<title>Ophthalmoplegia secondary to raised intracranial pressure after unilateral neck dissection with internal jugular vein sacrifice</title>
<link>http://dx.doi.org/10.1002%2Fhed.21309</link>
<description><![CDATA[Neck dissection is commonly performed in the management of head and neck malignancy and may involve internal jugular vein (IJV) sacrifice. Potential complications include intracranial hypertension. This is well documented after bilateral neck dissection, although only scattered reports exist after unilateral IJV sacrifice.A 54-year-old man underwent unilateral left modified radical neck dissection for T1N2b squamous cell carcinoma of the tongue base. He presented 13 days postoperatively with symptoms of headache and diplopia.Investigations revealed intracranial hypertension and bilateral abducens nerve palsies. He was treated with serial lumbar puncture, and his symptoms improved over the course of 2 weeks.Intracranial hypertension sufficient to cause visual disturbance is a serious complication of unilateral neck dissection. Head and neck surgeons must be aware of this and have a low threshold for investigation of the signs and symptoms of intracranial hypertension in the postoperative period. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21325">
<title>Characterization of side population cells from laryngeal cancer cell lines</title>
<link>http://dx.doi.org/10.1002%2Fhed.21325</link>
<description><![CDATA[Analysis of the hematopoietic system has shown that bone marrow stem cells contain a subpopulation that effluxes the DNA binding dye, Hoechst 33342, out of the cell membrane. These cells are called side population (SP) cells and have been shown to have stem cell characteristics. SP cells have already been found in solid tumors, although there are no published reports examining the role of SP cells in human laryngeal cancer.SP cells were identified in the laryngeal cancer cell lines, AMC-HN-8 (head and neck cancer cell line 8, from the Asan Medical Center) and Hep-2 (human epithelial type 2) cell lines, by flow cytometry. Hep-2 SP cells were isolated and analyzed in proliferation assays, differentiation studies, radiotherapy resistance studies, and tumorigenesis ability.The AMC-HN-8 and Hep-2 cell lines contained 11.8 ± 1.7% and 17.1 ± 2.0% SP cells, respectively. SP cell proportion was reduced by verapamil. Hep-2 SP cells exhibited higher self-regeneration, proliferation, radiotherapy resistance, and tumorigenicity.SP cells purified from the Hep-2 cell line harbor cancer stem cell-like properties, and they are heterogeneous, indicating that SP cells are not identical to stem cells. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21320">
<title>Usefulness of the combination of ultrasonography and 99mTc-sestamibi scintigraphy in the preoperative evaluation of uremic secondary hyperparathyroidism</title>
<link>http://dx.doi.org/10.1002%2Fhed.21320</link>
<description><![CDATA[The usefulness of the combination of technetium-99m-methoxyisobutylisonitrile (99mTc-MIBI) parathyroid scintigraphy and ultrasonography to detect parathyroid glands (PTGs) in secondary hyperparathyroidism (SHPT) is still controversial.In all, 21 patients with SHPT underwent parathyroidectomy. The sensitivity and specificity of ultrasonography and scintigraphy related to site, size, hyperplasia type of PTG, concomitant thyroid disease, and the frequency of intraoperative frozen sections were determined.The sensitivities of scintigraphy and ultrasonography were 62% and 55%, and the specificity was 95% for both procedures. The sensitivity of combined techniques was 73%. The scintigraphy detected 7/9 (78%) ectopic PTGs, whereas ultrasonography was always negative. A PTG maximum longitudinal diameter <8 mm, the presence of diffuse hyperplasia, the upper localization of glands, and the presence of concomitant thyroid disease reduced the sensitivity and specificity of imaging techniques. In cases of positive imaging, the rate of intraoperative frozen sections was significantly lower.The ultrasonography and sestamibi scintigraphy, which showed a higher sensitivity than that of either ultrasonography or scintigraphy alone, led to a reduction of intraoperative frozen sections and to preoperative diagnosis of ectopic (29%) or supernumerary PTGs (10%) and concomitant nodular thyroid disease (24%). © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21338">
<title>Proliferative activity and diagnostic delay in oral cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21338</link>
<description><![CDATA[Tumor stage may relate to the chronology of neoplasm growth and has been used as an outcome variable when studying diagnostic delay in oral cancer. However, tumor growth rate may act as a confounding factor.We reviewed a total of 63 incident cases of oral cancer. The variables considered for the study included age, sex, smoking history, tumor site, TNM stage, Ki-67 score, and diagnostic delay.Significant differences between survivors and exitus were found in terms of tumor stage at diagnosis (I-II vs III-IV), sex, and Ki-67 scores. When the analysis was adjusted for tumor stage at diagnosis (I-II vs III-IV), proliferative activity resulted to be an independent prognostic factor for survival, whereas diagnostic delay did not influence survival.These results seem to suggest that survival from oral cancer is affected more by the biology of the cancer (rapid tumor growth) than by diagnostic delay. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21336">
<title>Minimally invasive video-assisted total thyroidectomy: An easy to learn technique for skillful surgeons</title>
<link>http://dx.doi.org/10.1002%2Fhed.21336</link>
<description><![CDATA[Minimally invasive video-assisted total thyroidectomy (MIVATT) is a treating option for small thyroids that demands skills required for both traditional thyroidectomy and endoscopic surgery. This prospective study aims to define the learning curve for MIVATT for residents, with experience in traditional thyroid and laparoscopic surgery.In all, 36 MIVATTs for benign disease were evenly divided among 4 residents. We recorded and analyzed: age, sex, pathology, thyroid weight, duration of the operation, [Delta]Ca (postoperative minus preoperative calcemia), [Delta]WBC (postoperative minus preoperative white blood cell count), vocal motility, operative difficulty, postoperative vocal alteration, postoperative pain, complications, gram of gland excised per minute of the operation, conversion, and hospitalization.Statistically significant differences were observed in the different learning points, between duration of surgery (p < .001), operative difficulty (p = .022), grams of gland excised per minute of operation (p < .001), and WBC (p = .011).Surgeons that are experience in both thyroid and endoscopic surgery are subjects to a short learning curve concerning MIVATT. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21332">
<title>Predicting the pattern of regional metastases from cutaneous squamous cell carcinoma of the head and neck based on location of the primary</title>
<link>http://dx.doi.org/10.1002%2Fhed.21332</link>
<description><![CDATA[We aimed to analyze the distribution of regional nodal metastases according to primary tumor location in patients with cutaneous squamous cell carcinoma of the head and neck (SCCHN).Analysis of 295 neck dissections performed for patients with clinically evident regional metastases from cutaneous SCCHN between 1987 and 2009.Level I involvement in the absence of level II or III only occurred in patients with facial primaries. In patients with clear nodes in level II-III, the risk of level IV-V involvement was 0.0% for external ear primaries, 2.7% for face and anterior scalp, and 15.8% for posterior scalp and neck.In patients undergoing parotidectomy for metastatic cutaneous SCCHN with a clinically negative neck, the results of this study support selective neck dissection including level I-III for facial primaries, level II-III for anterior scalp and external ear primaries, and levels II-V for posterior scalp and neck primaries. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21331">
<title>Clinicopathologic and therapeutic risk factors for perioperative complications and prolonged hospital stay in free flap reconstruction of the head and neck</title>
<link>http://dx.doi.org/10.1002%2Fhed.21331</link>
<description><![CDATA[We aimed to determine predictors of morbidity in patients undergoing microvascular free flap reconstruction of the head and neck.We prospectively evaluated 796 cases between 1999 and 2007 using univariate and multivariate analysis to determine predictors of morbidity and prolonged hospital stay.Two hundred thirty-nine patients (30%) developed major complications. Age, body mass index (BMI), American Society of Anesthesiology (ASA) score, Kaplan Feinstein comorbidity index (KFI) score, preoperative hemoglobin, and tracheostomy were independent predictors of major complication. Predictors of prolonged hospital stay included age, recent weight loss, alcohol excess, ASA, KFI, preoperative hemoglobin, mucosal surgery, anesthesia duration, and crystalloid replacement volume.Several variables are associated with an increased risk of development of major complications following free flap reconstruction of the head and neck. Although many of these variables are irreversible, they aid risk stratification of patients undergoing free flap reconstruction, and assist clinicians in making treatment decisions, consenting, and providing patients with realistic expectations regarding their perioperative course. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21330">
<title>Higher incidence of head and neck cancers among Vietnamese American men in California</title>
<link>http://dx.doi.org/10.1002%2Fhed.21330</link>
<description><![CDATA[Our aim was to determine the incidence rates of head and neck cancer in Vietnamese Californians compared with other Asian and non-Asian Californians.Age-adjusted incidence rates of head and neck cancer between 1988 and 2004 were computed for Vietnamese Californians compared with other racial/ethnic groups by time period, ethnicity, neighborhood-level socioeconomic status (SES), and sex using data from the population-based California Cancer Registry (CCR). Data by smoking and alcohol status were tabulated from the California Health Interview Survey.Vietnamese men had a higher incidence rate of head and neck cancer than other Asian men. Specifically, the laryngeal cancer rate was significantly higher for Vietnamese men (6.5/100,000; 95% confidence interval [CI], 5.0-8.2) than all other Asian men (range, 2.6-3.8/100,000), except Korean men (5.1/100,000; 95% CI, 3.9-6.4). Both Vietnamese and Korean men had the highest percentage of current smokers. Neighborhood SES was inversely related to head and neck cancer rates among Vietnamese men and women.The higher incidence rate of head and neck cancer in Vietnamese men may correspond to the higher smoking prevalence in this group. Individual-level data are needed to establish the link of tobacco, alcohol, and other risk factors with head and neck cancer in these patients. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21329">
<title>Noninfectious painful neck mass mimicking malignancy in a child</title>
<link>http://dx.doi.org/10.1002%2Fhed.21329</link>
<description><![CDATA[A large painful mass on the posterior neck of a child of a relatively short duration is uncommon. Barring infectious origin, differential diagnosis can be difficult without a definitive biopsy.A 12-year-old girl had a markedly painful posterior neck mass and limitation of neck motion without fever for 1 month. The rapid clinical course and poorly defined marginal zone of the CT images led to suspicion of malignancy. Although the initial frozen section suggested low-grade fibrosarcoma, a successful wide excision and paraffin pathology confirmed the diagnosis of myositis ossificans circumscripta (MOC) from the semispinalis capitis muscle.The occurrence of MOC in children is rare and may easily be misdiagnosed as soft tissue sarcoma. Both knowledge of the disease and guidelines for taking an aggressive biopsy sample are essential for correct diagnosis and appropriate treatment. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21328">
<title>Usefulness of intraoperative parathyroid hormone measurements in patients with renal hyperparathyroidism</title>
<link>http://dx.doi.org/10.1002%2Fhed.21328</link>
<description><![CDATA[In renal hyperparathyroidism, it remains unclear whether intraoperative parathyroid hormone (PTH) measurements can predict postoperative outcome and guide the extent of surgical exploration.In 42 parathyroidectomies for renal hyperparathyroidism, we analyzed the predictive value of the Miami Criterion of 50% intraoperative PTH decrease. We used receiver operating characteristic (ROC) curves to find the criterion with the best diagnostic performance. We also investigated whether the whole PTH assay improved accuracy.Twenty-six operations (62%) resulted in normal postoperative PTH. With the Miami Criterion, cure was predicted with a sensitivity of 95% and specificity of only 8%. Specificity could be improved to 50% using a 70% PTH decrease as cut-off level. The whole PTH assay did not improve accuracy.Prediction of cure after parathyroidectomy for renal hyperparathyroidism might be improved with a criterion of 70% PTH decrease 10 minutes after excision of all parathyroid glands. Prospective analysis needs to validate this new criterion. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21324">
<title>Investigation of optimal intensity and safety of electrical nerve stimulation during intraoperative neuromonitoring of the recurrent laryngeal nerve: a prospective porcine model</title>
<link>http://dx.doi.org/10.1002%2Fhed.21324</link>
<description><![CDATA[Intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) has recently been more frequently applied in thyroid surgery. However, concerns have been raised regarding the safety and optimal intensity of electrical nerve stimulation.Eight piglets were enrolled, and electrically evoked electromyography (EMG) was recorded from the vocalis muscles via endotracheal surface electrodes. The baseline EMG was measured and continuous pulsatile stimulations were performed on the vagus nerve and RLN for 10 minutes. Changes of EMG waveform and cardiopulmonary status were analyzed.A dose-response curve existed with increasing EMG amplitude as stimulating current was increased, with maximum amplitude elicited on vagal and RLN stimulation at <1 mA. No obvious EMG changes and untoward cardiopulmonary effects were observed after the stimulation.Electrical stimulation is safe during IONM in this porcine model. Minimal current that required generating the maximal evoked EMG, approximately 1 mA in this study, can be selected to minimize the risk of nerve damage and cardiopulmonary effects. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21321">
<title>Optical and molecular techniques to identify tumor margins within the larynx</title>
<link>http://dx.doi.org/10.1002%2Fhed.21321</link>
<description><![CDATA[Failure to remove tumor cells from the larynx significantly increases the risk of local recurrence following surgical excision. Healthy tissue must be preserved to optimize long-term vocal and swallowing function. It is essential to accurately distinguish between healthy mucosa, dysplasia, and invasive carcinoma. Optical and molecular examining technologies have been developed to improve tumor margin identification in vivo. We aimed to review the efficacy of these technologies. Published articles were identified using MEDLINE, EMBASE, and Cochrane central register of controlled trials (CENTRAL). Randomized clinical trials are required to establish the benefit to patients and cost to the health service of using 5-aminolevulinic acid (ALA)-induced fluorescent imaging, contact endoscopy, and optical coherence tomography (OCT). Furthermore, primary research is required to validate other techniques, such as confocal endomicroscopy and Raman spectroscopy, and to develop their clinical applications in the larynx. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21339">
<title>Importance of intraoperative parathyroid hormone measurement in the diagnosis of parathyroid lipoadenoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21339</link>
<description><![CDATA[Background.Parathyroid lipoadenoma is an uncommon tumor that may be difficult to diagnose on intraoperative frozen section. Intraoperative parathyroid hormone (PTH) measurement is useful in assessing the adequacy of parathyroidectomy. This case demonstrates the value of intraoperative PTH measurement in recognizing a parathyroid lipoadenoma.Methods and Results.A case of a 62-year-old woman with primary hyperparathyroidism in which intraoperative PTH measurement helped confirm the diagnosis of parathyroid lipoadenoma is presented.Conclusions.In patients with primary hyperparathyroidism, a significant decrease in intraoperative PTH confirms that an enlarged parathyroid with normal to low cellularity containing abundant fat is a lipoadenoma and that further exploration is not necessary. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21337">
<title>Hypopharyngeal perforation during endoscopic ultrasound treated by primary repair</title>
<link>http://dx.doi.org/10.1002%2Fhed.21337</link>
<description><![CDATA[Background.An endoscopic ultrasound scan is a common procedure used to diagnose conditions of the upper gastrointestinal tract. We present a case of hypopharyngeal perforation complicating endoscopic ultrasound scan treated with primary surgical repair.Methods and Results.A 62-year-old woman underwent an endoscopic ultrasound scan for investigation of a pancreatic lesion. A high esophageal perforation occurred during the procedure. She underwent emergency repair of this perforation via an external approach. Unfortunately her recovery was complicated by a pleural effusion which required a chest drain. She made a complete recovery, which was confirmed with a barium swallow.Discussion.Upper esophageal perforation is a rare complication of an endoscopic ultrasound scan and, to our knowledge, there have been no reported cases of hypopharyngeal perforation. The risk factors, incidence, and management of perforations are reviewed. Early recognition of hypopharyngeal perforation is important and, in selected cases, immediate repair of the defect can lead to a good result. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21335">
<title>Expression of placenta growth factor: An independent factor for prediction of progression and prognosis of oral cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21335</link>
<description><![CDATA[Background.Expression of placenta growth factor (PlGF) is found to correlate with the progression and prognosis of several human cancers.Methods.This study used an immunohistochemical technique to examine the expression of PlGF in 100 specimens of oral squamous cell carcinoma (OSCC).Results.We found that the higher mean PlGF labeling index was significantly associated with OSCCs with positive lymph node metastasis (p = .014) or with more advanced clinical stages (p = .016). Positive lymph node metastasis (p = .008) and PlGF labeling index >40% (p = .010) were identified as independent unfavorable prognosis factors by multivariate analyses with Cox regression model. Moreover, a Kaplan-Meier curve showed that OSCC patients with a PlGF labeling index >40% had a significantly poorer cumulative survival than those with a PlGF labeling index [le]40% (log-rank test, p = .003).Conclusions.The PlGF labeling index can predict the progression and prognosis of OSCCs in Taiwan. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21315">
<title>Single-marker identification of head and neck squamous cell carcinoma cancer stem cells with aldehyde dehydrogenase</title>
<link>http://dx.doi.org/10.1002%2Fhed.21315</link>
<description><![CDATA[In accord with the cancer stem cell (CSC) theory, only a small subset of cancer cells are capable of forming tumors. We previously reported that CD44 isolates tumorigenic cells from head and neck squamous cell cancer (HNSCC). Recent studies indicate that aldehyde dehydrogenase (ALDH) activity may represent a more specific marker of CSCs.Six primary HNSCCs were collected. Cells with high and low ALDH activity (ALDHhigh/ALDHlow) were isolated. ALDHhigh and ALDHlow populations were implanted into NOD/SCID mice and monitored for tumor development.ALDHhigh cells represented a small percentage of the tumor cells (1% to 7.8%). ALDHhigh cells formed tumors from as few as 500 cells in 24/45 implantations, whereas only 3/37 implantations of ALDHlow cells formed tumors.ALDHhigh cells comprise a subpopulation cells in HNSCCs that are tumorigenic and capable of producing tumors at very low numbers. This finding indicates that ALDH activity on its own is a highly selective marker for CSCs in HNSCC. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21327">
<title>Neural outcomes after plasma knife dissection: A pathologic study and clinical correlation</title>
<link>http://dx.doi.org/10.1002%2Fhed.21327</link>
<description><![CDATA[The initial aim was to determine the rate of pathologic tissue damage when dissecting the rat sciatic nerve with either bipolar forceps or low-temperature tripolar plasma knife. The second aim was to determine the safety and effectiveness of the plasma knife during parotid surgery.A prospective, randomized, single-blind study was performed on 40 rat sciatic nerves dissected by either bipolar electrocautery with a cold knife or a plasma knife. Dissected nerves were excised and submitted blindly to pathology for analysis of nerve injury. The degree of nerve trauma was graded by the Carlander nerve injury classification. Separately, a review was performed on the facial nerve outcomes of 30 patients who underwent plasma knife parotidectomy.No thermal or neural injury was noted in the 40 rat sciatic nerves dissected by either bipolar electrocautery or plasma knife (p = 1.0). Two plasma knife-dissected nerves (8%) demonstrated significant numbers of mast cells in the perineural soft tissue. In 30 patients undergoing plasma knife-parotidectomy, 10 (33%) had mild weakness of 1 or 2 preserved facial nerve branch postoperatively (House-Brackmann 2) that resolved within 1 month, whereas 2 (7%) had visible weakness in 1 branch (HB 3) that normalized after 3 months of follow-up.Plasma knife nerve dissection seems to be a safe and effective alternative to conventional methods. This technique may confer some advantages over conventional methods with the ability to simultaneously cut and coagulate tissue with minimal thermal spread and electrical stimulation of adjacent neural structures. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21326">
<title>Modern management and pathophysiology of ranula: Literature review</title>
<link>http://dx.doi.org/10.1002%2Fhed.21326</link>
<description><![CDATA[There is a lack of consensus about the appropriate treatment of ranula. The objective of the present investigation was to produce a scientific basis for treatment.A review of the relevant literature is interpreted in the light of improved knowledge about the local anatomy and the pathophysiology of the salivary glands.The oral and plunging ranulas are cystic extravasation mucoceles that arise from the sublingual gland and usually from a torn duct of Rivinus. The sublingual gland is a spontaneous secretor and the salivary flow is resistant to obstruction, which is caused by fibrosis induced by the extravasation. The submandibular gland is not a spontaneous secretor, is less resistant, and does not give rise to ranulas.Effective treatment is removal of the involved unit of the sublingual gland or inducing sufficient fibrosis to seal the leak through which the mucus extravasates. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21323">
<title>Immunotherapy using allogeneic squamous cell tumor-dendritic cell fusion hybrids</title>
<link>http://dx.doi.org/10.1002%2Fhed.21323</link>
<description><![CDATA[Tumor-associated antigens (TAAs) are known to be immunotherapy targets; thus tumor-sharing TAA may be used as a fusion hybrid partner to confer protection against subsequent tumor challenge.The squamous cell carcinomas (SCCs), SCCVII and B4B8, were used in C3H/HEN mice: SCCVII (H-2k) is syngeneic, B4B8 (H-2d) is allogeneic. Experiments using tumor alone included hyperimmunization schedule, subdermal and intranodal routes. Mice were challenged 2 weeks later. Fusion hybrids were created from both SCC tumor cell lines and syngeneic dendritic cells (DCs). These were delivered intranodally for immunization, and mice were challenged with tumor 2 weeks later.Only syngeneic tumor given subdermally was able to protect after tumor challenge 2 weeks later. Hyperimmunization schedule did not alter these findings. However, fusion hybrid immunization from both allogeneic and syngeneic SCCs conferred protection after tumor challenge.Allogeneic tumor-DC fusion hybrids targeting TAA can protect against subsequent tumor challenge. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21322">
<title>Predictors of functional decline in locally advanced head and neck cancer patients from South Brazil</title>
<link>http://dx.doi.org/10.1002%2Fhed.21322</link>
<description><![CDATA[Functional decline in Brazilian patients with head and neck squamous cell carcinoma (HNSCC) is associated with impaired recovery, quality of life, and health care costs.Sixty patients enrolled at the regional oncology center in Curitiba, Brazil, were assessed over 6 months for toxicities, nutritional status, anthropometry, fatigue, stress, and functionality.Severe mid-arm and mid-calf circumference depletion accompanied weight loss. Total fatigue score increased 64% (p < .001), as did perceived stress and serum cortisol (p = .01). Instrumental activities of daily living (IADL) dependence doubled, and activities of daily living (ADL) dependence quadrupled (p < .001). Difficulty chewing or swallowing, weight loss, fatigue, perceived stress, and IADL dependence accounted for 48.2% of ADL dependence.The physical and psychological impact of HNSCC and its treatment are universally experienced; yet, screening and intervention for symptoms such as fatigue and stress are not typical clinical practice. Moreover, assessment of functional status is usually limited to chewing and swallowing. This study identified symptoms that require systematic intervention and randomized trials with functional independence as the outcome. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21319">
<title>Role of pretreatment 18FDG-PET/CT in surgical decision-making for head and neck cancers</title>
<link>http://dx.doi.org/10.1002%2Fhed.21319</link>
<description><![CDATA[Despite widespread use, the utility of pretreatment positron emission tomography/computed tomography (PET/CT) remains undefined. In this study, we aim to determine its accuracy in nodal disease.In all, 111 patients managed between 2003 and 2007 were analyzed.For squamous cell cancers (SCCs) with any increased nodal uptake (mild to high), sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) were 75%, 95%, 85%, and 90%. However, if PET was deemed positive for only moderate to high uptake, sensitivity, specificity, PPV, and NPV were 71%, 95%, 85%, and 89%. In patients undergoing elective neck dissection, the accuracy was lower: for any increased uptake, sensitivity, specificity, PPV, and NPV were 66%, 96%, 83%, and 92%, whereas for moderate to high uptake, these were 52%, 97%, 79%, and 89%.Despite advances in PET/CT technology, these statistics suggest that PET/CT is not sufficiently accurate to direct superselective neck dissections, or to guide therapeutic decisions in the N0 neck. © 2010 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21317">
<title>Intrinsic differences in cisplatin sensitivity of head and neck cancer cell lines: Correlation to lysosomal pH</title>
<link>http://dx.doi.org/10.1002%2Fhed.21317</link>
<description><![CDATA[Cisplatin treatment is beneficial for approximately 20% of patients with head and neck squamous cell carcinoma (HNSCC). Tools to predict the clinical outcome and evaluate intrinsic cisplatin sensitivity are, therefore, required.Cisplatin sensitivity, lysosomal pH, and cell death pathway was studied in 5 HNSCC lines and compared with normal oral keratinocytes.We identified a linear relationship between lysosomal pH and cisplatin sensitivity. Reduced lysosomal acidification was correlated to decreased expression of the V0V1-ATPase B2 subunit, which is part of the lysosomal acidifying complex. Cisplatin caused apoptosis accompanied by lysosomal membrane permeabilization, and inhibition of lysosomal proteases (cathepsins) partly prevented cell death.Cisplatin-induced apoptosis of HNSCC is more efficient in cell lines with low lysosomal pH and is mediated by the release of lysosomal content. Lysosomal pH and expression of V0V1-ATPase subunits are possible future markers of intrinsic cisplatin sensitivity. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21314">
<title>Prognostic value of MAGE-A and NY-ESO-1 expression in pharyngeal cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21314</link>
<description><![CDATA[The prognostic value of cancer testis antigens in pharyngeal cancer is understudied.We recruited 90 patients who were treated for pharyngeal cancer. Monoclonal antibodies 57B and B9.8.1.1 were used for detection of MAGE-A and NY-ESO-1 genes.MAGE-A and NY-ESO-1 gene products were detectable in 70.0% and 33.3% of pharyngeal tumors, respectively. No correlation was established between MAGE-A and NY-ESO-1 expression and TNM staging at presentation. Survival analysis showed a trend toward a shorter 5-year disease-free survival in the group of patients with MAGE-A-positive tumors (log-rank test, p = .122). In contrast, a trend toward a prolonged 5-year disease-free survival was observed in the group of patients with NY-ESO-1-positive tumors (log-rank test, p = .219).In a large population of patients with pharyngeal cancer and available 5-year survival data, prognosis tended to be poorer with MAGE-A expression and better with NY-ESO-1 expression, but the correlations did not reach statistical significance. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21316">
<title>Interpretation of treatment outcome in the clinically node-negative neck in primary parotid carcinoma: A systematic review of the literature</title>
<link>http://dx.doi.org/10.1002%2Fhed.21316</link>
<description><![CDATA[Critical evaluation of outcome of primary parotid carcinoma treatment is limited by pathologic diversity and low incidence numbers. Scientific evidence for the optimal management of the N0-neck is scarce and was, therefore, investigated in a systematic literature review.The articles included were published in English between 1997 and 2007 and describe populations with the definitive pathology, staging, and treatment. Of 1104 articles, 19 were selected, describing 2703 patients.Of eligible populations, 83% were clinically N0. Pathology reporting of elective lymph node dissection (ELND) had limitations, but 23% showed occult metastases. Regional recurrence occurred in 5% of patients.The discrepancy between the relatively high percentage of occult metastases and reported low regional recurrence rates may indicate the efficacy of treatment, being either ELND or radiotherapy of the neck. Pooling, standardized collection, and reporting of data are essential in comparing outcomes in populations to determine optimal treatment. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21313">
<title>Incidence and circumstances of cervical hematoma complicating thyroidectomy and its relationship to postoperative vomiting</title>
<link>http://dx.doi.org/10.1002%2Fhed.21313</link>
<description><![CDATA[Cervical hematoma is hardly a predictable complication of thyroid surgery. Postoperative vomiting has been reported as a likely risk factor.Five hundred sixty-two patients undergoing thyroidectomy were prospectively enrolled in the study and divided into 2 groups. Patients in group A received ondansetron to prevent postoperative vomiting. In group B, patients with low vomiting risk received ondansetron whereas patients at high risk received ondansetron plus dexamethasone. Postoperative outcomes of the groups were analyzed and compared.Cervical hematomas developed in 3 patients (0.53%): 2 in group A and 1 in group B. All hematomas occurred after 6 hours. The incidence of postoperative vomiting was 11.4% in group A and 6.4% in group B (p = .04).Careful hemostasis remains of prime importance in preventing cervical hematoma. Postoperative vomiting has not been confirmed by this study as a risk factor for the development of hematoma. Ambulatory thyroid surgery is not advisable. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21310">
<title>Narrow-band imaging for detecting early recurrent nasopharyngeal carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21310</link>
<description><![CDATA[Detection of early recurrent nasopharyngeal carcinoma (NPC) is clinically challenging. Narrow-band imaging (NBI) is powerful in detecting early superficial lesions in the head and neck, although the utility of NBI in detecting nasopharyngeal cancer is still unknown.We describe a case of a 51-year-old man with early recurrent NPC detected in subclinical stage by NBI coupled with conventional endoscopy. MRI revealed no obvious bulging or inward invasion over the nasopharynx. Because of superficial, localized recurrence, we performed laser nasopharyngectomy and his postoperation course was uneventful.We demonstrated that postirradiated NPC in a patient with early recurrence was successfully detected by NBI coupled with conventional endoscopy. NBI endoscopy is a simple, convenient, and reliable tool, and adds additional value to detect local recurrence in the early phase. It may serve as an ideal tool in posttreatment surveillance in a patient with NPC. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21308">
<title>Differences in serum thyroglobulin measurements by 3 commercial immunoradiometric assay kits and laboratory standardization using Certified Reference Material 457 (CRM-457)</title>
<link>http://dx.doi.org/10.1002%2Fhed.21308</link>
<description><![CDATA[Serum thyroglobulin (Tg) is essential in the follow-up of patients with differentiated thyroid carcinoma (DTC). However, interchangeability and standardization between Tg assays have not yet been achieved, even with the development of an international Tg standard (Certified Reference Material 457 [CRM-457]).Serum Tg from 30 DTC patients and serially diluted CRM-457 were measured using 3 different immunoradiometric assays (IRMA-1, IRMA-2, IRMA-3). The intraclass correlation coefficient (ICC) method was used to describe the concordance of each IRMA to CRM-457.The serum Tg measured by 3 different IRMAs correlated well (r > .85, p < .0001), but clinically relevant discrepancies were found in 13.3% of patients. IRMA-3, which claims to be standardized to CRM-457, showed the best ICC (p1 = .98) for the CRM-457.Hospitals caring for patients with DTC should either set their own cutoffs for IRMAs for Tg based on their patient pools, or adopt IRMAs standardized to CRM-457 and calibrate their laboratory using CRM-457. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21262">
<title>Role of radiotherapy in early glottic carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21262</link>
<description><![CDATA[Early glottic carcinoma has a high local control prospect with radiotherapy. This review evaluates a single center's experience.All patients from 1967 to 2006 diagnosed with Tis/T1/T2/N0 early glottic carcinoma treated definitively with radiotherapy at Prince of Wales Hospital were reviewed. Local control and cancer-specific survival (CSS) rates were primary endpoints, and the impact of various factors on these outcomes was statistically analyzed.This review of 522 patients includes 24 with Tis, 356 with T1, and 142 with T2. Ultimate local control rates were as follows: Tis 87.5%, T1 94.7%, and T2 84.5%. Multivariate analysis found fitness for surgery, no involvement of anterior commissure, normal cord movement, and radiotherapy dose >60 Gy significant for local control. Fitness for surgery, no involvement of the anterior commissure, normal cord movement, and no ventricular involvement were significant prognostic factors for CSS.Definitive radiotherapy for early glottic carcinoma provides high local control rates, with the option of surgical salvage to achieve ultimate local control. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21311">
<title>Integrative molecular characterization of head and neck cancer cell model genomes</title>
<link>http://dx.doi.org/10.1002%2Fhed.21311</link>
<description><![CDATA[Cell lines are invaluable model systems for the investigation of cancer. Knowledge of the molecular alterations that exist within cell models is required to define the mechanisms governing cellular phenotypes.Five tongue squamous cell carcinomas cell lines and 1 submaxillary salivary gland epidermoid carcinoma cell line were analyzed for copy number and mRNA expression by tiling-path DNA microarrays and Agilent Whole Human Genome Oligoarrays, respectively.Integrative analysis of genetic and expression alterations revealed the molecular landscape of each cell line. Molecular results for individual cell lines and across all samples have been summarized and made available for easy reference.Our integrative genomic analyses have defined the DNA and RNA alterations for each individual line. These data will be useful to anyone modeling oral cancer behavior, providing a molecular context that will be useful for deciphering cell phenotypes. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21284">
<title>Microsurgical free flap in head and neck reconstruction</title>
<link>http://dx.doi.org/10.1002%2Fhed.21284</link>
<description><![CDATA[Microsurgical free flaps are today considered state of the art in head and neck reconstruction after composite tumor resections. Free flaps provide superior functional and aesthetic restoration with less donor-site morbidity. This article details our approach to this challenging and complex procedure. Free tissue transfer can be viewed as consisting of 4 essential stages: (1) defect assessment, (2) preparation of recipient vessels, (3) flap selection and harvest, and (4) flap inset and microsurgical anastomoses. The essential details of each step are highlighted. Meticulous attention to each step is important because each plays a crucial role in the overall success of the procedure. Workhorse flaps in our practice are the anterolateral thigh, radial forearm, fibula, and jejunum flaps. Unique issues related to postoperative care and monitoring of head and neck free flaps are discussed. The management of complications, in particular those threatening flap survival, are reviewed in detail. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21247">
<title>Levels of oxidative damage and lipid peroxidation in thyroid neoplasia</title>
<link>http://dx.doi.org/10.1002%2Fhed.21247</link>
<description><![CDATA[Background.This study assessed the presence of oxidative damage and lipid peroxidation in thyroid neoplasia.Methods.Using tissue microarrays and immunohistochemistry, we assessed levels of DNA damage (8-oxo-dG) and lipid peroxidation (4-HNE) in 71 follicular thyroid adenoma (FTA), 45 papillary thyroid carcinoma (PTC), and 17 follicular thyroid carcinoma (FTC) and matched normal thyroid tissue.Results.Cytoplasmic 8-oxo-dG and 4-HNE expression was significantly higher in FTA, FTC, and PTC tissue compared to matched normal tissue (all p values < .001). Similarly, elevated nuclear levels of 8-oxo-dG were seen in all in FTA, FTC, and PTC tissue compared to matched normal (p values < .07, < .001, < .001, respectively). In contrast, a higher level of 4-HNE expression was detected in normal thyroid tissue compared with matched tumor tissue (p < .001 for all groups). Comparing all 3 groups, 4-HNE levels were higher than 8-oxo-dG levels (p < .001 for all groups) except that cytoplasmic levels of 8-oxo-dG were higher than 4-HNE in all (p < .001). These results were independent of proliferation status.Conclusion.High levels of DNA damage and lipid peroxidation in benign and malignant thyroid neoplasia indicates this damage is an early event that may influence disease progression. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21273">
<title>Salvage treatment for recurrent oropharyngeal squamous cell carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21273</link>
<description><![CDATA[Background.This study evaluates the oncological outcome of patients with recurrent oropharyngeal squamous cell carcinoma (OPSCC) after primary radiation therapy ± chemotherapy, primary surgical therapy, and surgical therapy followed by radiation therapy ± chemotherapy.Methods.A total of 156 patients (36%) of a cohort of 427 treated for OPSCC between 1990 and 2006 developed recurrent disease. Fifty-one patients (12%) qualified for salvage treatment. Study endpoints were 5-year overall survival (OS) and disease-specific survival (DSS).Results.The 5-year OS and DSS rates after salvage treatment were 29% and 40%; after initial primary radiation therapy, 25% and 40%; after initial surgery followed by radiation therapy, 40% and 40%; and after initial surgery alone, 20% and 40%.Conclusions.Patients with an advanced OPSCC have a considerable risk for recurrence. Despite poor ultimate outcome, salvage treatment should be attempted in patients with resectable disease, good performance status, and absence of distant metastases. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21305">
<title>Successful endovascular treatment of intractable epistaxis due to ruptured internal carotid artery pseudoaneurysm secondary to invasive fungal sinusitis</title>
<link>http://dx.doi.org/10.1002%2Fhed.21305</link>
<description><![CDATA[Background.Mycotic pseudoaneurysm from the cavernous segment of the internal carotid artery (ICA) secondary to an invasive aspergillus sinusitis is rare. Surgical intervention with ICA ligation is generally accepted for most mycotic aneurysms or pseudoaneurysms. When presented with massive epistaxis due to a fungal aspergillus ICA invasion, mortality rates are high.Methods.We present the case of a 76-year-old man who developed intractable epistaxis due to a mycotic pseudoaneurysm arising from the cavernous segment of the right ICA.Results.The patient was successfully treated by endovascular embolization at the orifice of the pseudoaneurysm followed by the total ICA trapping technique using electrolytically Guglielmi detachable coils (GDCs) and injection of N-butyl-2-cyanoacrylate (n-BCA). The patient survived for 7 months but eventually died of urosepsis and cardiorespiratory failure.Conclusion.Endovascular embolization is a feasible and life-saving approach for emergent management of massive intractable epistaxis secondary to a complicated invasive fungal sinusitis. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21303">
<title>Preoperative predictors of sternotomy need in mediastinal goiter management</title>
<link>http://dx.doi.org/10.1002%2Fhed.21303</link>
<description><![CDATA[Background.The objective of this study was to identify the preoperative risk factors for patients in need of a sternotomy in the management of mediastinal goiters in order to provide better preoperative planning and patient consent.Methods.We analyzed 98 patients who underwent surgery for mediastinal goiters (goiters extending below the thoracic inlet [ge]3 cm with the neck in hyperextension) between 1995 and 2008. Twelve (12.2%) of the patients required a sternotomy. The patients' features were analyzed by the surgical approach performed. Logistic regression analysis was used to study which variables were influencing the surgical strategy. The receiver operating characteristic (ROC) curves were designed when appropriate.Results.The analysis disclosed the following risk factors: radiologic extension of mediastinal goiters below the aortic arch (odds ratio [OR] = 32.87; 95% confidence interval [CI] = 4.04-267.12; p 160 months: OR = 22.8; 95% CI = 5.28-98.53; p < .0001).Conclusions.Sternotomy need for mediastinal goiter removal can be predicted; in such cases surgeons should not hesitate to perform it for minimizing complications. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21301">
<title>Anticancer effect of photodynamic therapy with hexenyl ester of 5-aminolevulinic acid in oral squamous cell carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21301</link>
<description><![CDATA[Background.Five-aminolaevulinic acid (ALA) and its derivatives act as precursors of the photosensitizer protoporphyrin IX (PpIX). In this study, the effect of photodynamic therapy (PDT) with hexenyl ester of ALA (ALA-hx) was examined in a human oral squamous cell carcinoma, YD10B cells.Methods.PpIX accumulation and mRNA expression of coproporphyrinogen oxidase (CPO) by ALA and ALA-hx was examined. Cell viability was examined by MTT assay and the molecular mechanism was investigated.Results.The PpIX synthesis and mRNA expression of CPO was much higher in the cells treated with ALA-hx than ALA. At the concentration that PDT with ALA did not affect cell growth, ALA-hx PDT effectively produced reactive oxygen species (ROS) and suppressed cell growth. Growth inhibition by ALA-hx PDT was due to mitochondrial-dependent apoptosis.Conclusion.Our results suggest that ALA-hx PDT effectively induced apoptosis of YD-10B cells and can be considered as a therapeutic alternative for oral cancer. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21299">
<title>Cetuximab as primary treatment for cutaneous squamous cell carcinoma to the neck</title>
<link>http://dx.doi.org/10.1002%2Fhed.21299</link>
<description><![CDATA[Background.Head and neck cutaneous squamous cell carcinoma (SCC) metastatic to lymph nodes is commonly treated with surgery plus radiotherapy.Methods.We present the case of a 92-year-old man with cutaneous SCC metastatic to the neck (7 cm) who was treated with primary cetuximab and has had a durable complete response for 7 months. Because of his age, comorbidities, and unresectable neck lymphadenopathy, he received primary cetuximab. He received a 400 mg/m2 loading dose and a 250 mg/m2 weekly dose for 3 months and then had to discontinue as a result of other unrelated medical issues.Results.The patient had a complete response by 6 weeks. Seven months after discontinuing cetuximab, he continues to have a complete response.Conclusions.Primary cetuximab for cutaneous SCC metastatic to lymph nodes is an area that bears further investigation because of its apparent efficacy and excellent toxicity profile. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21297">
<title>Glutathione S-transferase P1 and alpha gene variants; role in susceptibility and tumor size development of oral cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21297</link>
<description><![CDATA[Background.The aim of this study was to estimate the relationship of glutathione S-transferases (GST)P1, GSTA1, GSTM1, and GSTT1 gene polymorphisms to oral cancer risk.Methods.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to measure these 4 gene polymorphisms in 274 controls and 164 oral cancer patients.Results.Individuals with at least 1 varied G allele of GSTP1 had a 1.53-fold risk (95% confidence interval [CI] = 1.01-2.31) of developing oral cancer compared with patients with wild-type A/A homozygotes. Oral cancer patients with at least 1 varied T allele of GSTA1 gene had a 0.42-fold risk (95% CI = 0.18-0.95) of having a tumor size >2 cm compared with patients with C/C homozygotes.Conclusions.The varied G allele of GSTP1 may be considered as a factor contributing to increased susceptibility, whereas the T allele of GSTA1 could be a protective factor for tumor size progression in Taiwanese with oral cancer. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21293">
<title>Influence of breathing resistance of heat and moisture exchangers on tracheal climate and breathing pattern in laryngectomized individuals</title>
<link>http://dx.doi.org/10.1002%2Fhed.21293</link>
<description><![CDATA[Background.The aim of this study was to determine the influence of breathing resistance of heat and moisture exchangers (HMEs) on endotracheal climate and breathing pattern.Methods.Endotracheal temperature and humidity and tidal volumes were measured in 11 laryngectomized patients with a regularly used HME with "standard" breathing resistance (Provox Normal HME; R-HME), a low breathing-resistance HME (Provox HiFlow HME; L-HME), and without HME.Results.Both R-HME and L-HME increased end-inspiratory humidity (+5.8 and 4.7 mgH2O/L, respectively), decreased end-inspiratory temperature (-1.6 and -1.0°C, respectively), and prolonged the exhalation breath length to approximately 0.5 seconds. The R-HME significantly enlarged tidal volumes (0.07 L; p < .05).Conclusions.Both HMEs significantly improve tracheal climate. The R-HME has better moistening properties and a small but significant positive effect on tidal volume. Therefore, if the higher resistance is tolerated, the R-HME is the preferred pulmonary rehabilitation device. The L-HME is indicated if lower breathing resistance is required. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21291">
<title>Use of nasotracheal intubation in patients receiving oral cavity free flap reconstruction</title>
<link>http://dx.doi.org/10.1002%2Fhed.21291</link>
<description><![CDATA[Background.The aim of this study was to evaluate the effect airway management has on perioperative outcomes of patients undergoing oral cavity free flap reconstruction.Methods.A retrospective review was performed on patients receiving oral cavity free flap reconstruction between March 2006 and October 2007. Patient, tumor, and treatment variables were recorded. Patients were managed with nasotracheal intubation (NTI) or elective tracheotomy and different perioperative outcomes were measured.Results.Thirty-seven patients received NTI and 21 received tracheotomy. No patients in the NTI group required conversion to tracheotomy or reintubation. The mean total hospital stay was prolonged in the tracheotomy group (12.4 days vs 8.4 days), as was their likelihood of requiring a feeding tube at discharge (76% vs 19%). In multivariate analyses, placement of a tracheotomy was independently correlated with longer hospital stay and feeding tube dependence at discharge.Conclusions.NTI is a safe alternative to tracheotomy for select patients receiving oral cavity free flap reconstruction and may reduce hospital stay and feeding tube dependence at discharge. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21289">
<title>Evaluation of available surgical management options for early supraglottic cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21289</link>
<description><![CDATA[Background.This study was undertaken to evaluate the oncologic results of endoscopic and open surgical techniques in early supraglottic cancer.Methods.We performed a retrospective evaluation of 101 patients surgically treated for stage I or II supraglottic carcinomas. Laser surgery, horizontal laryngectomy, and total laryngectomy were compared for disease-specific survival and local control rates. Surgical techniques were additionally compared for incidence of major complications, related tracheotomies, and swallowing function retention.Results.No statistically significant differences were noted among the different types of procedures regarding disease-specific survival and local control. A lower incidence of major complications, permanent gastrostomies, and significantly lower incidence of tracheotomies were noted for laser surgery compared with open techniques.Conclusion.Larynx-preserving surgical modalities offer comparable oncologic results with total laryngectomy in early supraglottic cancer. In addition, laser surgery has a lower incidence of complications and better functional results compared with open partial or total laryngectomy. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21288">
<title>Transoral laser microsurgery for T3 laryngeal tumors: Prognostic factors</title>
<link>http://dx.doi.org/10.1002%2Fhed.21288</link>
<description><![CDATA[Background.The objective of this study was to evaluate the outcomes of transoral laser microsurgery (TLM) in T3 laryngeal carcinomas and to identify prognostic factors for survival and laryngeal preservation.Methods.This study aimed to provide a retrospective analysis of 147 consecutive patients, evaluating their overall survival, disease-specific survival, laryngectomy-free survival, and function preservation rate.Results.Five-year overall, disease-specific, and laryngectomy-free survivals were 53.1%, 70.2%, and 62.3%, respectively. Disease-specific survival differed between glottic and supraglottic tumors (86.3% vs 61.8%; p = .015). Function preservation was 65.5% in supraglottic and 49.1% in glottic tumors (p = .002). Disease-specific survival was not related to pre-epiglottic involvement, cord fixation, or focal cartilage infiltration (p > .05). Vocal cord fixation and cartilage infiltration were independent negative prognostic factors for organ preservation (odds ratio [OR] = 0.184; 95% confidence interval [CI] = 0.082-0.411; p = .000 and OR = 0.331; 95% CI = 0.139-0.789; p = .013, respectively).Conclusion.Our conclusion is that TLM is a good alternative in a large number of T3 laryngeal tumors, with adequate survival and organ preservation rates above 60%. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21285">
<title>Chemotherapy alone for organ preservation in advanced laryngeal cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21285</link>
<description><![CDATA[Background.For patients with advanced laryngeal cancer, a trial was designed to determine if chemotherapy alone, in patients achieving a complete histologic complete response after a single neoadjuvant cycle, was an effective treatment with less morbidity than concurrent chemoradiotherapy.Methods.Thirty-two patients with advanced laryngeal or hypopharyngeal cancer received 1 cycle of induction chemotherapy, and subsequent treatment was decided based on response.Results.A histologic complete response was achieved in 4 patients and were treated with chemotherapy alone. All 4 patients' cancer relapsed in the neck and required surgery and postoperative radiotherapy (RT). Twenty-five patients were treated with concomitant chemoradiation. Three patients were treated with surgery. Overall survival and disease-specific survival at 3 years were 68% and 78%, respectively.Conclusion.Chemotherapy alone is not feasible for long-term control of regional disease in patients with advanced laryngeal cancer even when they achieve a histologic complete response at the primary site. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21304">
<title>Fatal central venous air embolism: A rare complication of esophageal dilation by rendezvous</title>
<link>http://dx.doi.org/10.1002%2Fhed.21304</link>
<description><![CDATA[Esophageal dilation by rendezvous is a useful technique for the treatment of complicated esophageal strictures.We present a case of a 74-year-old man with chronic dysphagia caused by a complete cervical esophageal stricture that developed after external beam radiotherapy for treatment of papillary thyroid carcinoma. During attempted dilation using the rendezvous technique, the patient suffered a fatal pulmonary air embolism. The technique of esophageal dilation by rendezvous, complications, and risk factors for development of venous air embolism are discussed.To the best of our knowledge, this is the first report in the literature of fatal venous air embolism after dilation by rendezvous. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21292">
<title>Impact of age at diagnosis on prognosis and treatment in laryngeal cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21292</link>
<description><![CDATA[The aims of this study were to analyze how age affects treatment and treatment outcome, and to determine whether tumor characteristics differ between different age groups with laryngeal cancer.Patients with laryngeal cancer during 1978-2004 in the Uppsala-Örebro region in Sweden were retrospectively studied.There were no significant differences in the 945 cases between age groups concerning major patient and tumor characteristics, such as male/female ratio, distribution of glottic/supraglottic tumors, stage, or site of recurrence. Overall survival (OS) and disease-specific survival (DSS) were worse among the oldest, although a significant proportion was cured. Relapse risk was lower among the oldest (12%) compared with the youngest (23%). The risk of never becoming tumor-free was 25% among the oldest and 7% in the youngest. Among the most elderly, only 1 late recurrence occurred.Elderly patients with laryngeal carcinoma cope well with treatment. Undertreatment may determine outcome more than age. The oldest group should be followed for a minimum of 2 years. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21290">
<title>Complications and functional outcomes following complex oropharyngeal reconstruction</title>
<link>http://dx.doi.org/10.1002%2Fhed.21290</link>
<description><![CDATA[We sought to evaluate postoperative complications and functional outcomes in patients who underwent oropharyngeal reconstruction after oncologic resection.The evaluation constituted a retrospective review of 65 patients who underwent microvascular free flap (85%) and/or pectoralis pedicled flap (18%) oropharyngeal reconstruction after composite resection for advanced oropharyngeal squamous cell carcinoma.Perioperative mortality was 1.5%. Overall, 29 patients (45%) experienced surgical or medical complications; however, only 2 patients (3%) required operative intervention. The flap success rate was 100%. Eighty-six percent of patients were decannulated, 34% were able to meet all of their nutritional needs orally, and 69% attained >80% speech intelligibility. Preoperative swallowing impairment was associated with postoperative feeding tube dependence (p = .006).Microvascular free flap and/or pectoralis pedicled flap reconstruction of extensive oropharyngeal defects is safe and reliable, even with advanced disease. Although most patients achieved decannulation and functional speech, almost two thirds remained at least partially feeding tube dependent. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21287">
<title>Positive association of glucose-regulated protein 78 during oral cancer progression and the prognostic value in oral precancerous lesions</title>
<link>http://dx.doi.org/10.1002%2Fhed.21287</link>
<description><![CDATA[Our aim was to examine the potential role of glucose-regulated protein (GRP)78 during oral cancer progression and the prognostic value in oral precancerous lesions.A total of 204 patients with oral cancer and 86 with precancerous lesions were investigated. GRP78 expression was determined in the lesion tissues by Western blot analysis. Association of GRP78 with clinicopathology or disease prognosis was examined using Fisher's exact, Kaplan-Meier, or Cox regression method.Hyperexpression of GRP78 was found to be correlated with increasing malignant potential of oral lesions, with 14% in leukoplakia, 27% in erythroplakia, 50% in verrucous lesion, and 74% in oral cancer (p < .0001), suggesting this molecule plays a crucial role in the early steps of oral oncogenesis. In patients with precancerous lesions of the oral cavity, GRP78 expression predicts poorer same-site premalignancy-free survival (p = .002) and malignancy-free survival rates (p = .002).Determination of GRP78 expression levels might enable a better risk stratification for patients with oral premalignant lesions. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21286">
<title>Superficial selective cervical plexus block following total thyroidectomy: A randomized trial</title>
<link>http://dx.doi.org/10.1002%2Fhed.21286</link>
<description><![CDATA[Pain after thyroid surgery is of moderate intensity and short duration. Bilaterally superficial cervical plexus block (BSCPB) may reduce analgesic requirements. However, its effectiveness in decreasing pain after thyroidectomy is debated.This double-blind, randomized placebo-controlled study in 100 patients undergoing total thyroidectomy evaluates the effects of BSCPB done with 20 mL of 0.75% ropivacaine. Additional parecoxib was administrated immediately postoperatively and 12 hours later.Postoperative pain was assessed by visual analogue rating scale. All parameters were recorded at 0, 3, 6, 9, 12, and 24 hours after surgery. The control group had higher values than the ropivacaine group at all moments (p < .05) except H12 (p = .76). Additional analgesia was needed for 7 patients (14%) in the control group and for 8 patients (16%) in the group with ropivacaine (p = .96).Two-point bilateral BSCPB has a major analgesic effect on patients after total thyroidectomy, with a statistically significant reduction in postoperative pain scores. However, no significant difference was noted in the proportion of patients that required additional analgesics. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21283">
<title>Blowing ratio as an evaluation tool for velopharyngeal function after oral and oropharyngeal cancer resection</title>
<link>http://dx.doi.org/10.1002%2Fhed.21283</link>
<description><![CDATA[Our objective was to evaluate the value of the blowing test to measure the speech and swallowing function after resection of oral or oropharyngeal cancer.Speech and swallowing functions of the patients after surgical resection of oral or oropharyngeal cancer were assessed by a speech intelligibility test, blowing time, questionnaires, and oropharyngeal pressures. Blowing time (pressure) ratio was determined by dividing blowing time (pressure) with open nose by blowing time (pressure) with closed nose.Blowing time ratio had significant correlation with blowing pressure ratio (p = .014), score of speech intelligibility test (p = .0014), questionnaire for aspiration (p = .029), nasopharyngeal backflow (CC = 0.676, p = .032), amount of food to swallow (p = .037), and oropharyngeal pressure during swallowing (p = .024).The present results demonstrated the value of blowing time ratio as a simple objective tool for speech and swallowing ability related to velopharyngeal function after resection of oral and oropharyngeal cancers. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21275">
<title>Sequential evaluation of swallowing function in patients with unilateral neck dissection</title>
<link>http://dx.doi.org/10.1002%2Fhed.21275</link>
<description><![CDATA[Neck dissection is the most reliable treatment for cervical lymph node metastases in head and neck cancer. However, it is unknown whether neck dissection can cause dysphagia. The aim of this study was to evaluate swallowing function after neck dissection.By using videofluoroscopic and videoendoscopic methods, swallowing function was evaluated in 17 patients prior to, 1 month after, and 4 months after neck dissection.In comparison with preoperative observations, swallowing function after neck dissection was affected by the following changes: a forward and downward displacement of the hyoid bone at rest and at its highest position, a decrease in the distance traversed by the hyoid bone during swallowing, and an increase in laryngeal penetration. Pharyngeal residue and aspiration were not observed in any of the patients.Although swallowing function is affected by neck dissection, serious clinical problems are not likely to occur. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21263">
<title>Neck ultrasound for prediction of right nonrecurrent laryngeal nerve</title>
<link>http://dx.doi.org/10.1002%2Fhed.21263</link>
<description><![CDATA[Nonrecurrent laryngeal nerve (NRLN) is 1 of the important causes for nerve damage during neck surgery. The anomaly is almost associated with congenital vascular abnormally. Most neck vascular anomalies can be detected by ultrasound.Both 3.5-MHz and 10-MHz probe neck ultrasound scans were performed for 2330 patients undergoing thyroidectomy preoperatively. Absence of innominate artery (INA) was defined as positive with right NRLN.Of 13 positive patients found by 10-MHz probe, 11 were also identified by 3.5-MHz probe, and proved to be with right NRLN during operation. Two false-positive patients (18%) found by 10-MHz probe were due to short INA and tortuous INA, respectively. The incidence of right NRLN was 0.47% in Chinese people. Both the sensitivity and specificity for predicting right NRLN by 3.5-MHz probe were 100%.A 3.5-MHz probe neck ultrasound scan can accurately demonstrate right NRLN. Applying this tool for neck surgery to reduce the nerve damage is highly advised. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21272">
<title>Effect of repeated laser microsurgical operations on laryngeal cancer prognosis</title>
<link>http://dx.doi.org/10.1002%2Fhed.21272</link>
<description><![CDATA[The aim of this study was to evaluate whether repeated sessions of transoral CO2 laser microsurgery (TLM) aiming to achieve clear histologic margins carry a negative effect on the prognosis of laryngeal cancer.This was a retrospective evaluation of 763 cases that underwent primary TLM treatment for laryngeal cancer. Cases were compared for overall survival and local control rates with respect to status of surgical margins and number of procedures necessary to achieve these margins.No significant differences were noted among cases with negative surgical margins regardless of the number of procedures necessary to achieve these margins. On the other hand, positive margins at the end of surgical treatment carried significant negative prognostic effect.The prognostic effect of negative surgical margins in TLM for laryngeal cancer is significant regardless of the number of procedures required to obtain such margins. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21274">
<title>Treatment guideline for hemangiomas and vascular malformations of the head and neck</title>
<link>http://dx.doi.org/10.1002%2Fhed.21274</link>
<description><![CDATA[Vascular anomalies are among the most common congenital and neonatal dysmorphogenesis, which are separated into hemangiomas and vascular malformations. They can occur in various areas throughout the body, with 60% being located in the head and neck. The true mechanism of pathogenesis of vascular anomalies is still unclear. Various treatment methods have been reported, and there are still controversies over the selection of different treatment modalities. Based on the clinical and basic research and current literature, the Chinese Division of Oral and Maxillofacial Vascular Anomalies formulated a treatment guideline for hemangiomas and vascular malformations of the head and neck, which will be modified and updated periodically based on new medical evidence and research. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21281">
<title>Continued alcohol use in patients with head and neck cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21281</link>
<description><![CDATA[The effect of posttreatment alcohol consumption on health-related quality of life (QOL) and factors predicting overall QOL and continued alcohol consumption were examined in patients with head and neck cancer.Self-reported alcohol use and abuse 1 year after diagnosis was analyzed.Although current drinkers (44.5% of 283 patients) had better overall QOL and fewer depressive symptoms, current social drinkers had the best scores, whereas current problem drinkers had the worst. Female sex, fewer depressive symptoms, less pain, and better eating function predicted better QOL. Oral function was the only predictor of 12-month alcohol use.Depression, pain, and eating function predicted overall QOL. Alcohol consumption was not associated with QOL, but was associated with better oral function, which in turn predicted better QOL. Alcohol consumption itself does not improve QOL in this population, and these patients should be counseled regarding detrimental effects of continued drinking after treatment. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21282">
<title>Widespread expression of prostate apoptosis response-4 in nasopharyngeal carcinoma</title>
<link>http://dx.doi.org/10.1002%2Fhed.21282</link>
<description><![CDATA[Prostate apoptosis response-4 (Par-4) augments apoptosis in various tumors, either during apoptotic insult or by ectopic overexpression. However, investigation of Par-4 expression in nasopharyngeal carcinoma (NPC) is lacking.Specimens from patients with NPC, hypopharyngeal carcinoma (HPC), or oral cavity cancer were examined for Par-4 expression using immunohistochemistry. NPC cell proliferation and apoptosis were analyzed using immunohistochemical staining for Ki67, B-cell lymphoma 2 (Bcl-2), and in situ terminal deoxyribonucleotidyl transferase (TdT)-mediated biotin-16-dUTP nick end-labeling (TUNEL) assay, respectively.Par-4 was ubiquitously expressed in NPC biopsies (96.2%, 25/26) and was significantly higher than in HPC (47.6%, 50/105, p < .0001) and oral cavity cancers (38.7%, 12/31, p < .0001). Remarkably, apoptosis of NPC cells was absent and Par-4 expression was associated with obvious expression of Bcl-2 and Ki67 in all patients tested with NPC.Immunohistochemistry results showed widespread expression of Par-4 in NPC and revealed sustainable proliferation of NPC cells regardless of Par-4 expression.© 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21241">
<title>Toll-like receptor agonists as third signals for dendritic cell-tumor fusion vaccines</title>
<link>http://dx.doi.org/10.1002%2Fhed.21241</link>
<description><![CDATA[The aim of the present study was to evaluate the therapeutic efficacy of dendritic cell (DC)-tumor fusion hybrids with Toll-like receptor (TLR) agonists.DC-tumor fusion hybrids were generated by electrofusion and injected into the inguinal lymph nodes of C57BL/6 mice with 3-day established pulmonary metastases. Paired TLR agonists polyinosine:polycytadilic acid [poly(I:C)] and cytosine-phosphate-guanine (CpG) were then injected intraperitoneally. Enzyme-linked immunosorbent assay (ELISA) was used to evaluate interleukin (IL)-12 production from the DC-tumor fusion hybrids in vitro.Fusion + TLR agonists (60 metastases) had significantly fewer metastases than did the untreated control (262 metastases, p = .0001) and fusion alone (150 metastases, p = .02). ELISA showed that the DC-tumor fusion hybrids yielded 90 pg of IL-12 after TLR stimulation compared with 1610 pg from dendritic cells alone.CpG and poly(I:C) administered as a third signal with fusion hybrids as described significantly reduce melanoma metastasis compared with fusion hybrids alone. Fusion hybrids do not appear to be a significant source for IL-12 secretion. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21278">
<title>Transoral CO2 laser treatment for Tis-T3 glottic cancer: The University of Brescia experience on 595 patients</title>
<link>http://dx.doi.org/10.1002%2Fhed.21278</link>
<description><![CDATA[Transoral CO2 laser surgery has been accepted as a valuable therapeutic option for glottic cancer.This was a retrospective analysis of 595 patients. Five-year overall and disease-specific survivals, local control with laser, locoregional, regional control, and organ preservation rates were calculated. The impact of different variables was calculated by univariate analysis.Overall, disease-specific and disease-free survivals, local control with laser, locoregional, regional control, and organ preservation rates were 87.5%, 99%, 81.3%, 92.7%, 98.9%, 98.2%, and 97.1%, respectively. Univariate analysis showed a significant impact of pT category on local control with laser, organ preservation, locoregional and regional control, of endoscopic re-treatment for positive deep surgical margins on local control with laser and organ preservation, and recurrence after endoscopic re-treatment on local control with laser and organ preservation.This series confirms the good oncologic outcomes of endoscopic laser surgery for Tis, T1, and selected T2 and T3 glottic tumors. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21277">
<title>Expression of matrix metalloproteinase-1, -7, -9, -13, Ki-67, and HER-2 in epithelial-myoepithelial salivary gland cancer</title>
<link>http://dx.doi.org/10.1002%2Fhed.21277</link>
<description><![CDATA[The expression of matrix metalloproteinases (MMPs) in epithelial-myoepithelial salivary gland carcinoma has not been studied previously.Immunohistochemistry for MMP-1, -7, -9, -13, Ki-67, and HER-2, as well as HER-2 gene amplification by silver enhanced in situ hybridization was performed in a series of 12 paraffin-embedded histopathologic samples of patients from Canada and Finland.A positive MMP-13 (p = .0022), higher MMP-13 (p = .0274), and higher MMP-9 (p = .0274) index (multiplication of staining intensity by percentage of the positive cells) predicted better overall survival. In disease-specific analysis, higher MMP-9 index (p = .0327) predicted better survival. A higher volume corrected index (VCI) of Ki-67 (p = .0339) predicted worse disease-specific survival. In 1 patient, HER-2 oncogene amplification was observed.MMPs and Ki-67 may have prognostic impact in epithelial-myoepithelial carcinoma. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></description>
</item>

<item rdf:about="http://dx.doi.org/10.1002%2Fhed.21271">
<title>Arteriovenous malformation in the pretragal region: Case report</title>
<link>http://dx.doi.org/10.1002%2Fhed.21271</link>
<description><![CDATA[Arteriovenous malformation (AVM) in the extracranial region is uncommon. The most common sites are cheek, ear, nose, and forehead in order of frequency in the extracranial region. Although the external ear is the second most common site for the extracranial AVM, AVM in the pretragal region has not been reported until now.We reported a case of AVM in the pretragal region, which was successfully removed by complete excision after preoperative selective embolization in a 32-year-old man. Combined superselective and particle embolization is a useful method to decrease the blood flow in the pretragal AVM.We successfully treated the patient for the AVM in the pretragal area by complete excision within 72 hours after the preoperative combined superselective and particle embolization. Although our case is similar to auricular AVMs in point of symptoms and treatment, this is the first case reported at this unusual site. © 2009 Wiley Periodicals, Inc. Head Neck, 2010]]></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.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.21264">
<title>Microvascular free flap reconstruction versus palatal obturation for maxillectomy defects</title>
<link>http://dx.doi.org/10.1002%2Fhed.21264</link>
<description><![CDATA[Palatal obturators and microvascular free flaps are both used to treat patients with maxillectomy defects, however, the optimal technique remains controversial.A retrospective analysis of 113 patients undergoing maxillectomy for cancer was performed. Seventy-three patients received an obturator and 40 patients were reconstructed with a free flap.Speech intelligibility and postoperative diet were comparable between the obturator and free flap groups, except in cases of extensive (>50%) palatal defects, where free flap reconstruction was superior in both aspects (p = .019 and p = .043, respectively). The average time for presenting with a local recurrence in advanced cancer involving the palate was comparable in both groups (p = .33).Moderate-sized maxillectomy defects involving the palate can be successfully treated with either an obturator or free flap reconstruction. Extensive defects have a better functional outcome with free flaps. Evidence does not suggest that free flap reconstructions delay diagnosis of local recurrences. © 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.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.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.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.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.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.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.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.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.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.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.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.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.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.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>

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