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Background: Fine-needle aspiration (FNA) cytology is frequently used for initial and/or preoperative diagnosis of tumors in the head and neck region. However, false-negative results can lead to misdiagnosis. The aim of this study was to investigate the diagnostic results of FNA in the head and neck region and the reasons for false-negative cases.Methods: The study population comprised 1,341 patients with pathologically confirmed head and neck tumors in whom FNA was performed before surgery or biopsy in the Otolaryngology Department at Numazu City Hospital between 2002 and 2016. We evaluated the false-negative FNA cytology rate as well as the site of the primary nodule, patient age and sex, sensitivity, accuracy, specificity, positive predictive value, negative predictive value, and the pathologic diagnosis after resection.Results: The rate of false-negative FNA results was 5.9% (78/1,315 cases). The main sites of false-negative cases were the thyroid gland (n = 50), the lymph nodes (n = 16), and the salivary glands (n = 9). The sensitivity of FNA for head and neck tumors was 82.0%, with specificity and accuracy rates of 94% and 92.0%, respectively.Conclusions: We have assessed the quality of preoperative FNA cytology in head and neck tumors. To avoid misdiagnosis by FNA, it is important that the target tumor is punctured accurately. If the specimen obtained is too small, FNA should be repeated. [ABSTRACT FROM AUTHOR]

Background Tracheotomy for pediatric patients is a surgical procedure with greater technical difficulty and higher rates of morbidity and mortality than that in adults. We report a new technique for pediatric tracheotomy that reduces the issue of granulation and recannulation after accidental decannulation. Methods Clinical data were retrospectively reviewed for 32 pediatric patients aged 3 weeks–32 months who underwent Quattro Flap Tracheotomy (QFT) at our hospital. The technique for the procedure is described and illustrated in detail. We analyzed the complications of surgery and the prognosis of patients. Results Twenty-seven out of 32 pediatric tracheotomy patients were aged < 12 months. Overall, one patient with subglottic stenosis developed granulation and required a resection. Three patients with granulation were cured using conservative treatment. Neither pneumothorax nor accidental decannulation and failure to reinsert the cannula occurred with QFT. No tracheotomy-related deaths occurred. The overall rate of postoperative complications was lower in the study group (4/32 cases, 12.5%) than in the control group (12/32 cases, 37.5%; p = 0.041). Conclusion QFT is a new method for pediatric tracheotomy that should be performed in younger infants. If performed appropriately, QFT may reduce the incidence of complications and death in many cases that involve persistent granulation. Levels of evidence IV. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the clinical factors associated with outcomes of head and neck small cell neuroendocrine carcinoma (SCNEC-HN).Materials and Methods: A retrospective review of clinical data was performed for 11 patients with SCNEC-HN treated at the Hamamatsu University Hospital (Hamamatsu, Japan). Clinical features, treatment methods, and outcomes were evaluated. The main outcome measurements were disease stage, patient age, primary tumor site, treatment procedures, and estimated survival rates. Survival rates were calculated using the Kaplan-Meier method.Results: Patients were followed for a mean of 40.0 months (range, 8 to 191 months). The 1-, 2-, and 5-year overall survival rates were 52.0, 20.8, and 10.4%, respectively. Rates did not differ significantly between the N2 and N0/1 groups, although the latter had a slightly better prognosis (P = .08).Conclusion: Chemoradiotherapy was a reasonable treatment for patients with SCNEC-HN. Those with N0/1 or maxillary sinus SCNEC-HN had a better prognosis than those with N2 disease or cancers at other sites, respectively. However, more aggressive treatment might not be warranted even for patients with limited disease. The outcomes continue to be suboptimal, and more effective therapies are needed because most patients had local or distant failure. [ABSTRACT FROM AUTHOR]

Photodynamic therapy (PDT) is a minimally invasive therapy used in the treatment of premalignant and malignant diseases, including head and neck carcinomas. It can be applied before or after chemotherapy, irradiation, or surgery. Unlike irradiation and surgery, it can be repeated many times at the same site, and it is also associated with better cosmetic and functional outcomes [ 1 ]. We have treated 10 patients with laryngeal carcinomas with PDT since 1998, and herein we describe two such patients who developed vocal cord adhesion due to PDT. To our knowledge, there are no previous reports of patients with glottis atresia due to PDT, thus the cases reported herein are rare, and educationally valuable. [ABSTRACT FROM AUTHOR]

An abstract of the article "A report of the next-generation catalog information service by National Institute of Informatics," by Seiji Hosokawa, Yoshiro Hirata, and Yasuo Saito is presented.

A 74-year-old man was brought to the emergency department (ED) due to a 1-hour course of dyspnea and dysphonia. At arrival in the ED, his airway was managed by bag-valve-mask ventilation. The patient was intubated using a Macintosh laryngoscope with a gum elastic bougie guide. An indirect endoscopic examination revealed prominent epiglottal swelling. Simultaneously, we found a bilateral conjugate deviation to the right and a positive Barré sign for the left arm. Diffusion-weighted magnetic resonance imaging, magnetic resonance angiography, and computed tomography with contrast enhancement revealed a right cerebral hemisphere infarction and dissection of the brachiocephalic artery to the right internal carotid artery. After admission, the patient stated that the movement of his left arm was intact when he became aware of the dyspnea and that he noticed the paralysis of his left arm during transportation to the ED. We believed that these signs resulted from the right hemisphere brain infarction caused by dissection of the brachiocephalic artery to the right internal carotid artery, secondary to the acute epiglottitis. A decrease of intrathoracic pressure due to an upper airway obstruction may cause distention of the intrathoracic arteries and an afterload increase on the left ventricle. The patient was moved to another hospital for rehabilitation on the 20th day after admission. This is the first report of a brain infarction after a dissection of the intrathoracic arteries secondary to acute epiglottitis. Patients with acute epiglottitis should be closely monitored for both airway management and the pathology caused by decreasing intrathoracic pressure. [ABSTRACT FROM AUTHOR]

• Head and neck squamous cell carcinoma patients received photodynamic therapy (PDT). • The efficacy and 5-year overall survival rates were 97.6 % and 57.8 %, respectively. • Sex, tumor stage, and tumor location were associated with overall survival. • Light dose was not significantly associated with local control or survival. • Photofrin-mediated PDT is a useful therapy in head and neck squamous cell carcinoma. Photodynamic therapy is a less invasive therapeutic procedure for carcinomas. The goal of this study was to evaluate the utility of Photofrin (porfimer sodium)-mediated photodynamic therapy in patients with head and neck squamous cell carcinoma. Forty-two head and neck squamous cell carcinoma patients who underwent Photofrin-mediated photodynamic therapy were treated by intraoperative light activation at 630 nm via a fiber optic microlens, 48 h after injection. We evaluated the impact of age, sex, tumor stage, primary site, light dose, and cancer history on overall survival using a Cox proportional hazards model. Information on the survival status of patients was obtained after a mean follow-up period of 51 months (range, 6–180 months). The 5-year overall survival for all patients was 57.8 % (95 % confidence interval of the survival rate: 39.8 %–72.1 %). The complete response rate was 69.0 %, and the efficacy (complete response + partial response) was 97.6 %. Earlier tumor stage was associated with increased survival (p = 0.012). Diseases of the respiratory tract also showed significant association with survival as compared to those of the alimentary tract (p = 0.01). Photofrin-mediated photodynamic therapy is useful for treating head and neck squamous cell carcinomas, and provides an improved quality of life in patients with recurrent or residual disease. [ABSTRACT FROM AUTHOR]

Purpose: Methods for cytologic diagnosis, such as fine-needle aspiration (FNA) and touch smear (TS) cytology, have been frequently used for malignant tumor screening; however, false-negative cases often result in misdiagnosis. The purpose of this study was to investigate the causes of false-negative cases and methods to decrease the false-negative rate in salivary gland tumor TS cytology.Materials and Methods: In this cross-sectional study, the authors examined pathologically confirmed salivary gland tumors in 127 cases in which FNA and TS cytology were performed before the operation or open biopsy at Numazu City Hospital (Numazu, Japan) from 2002 to 2016. The authors evaluated the false-negative rates of TS and FNA cytology separately and when used in combination and other variables, such as age, gender, sensitivity, accuracy, specificity, and overall pathologic diagnosis by resection.Results: The overall false-negative rate of postoperative pathologic diagnosis was lower when TS and FNA were combined (1 of 127 cases; 0.8%) compared with FNA cytology alone (10 of 127 cases; 7.9%; P = .034). Suggested causes of a false-negative FNA (or TS) result include cytologic difficulties present in certain malignancies, such as mucoepidermoid carcinoma, adenoid cystic carcinoma, and others.Conclusion: False-negative cases were decreased when a combination of preoperative FNA and intraoperative TS cytology was performed. TS cytology appears to be a useful method to avoid misdiagnosis in salivary gland diseases. [ABSTRACT FROM AUTHOR]

Small cell neuroendocrine carcinoma (SNEC) of the paranasal sinuses is an extremely rare and distinctive tumor with aggressive clinical behavior. Moreover, SNECs originating in the head and neck region have been reported to be highly aggressive and to have a poor prognosis. This report describes a patient with a maxillary sinus SNEC who was successfully treated with induction chemotherapy using cisplatin and etoposide followed by concurrent chemoradiation therapy with cisplatin and etoposide as radiosensitizers. The patient has remained free of recurrence during 7 years of follow-up. To the authors' knowledge, this is the first case report describing long-term survival in a patient with a resolved primary SNEC of the maxilla that was successfully treated with neoadjuvant chemotherapy and concurrent chemoradiotherapy. The clinical and pathologic features of the tumor and the optimal treatment of this patient are discussed. [ABSTRACT FROM AUTHOR]