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The number of unexpected focal [18F]FDG-avid findings (incidentalomas) within the parotid gland (PGI) continues to increase with the expanding use of PET/CT scanning. The prevalence of malignancy in PGIs is uncertain and appropriate management is unsettled. We aimed to explore the underlying pathologies associated with PGI. A retrospective review of all patients with parotid gland incidentaloma(s) treated at the Ear-Nose-Throat Department, Aarhus University Hospital, Denmark in the period 2012–2021, was performed. In total, 94 patients with one (n = 86) or two (n = 8) PGI(s) were included. In patients with one PGI, 72 (84%) focuses were benign, two (2%) focuses were malignant (both malignant melanoma metastases), and 12 (14%) focuses were undiagnosed. In patients with two PGIs, all 12 lesions with pathological examinations were benign (4 PGIs were undiagnosed). The median SUVmax found in benign lesions was higher (12.0) compared to malignant lesions (5.5) (p =.043). The prevalence of malignancy was low (2/94, 2.4%) in PGIs. Based on our findings, PGI in patients without a history of parotid malignancy, who undergo PET/CT scanning for reasons other than head and neck cancer (including malignant melanoma), may be managed similarly to patients with asymptomatic parotid gland tumors. [ABSTRACT FROM AUTHOR]

Recurrent respiratory papillomatosis (RRP) is a wart-like lesion mainly affecting the larynx, caused by human papillomavirus (HPV) genotypes 6 and 11. The disease affects both children and adults, and there is no cure. Surgery is the current symptom-relieving treatment; however, HPV vaccination is used as an adjuvant treatment. The aims were to study effects of HPV vaccination in RRP cases and to compare juvenile-onset to adult-onset disease and high treatment frequency (TF) to low TF cases. Medical records of RRP patients were studied from May 2006 to January 2023. Eighty-five RRP cases, tested for HPV genotypes with PapilloCheck®, were included. Vaccination- onset- and treatment analysis were performed. Twelve percent of the cases were vaccinated. The number of surgeries decreased from 2.0 to 0.8/year after HPV vaccination. Most cases had an adult-onset and less than one treatment per year. Juvenile-onset cases had a higher vaccination treatment ratio compared to adult-onset. HPV vaccination was associated with a lower number of treatments per year, supporting the use of vaccination as an adjuvant treatment. Vaccination as adjuvant treatment to surgery may lead to increased quality of life for RRP patients and saved healthcare resources. [ABSTRACT FROM AUTHOR]

Chronic suppurative otitis media (CSOM) is a prevalent chronic inflammatory disease globally. Current research suggests a possible association between anaemia and the development of CSOM. The objective of this trial was to investigate the relationship between iron metabolism and chronic suppurative otitis media (CSOM) in adults aged 20–60 years. A consecutive sampling case-control study was used. The study participants were divided into a case group (42 children diagnosed with CSOM) and a control group (42 children with normal ears). Haemoglobin (Hb), Hematocrit (Hct), mean corpuscular volume of erythrocytes (MCV), serum iron level (SI), unsaturated iron-binding capacity (UIBC), total iron-binding capacity (TIBC), transferrin (TF), ferritin (Fer) were tested in all the participants, and the results were compared with the normal ranges of the World Health Organization (WHO). The comparative analysis of cases and controls was performed using the Fisher extract test, independence t-test, or Mann–Whitney U test. p-value <.05 was considered statistically significant for correlation. There were 61 patients with CSOM and 61 controls included in the study. In the case group, 16 out of 61 patients (26.2%) had low ferritin levels and in the control group, 1 out of 61 patients (1.6%) had low ferritin levels (p <.001). In the case group, 6 (9.8%) of 61 patients had IDA, and in the control group, there were no patients with IDA among 61 patients (p =.027). There were significant differences in SI, UIBC, and Fer parameters between the groups. In adult patients, the incidence of iron deficiency was higher in CSOM patients than in controls. Iron deficiency may be considered a potential risk factor for chronic suppurative otitis media, and serum iron parameters should be evaluated in these CSOM patients and further studies should be conducted to better understand the potential link between iron deficiency and CSOM. [ABSTRACT FROM AUTHOR]

Pain is prevalent after most TransOral Robotic Surgery (TORS) procedures and may limit function i.e. swallowing. Currently, there is limited knowledge regarding optimal pain treatment in TORS. This clinical trial randomized patients to either a high-dose dexamethasone or low-dose dexamethasone treatment in addition to a multimodal basic analgesic protocol. The aim of the trial was to investigate the pain intensity during rest and swallowing using the Visual Analogue Scale (VAS) after TORS lingual tonsillectomy. Secondary outcomes were acceptable food consistency, nausea, vomiting, opioid rescue usage, length of hospitalization, feeding tube placements, readmissions, blood glucose levels and postoperative complications. The trial was conducted between August 2020 and October 2022. Eligible patients were patients scheduled for TORS-L treatment of obstructive sleep apnea syndrome or as part of the diagnostic work-up of head and neck carcinoma of unknown primary. Eighteen patients were and randomized 1:1. There were overall no significant differences between groups in the reported VAS scores during rest or swallowing (p ≥.05). Overall, there were no differences in the secondary outcomes. There were no differences in the pain intensity in the two treatment groups allocated to a basic multimodal analgesic package and either high-dose dexamethasone or low-dose dexamethasone treatment. The trial is the first RCT to include pain measurement during a procedure-relevant activity, thus creating a platform for future recovery studies. [ABSTRACT FROM AUTHOR]

Long-term voice-abuse or sudden vocal fold microvascular disruption can lead to injury and subsequent repair/remodeling of the vocal fold mucosa. Periostin is known to be involved in airway remodeling and in various otolaryngological diseases. In ischemic heart disease, increased CD31 expression has been observed around cardiomyocytes during remodeling, and endothelial proliferation has been reported to occur at these sites. We investigated the expression and the roles of CD31, CD34, and periostin in the formation of vocal fold polyps. Fifty-seven samples of vocal fold polyps were investigate histopathologically and immunohistochemically. Expression of CD31 and CD34 was detected in 41 (71.9%) and 53 (93.0%) samples, respectively, obtained from patients with vocal fold polyp. Expression of periostin was detected in 41 (71.9%) samples obtained from patients with vocal polyps. The vocal polyp samples could be classified into three histological subtypes. Three patterns of CD31 and CD34 expression were observed in the vocal polyp. Four patterns of periostin expression were observed in vocal polyps. An association was observed between the CD31 expression pattern and the histological subtype of vocal fold polyps. In vocal fold polyps, evaluation of vascular endothelial markers may be useful for staging. [ABSTRACT FROM AUTHOR]

Acute facial-nerve injury. To investigate the effects of platelet-rich fibrin (PRF) and dexamethasone on nerve regeneration. Thirty-six rats were randomly divided into six groups. Facial-nerve injury was created using a full-thickness incision in all groups except Group E. Next, primary anastomosis, PRF application, topical dexamethasone application, primary anastomosis with topical PRF and dexamethasone application, and no facial-nerve repair were performed in Groups A, B, C, D, and F, respectively. Clinical, functional, and structural improvements were evaluated at eight weeks. The mean eye-closure movement score in Group B was significantly higher than that in Group F (p <.001). The mean whisker-movement score in Group B was significantly higher than that in Group F (p =.001). The mean amplitude of whisker movement in Group F was significantly lower than those in Groups A, B, C, and E, and the mean amplitude in Group D was significantly lower than that in Group E (p <.001). Furthermore, an improvement in nerve ultrastructure was observed in Group B. PRF application has a positive effect on nerve recovery after anastomosis. Contribute to the literature to improve nerve regeneration. [ABSTRACT FROM AUTHOR]

Peritonsillar abscess (PTA) can be treated with aspiration or incision for drainage, but a subsequent PTA can occur if tonsillectomy is not performed. Better understanding is needed of when tonsillectomy should be performed to avoid PTA recurrence. This study investigated the recurrence rate of PTA following aspiration or incision for drainage and evaluated the risk factors for recurrence. The medical records of 292 patients treated for PTA were reviewed. Recurrence of PTA and elective or quinsy tonsillectomy were the primary endpoints. A Cox proportional hazards regression model for PTA recurrence was constructed with sex, age, and PTA history as predictors. Young age was the only significant predictor of PTA recurrence. Patients aged 15 to 24 years had a 30-day recurrence rate of 15.5% and a total recurrence rate of 26.6%. The total recurrence rate among patients over 30 years of age was significantly less at 4.0% (Fisher's exact test, p <.05). Based on our results, tonsillectomy should be considered for PTA patients between 15 and 25 years of age and, to effectively avoid future recurrence of PTA, should be performed urgently. [ABSTRACT FROM AUTHOR]

Listening difficulties (LiD) present difficulties in listening and paying attention to spoken information despite normal pure tone audiometry. Endolymphatic hydrops (EH) is a common inner ear condition associated with Ménière's disease but may also be present in the asymptomatic ear. Using magnetic resonance imaging, we investigated EH in patients with LiD and assessed whether the severity of EH was related to the results of auditory processing tests (APTs). 111 patients with no abnormalities on pure tone audiometry, but displaying difficulties in listening, underwent evaluation through APTs and questionnaires. Upon obtaining informed consent, the inner ears of 20 consenting patients were evaluated utilizing a 3-Tesla magnetic resonance imaging. A higher percentage of patients diagnosed with LiD by APTs had significant EH in the cochlea and vestibule than in previously reported control cases. The percentage of correct answers in the speech-in-noise test was significantly lower in patients with than in those without significant EH. In this study, significant EH of the cochlea was associated with poor listening to noise. The presence of EH affects the functioning of the auditory processing system, even in ears that test normally on standard audiometric tests. [ABSTRACT FROM AUTHOR]

Increasing life expectancy and declining birth rate are two key drivers of population aging globally, resulting in a falling population. This study investigated the evolution of pediatric patients with vertigo/dizziness during the past two decades. From 2001 to 2010, a total of 17,123 new patients with vertigo/dizziness visited our neurotological clinic. Of them, 472 (2.8%) were children (Group A). In contrast, 260 children (1.3%) out of 20,404 new patients with vertigo/dizziness were experienced during the period 2011–2020 (Group B). All patients underwent an inner ear test battery before diagnosis. The incidence of pediatric vertigo/dizziness in relation to overall neurotological cases significantly decreased from the first decade (2.8%) to the second decade (1.3%). Approximately 80% prevalence of pediatric vertigo/dizziness cases were referred to as vestibular migraine and benign paroxysmal vertigo of childhood regardless of Group A or B. Correlation between annual birth rate (x) and incidence of pediatric vertigo/dizziness cases in relation to overall neurotological cases (y) represented as y = 6.488x − 0.037 via linear regression analysis. The evolution of pediatric vertigo/dizziness revealed decreased incidence from 2.8% (2001–2010) to 1.3% (2011–2020), which may be related to the declined annual birth rate from 11.7‰ (2001) to 7.0‰ (2020). [ABSTRACT FROM AUTHOR]

Malnutrition and systemic inflammatory response have been confirmed to be important risk factors for various cancers. To compare pretreatment prognostic nutrition index (PNI) among patients with laryngeal squamous cell carcinoma (LSCC), laryngeal precancerous lesion (LPL) and laryngeal benign lesion (LBL). A total of 253 male patients with laryngeal lesions were divided into LBL, LPL with low risk (LPL (l)), LPL with high risk (LPL(h)), LSCC (i), LSCC (ii) and LSCC (iii) groups according to their histopathological findings and the TNM staging system. PNI and other clinical parameters were calculated. Kruskal–Wallis, Mann–Whitney U or Chi-square or Fisher's exact test were used for comparison of different parameters among groups. Logistic regression was performed to estimate the odds ratios (OR) and the corresponding 95% confidence intervals (CI). The PNI in the LSCC group was significantly lower than those of the LBL and LPL groups (p =.013 and p =.004, respectively), and decreased from LPL(l) to LSCC (iii) (from 53.97 ± 3.69 to 50.02 ± 4.75). LPL patients with lower PNI values had a higher risk of LSCC, the OR was 0.91 (95% CI: 0.84, 0.97) for a one-unit decrease. PNI could be a simple and reproducible marker for predicting the severity of laryngeal diseases. [ABSTRACT FROM AUTHOR]

The declining order of abnormality rates in inner ear test battery of patients with Meniere's disease (MD) is consistent with the decreasing sequence of prevalence of hydrops formation in temporal bone donors of MD. This study investigated inner ear deficits in MD patients with falls, without falls, and after sac operation to compare their inner ear deficits. Twenty MD patients with falls (Group A), 20 MD patients without falls (Group B), and 20 MD patients after sac operation (Group C) were enrolled. All patients underwent an inner ear test battery. Group A (with falls) revealed a declining sequence of abnormality rates running from audiometry (92%), cervical vestibular-evoked myogenic potential (cVEMP) test (71%), caloric test (42%) to ocular VEMP (oVEMP) test (38%). In contrast, Group B (without falls) displayed a different declining sequence of abnormality rates running from audiometry, cVEMP test, and oVEMP test to caloric test. Similarly, Group C also displayed the same declining sequence of inner ear deficits to Group A, indicating that Groups A and C may share a similar mechanism. Comparing the declining sequence of inner ear deficits in two inner ear disorders may help determine whether both disorders share a similar mechanism. [ABSTRACT FROM AUTHOR]

Background: Ménière's disease (MD) is a disorder of the inner ear, causing episodes of vertigo. Although surgery is reserved for intractable MD, intratympanic gentamicin (ITG) injection has become an alternative for controlling vertigo. Aims/Objectives: To investigate the genetic basis of ITG efficacy. Material and methods: We hypothesized that single nucleotide polymorphisms (SNPs) affect outcomes in patients with MD who receive ITG injections. Whole-exome sequencing was used to determine variations in coding regions. Results: Multivariate analysis revealed two SNPs, rs1052571 in caspase 9 (CASP9; p =.017) and rs3745274 in cytochrome P450 2B6 (p =.053), which were associated with susceptibility to ITG injections. Only the C-allele in the rs1052571 SNP was significantly associated with susceptibility (p =.027; odds ratio: 5.95; 95% confidence interval: 1.26–28.57, by Fisher's exact test). Conclusions and significance: Our results elucidated the role of the rs1052571 SNP and provide a genetic perspective on gentamicin efficacy (susceptibility) in treating intractable MD. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the effects metabolic syndrome (MetS) and its factors such as diabetes mellitus (DM), hypertension (HTN), obesity, hypertriglyceridemia (high TG) and low high-density lipoprotein cholesterol (low HDL-C) on the recovery rate of patients with BP. Methods: The medical records of 124 patients with BP were retrospectively reviewed. Patients were divided into a MetS group and a Non-MetS group according to the diagnostic criteria of MetS, and the demographic and clinical characteristics of the two groups at baseline and six months after BP onset were analyzed. Results: Age was significantly higher in the MetS group than in the Non-MetS group (p < .05), but there were no significant differences in sex ratio, initial House-Brackmann (H-B) grade, initial electroneurography and initial electromyography (p > .05). The most common comorbidity of BP was high TG, followed by low HDL-C, HTN, obesity and DM. There were no differences in initial H-B grade in patients with and without each component of the MetS (p > .05). The recovery rate of BP was significantly lower in the MetS than in the Non-MetS group and was particularly affected by DM, obesity and high TG. Conclusions: Recovery rate op BP is lower in patients with than without MetS. [ABSTRACT FROM AUTHOR]

Background: Multifocal human papillomavirus (HPV) infection into the palatine and pharyngeal tonsils, which might be linked to a second primary tumor of HPV-positive oropharyngeal cancer (OPC), was investigated. Patients and methods: One hundred and five patients with various head and neck diseases including 14 patients with OPC were enrolled in this study. Swabs from the palatine and pharyngeal tonsils were collected in each individual, and auto-nested GP5+/GP6+ PCR for HPV DNA was performed. Results: HPV DNA was detected in the palatine tonsil or the pharyngeal tonsil in a small subset of upper respiratory tract cancer other than OPC (URTC) and non-cancer diseases. Furthermore, HPV DNA was detected in both the palatine and pharyngeal tonsils in the same individual in 2 of 48 (4%) URTC cases, and 1 of 43 (2%) non-cancer cases. On the other hand, p16-positive OPC cases demonstrated a higher HPV DNA detection rate (4 of 9, 44.4%) compared with other disease groups. Conclusion: HPV DNA detection in both the palatine and pharyngeal tonsils in the same individual, especially in HPV-OPC, suggested the ability of HPV to infect tonsillar tissues of Waldeyer’s ring multifocally. [ABSTRACT FROM AUTHOR]

Background: Interstitial lung disease (ILD) is an occasionally fatal adverse event associated with cetuximab (Cmab) therapy. Our objective was to clarify to what degree pulmonary emphysema is a risk factor in the treatment of head and neck cancer with Cmab through a retrospective analysis. Methods: Subjects were 116 patients who were administered Cmab for head and neck squamous cell carcinoma. The degree of pulmonary emphysema before initiating treatment with Cmab was visually assessed retrospectively, with scoring according to the Goddard classification used in Japanese chronic obstructive pulmonary disease (COPD) guidelines for chest computed tomography (CT). Scoring was conducted by two diagnostic radiologists and mean scores were used. Cutoffs for the development and nondevelopment of ILD were examined by receiver operating characteristic (ROC) analysis and Fisher's exact test. Values of p<.05 were considered to indicate a significant difference. Results: Among the 116 patients, 11 (9.5%) developed ILD, and 105 (90.5%) did not. In ROC analysis, the optimal Goddard score cut-off of <3.0 offered 55% sensitivity and 81% specificity (p=.015). With a cutoff of <3.0, even very mild pulmonary emphysema would represent a risk factor for ILD when using Cmab. [ABSTRACT FROM AUTHOR]

Background: Myringoplasty is a common procedure in otorhinolaryngology. Many techniques with different complications and outcomes have been described, one of which is hyaluronic acid fat graft myringoplasty (HAFGM). This technique, as proposed by Saliba, uses fat tissue and hyaluronic acid discs. The technique is relatively fast with a high success rate and low complications. However, what outcomes can be expected when performed by other surgeons? In this paper, we report on the technique's success in our own hands. Materials and methods: Based on Saliba's protocol, we performed 86 HAFGMs by a transcanal approach between 2012 and August 2014. However, our 70% success rate was significantly different from Saliba's 92% (p value 2.8e − 05). We visited Saliba's clinic in order to identify critical differences between our approaches. We adapted the differences we found in our protocol and analysed another 50 HAFGMs performed afterwards, between October 2014 and December 2015. Results: The success rate increased to 86–89%, this percentage is not different compared to Saliba's results (p value.25 and.54). Conclusion: HAFGM is a reproducible technique in the hands of other surgeons, but critical following of the surgical protocol is important. [ABSTRACT FROM AUTHOR]

Conclusions: This study recommends using soft surgical principal and round window insertion to protect residual hearing with favorable anatomical exposure. Further studies are needed to evaluate the impact of the electrical stimulation on the organ of corti and hearing. Objective: The objective of this study is to analyze various factors that impact on preservation of residual hearing post-implantation. Methods: A retrospective study was performed to analyze loss of residual hearing in a cohort of 225 patients implanted in a large academic center. Sixty-four patients met the inclusion criteria. The impact of age at implantation, gender, etiology of hearing loss, cochleostomy vs round window insertion, partial vs full insertion, and effect of initial stimulation were analyzed using appropriate statistical analysis. Results: The overall hearing preservation rate for all implanted patients was 64%. Loss of residual hearing was significantly more observed in cases of cochleostomy and/or non-soft surgical techniques. No correlation was observed with age at implantation, gender, side of implant, device manufacturer, and presence of pre-lingual deafness vs post-lingual, full or partial electrode insertion. In addition, there was a small but significant decrease in hearing between pre-stimulation and post-stimulation audiograms at 6000 Hz. [ABSTRACT FROM AUTHOR]

Conclusions: It is considered that a regimen combining pharmacologic management and lifestyle modifications is the most effective treatment for laryngeal granulomas caused by GER. Objectives: This study compared the results of the combination therapy and surgery to determine the best treatment of laryngeal granuloma caused by gastro-esophageal reflux in 51 patients. Methods: Prospective study. Results: In the conservative treatment group, the CR rate was 89.7% and recurrence rate was 2.6%, while the lesions remained in patients (7.7%). This study compared the CR and recurrence rates between conservative treatment and surgery for granuloma. The results showed that the laryngeal granuloma recurrence rate was significantly lower with the conservative treatment regimen compared with surgery (p=.0016). [ABSTRACT FROM AUTHOR]

Conclusions: The two scales reliably measure laryngeal edema and dysfunction in laryngeal cancer patients. The eight categories from these scales, and abnormal pharyngeal squeeze, can be used to form a new rating scale intended to help clinicians identify and circumvent swallowing complications after chemo-irradiation. Objectives: The objectives were to compare two laryngeal edema rating scales in laryngeal cancer patients and determine if post-radiation +/- chemotherapy edema predicts dependence on a feeding tube and/or tracheostomy. Methods: A retrospective chart review between 2005-2008 revealed 28 laryngeal cancer patients status post-radiation +/- chemotherapy, with video laryngoscopies performed within 6 months after treatment. Four raters evaluated videos based on the Laryngopharyngeal Edema Scale (LES) and the Reflux Finding Score (RFS). Tracheostomy and feeding tube outcomes were then correlated with the two scales. Results: Feeding tube and tracheostomy dependence were associated with pre-treatment vocal cord paralysis, advanced T stage, and chemoradiation. Eight categories from the LES and RFS scales were significantly associated with the need for a feeding tube. [ABSTRACT FROM AUTHOR]

Conclusion: Lower-pole intracapsular tonsillectomy (LPIT) is a valuable surgical technique capable of decreasing post-operative bleeding in obstructive sleep apnea (OSA) patients. Objective: This study performed LPIT to simultaneously reduce post-operative bleeding of lower pole and prevent recurrent tonsillitis of upper pole and compared its effects to extracapsular tonsillectomy (ET). Methods: ET was performed in the extracapsular plane, with complete monopolar dissection. In LPIT, the upper pole of palatine tonsil was removed by electrocautery with the extracapsular plane, followed by removal of the lower-pole by plasma ablation with the intracapsular plane. Post-operative bleeding incidence, bleeding site, and degree of pain were compared between the two groups. Results: Three hundred and forty-seven patients diagnosed of OSA with polysomnography were enrolled. ET was performed in 152 patients and LPIT in 195 patients. There were no significant differences in post-operative pain between the two groups. The LPIT group showed significantly lower total bleeding incidence than the ET group (4.1% vs 9.2%; p=.05). In particular, lower-pole bleeding incidence was lower in the LPIT group than the ET group (1.0% vs 5.3%; p=.02). [ABSTRACT FROM AUTHOR]

Conclusion:In terms of operation time, anesthesia method, and low complication rate, ESS and balloon sinuplasty seemed comparable. The advantages of balloon sinuplasty were shown to be shortness of sick leave, possibility to be performed as an in-office procedure, and lower adhesion formation. Background:Endoscopic sinus surgery (ESS) has been considered as a treatment of choice for persistent chronic rhinosinusitis (CRS). During the last decade balloon sinuplasty has been introduced as an alternative technique to dilate the ostium. Although balloon sinuplasty is considered relatively safe and efficient, comparative evidence of its putative intra-operative and post-operative advantages remain limited. Objectives:The aim of this retrospective controlled study was to evaluate intra-operative factors and early post-operative outcomes among CRS patients who had undergone maxillary sinus operation with either balloon sinuplasty or ESS technique. Materials and methods:Data were collected from 208 patients with CRS treated either with ESS or balloon sinuplasty during the years 2008–2010. Intra- and peri-operative factors were collected from patient records of the patients who met the inclusion criteria (n = 39 in ESS group andn = 36 in balloon sinuplasty group). Results:There was no significant difference in operation time and anesthesia method between the two groups. No complications occurred with either technique. All ESS procedures and 67% of the balloon sinuplasty procedures were done in the hospital setting, whereas 33% of the balloon sinuplasty procedures were done in the office setting. The duration of sick leave and the number of patients with adhesions were significantly higher in the ESS group compared to the balloon sinuplasty group. [ABSTRACT FROM PUBLISHER]

Conclusion: At least two groups of parotid malignancies exist, including one whose parameters of dynamic MRI closely resemble those of pleomorphic adenomas. Also tumors with long time to peak enhancement after administration of a contrast agent (Tpeak) and low washout rate (WR) should be considered malignant, especially single masses with concomitant lymphadenopathy located within the deep parotid lobe. Objective: To verify if malignant tumors of the parotid are homogeneous in terms of parameters of preoperative dynamic MRI: Tpeak and WR. Methods: The retrospective analysis included 221 surgical patients with parotid tumors. Aside from fine needle biopsy, pre-operative examination included dynamic and diffusion-weighted MRI. Final diagnosis was based on histopathological examination of the surgical specimen. Results: Twenty-four of 221 (10.8%) malignant lesions were identified. Using k-means clustering based on Tpeak and WR values, two distinct clusters of parotid malignancies were identified. The cut-off value for Tpeak optimally differentiating between the clusters was 140 s; the cut-off value for WR could not be identified. The two clusters did not differ in terms of dynamic and diffusion-weighted MRI parameters, patient age, sex and prevalence of lymphadenopathy. Significant inter-cluster differences were found in the prevalence of deep parotid lobe involvement and presence of a single mass. [ABSTRACT FROM AUTHOR]

Conclusion:High levels of IgG4-positive plasma cells were observed in tissue samples from ∼30% of patients with chronic rhinosinusitis who satisfied the comprehensive diagnostic criteria for IgG4-related disease. Detection of increased numbers of IgG4-positive plasma cells in the nasal cavity or paranasal sinuses might not be sufficient to make a diagnosis of IgG4-related rhinosinusitis, and a comprehensive evaluation is required. Objectives:This study aimed to clarify the clinicopathological characteristics of IgG4-positive plasma cells in patients with chronic rhinosinusitis. Method:This study examined nasal mucosal specimens from 35 patients and assigned them to high-IgG4 and low-IgG4 groups based on infiltration of IgG4-positive plasma cells. It compared the pathological characteristics of the two groups, including the presence of fibrosis, phlebitis, hyperplasia of the nasal glands and infiltration of inflammatory cells. Results:No cases of chronic rhinosinusitis showed storiform fibrosis or obliterative phlebitis. The mean number of IgG4-positive plasma cells in samples from all patients was 29.8 ± 40.3/high-power field. Eleven of the 35 cases (31.4%) were classified as high-IgG4. Hyperplasia of the nasal glands was observed significantly more frequently in the high-IgG4 group than in the low-IgG4 group (p = .03). [ABSTRACT FROM PUBLISHER]

Conclusions:In microsurgical head and neck reconstruction, a higher rate of post-operative wound complication could be predicted by a lower pre-operative neutrophil ratio (< 64.9%), neutrophil-lymphocyte ratio (NLR) (< 3.5), and platelet-lymphocyte ratio (PLR) (< 160). Objectives:To evaluate the predictor of post-operative wound complications in microsurgical head and neck reconstruction. Methods:Patients who were undergoing tumor ablation and microsurgical reconstruction from April 2011 to March 2014 were analyzed retrospectively. The pre-operative hematological data, age, sex, co-morbidities, body mass index (BMI), adjuvant therapies, smoking, operation time, blood loss, total protein, T-stage, and Anesthesiologists Performance Status (ASA-PS) score were collected. Cases of post-operative wound healing failure were reviewed. Results:One hundred and three consecutive patients were enrolled. Among these, the results of 77 patients who were younger than 70 years of age were analyzed. The distributions of the neutrophil ratio (p = .0005), lymphocyte ratio (p = .0166), monocyte ratio (p = .0341), NLR (p = .005), and PLR (p = .008) differed significantly between the patients with and without post-operative wound healing failure. Neutrophil ratio, NLR, and PLR cut-off values of 64.9, 3.5, and 160 were significantly associated with the rate of wound healing failure rate (p = .0002, .00021, .0042, respectively). [ABSTRACT FROM PUBLISHER]

Conclusion:Like NAC ameliorates hearing loss from acoustic trauma in the inner ear, NAC may also rescue hearing loss from sudden deafness confined to the inner ear. Objective:This study assesses the effect ofN-acetyl-L-cysteine (NAC) as a single therapy for sudden deafness. Methods:Thirty-five sudden deafness patients with neither systemic disorders nor central signs in electronystagmography were treated with NAC alone and assigned to Group A. For comparison, another 35 sudden deafness patients treated by corticosteroids and plasma expander were assigned to Group B. There were no significant differences between the two groups in terms of age, sex, laterality, and pre-treatment mean hearing level. All patients underwent an inner ear test battery comprising audiometry, and ocular vestibular-evoked myogenic potential (oVEMP), cervical VEMP (cVEMP), and caloric tests. Results:Groups A and B did not significantly differ in the pre-treatment mean hearing level, and percentages of abnormal oVEMP, cVEMP, and caloric tests, indicating that the involvement severity of sudden deafness between the two groups was similar. However, Group A (43 ± 27 dB) showed significantly greater mean hearing gain than Group B (21 ± 28 dB), and Group A (91%) revealed better improved rate of hearing than Group B (57%). [ABSTRACT FROM PUBLISHER]

Conclusions:Surgical decompression performed within 2 weeks yields the best clinical prognosis for patients with TFP. This study also demonstrated that surgical exploration performed within 2 months results in acceptable outcomes. Objectives:The ideal timing for surgical intervention of traumatic facial paralysis (TFP) is still controversial. A systematic review was performed to appropriately determine the timing of surgical decompression. Methods:Related studies were identified by searching Pubmed, EMBASE, and Cochrane and reviewing the relevant reference lists until 1 March 2016. Surgical timing was classified into four sub-groups: <2 weeks, 2 weeks–1 month, 1–2 months, and >2 months. Results:Six studies including 119 patients (119 cases) fulfilled the study requirements. The number of patients who achieved perfect recovery of House-Brackmanm (H-B) grade 1 was 40 of 119 patients (33.6%). Good results were demonstrated in 94.4% (17/18) of patients managed with surgical decompression within 2 weeks vs 63.4% (64/101) of patients undergoing surgical intervention at >2 weeks (p = 0.009). [ABSTRACT FROM PUBLISHER]

ConclusionThis study indicates that IL-10 promoter polymorphism variants, smoking, and alcohol consumption increase the risk of recurrence and canceration in vocal leukoplakia. ObjectiveThis prospective, clinical trial was performed to evaluate the association of interleukin (IL)-10 promoter polymorphism variants and canceration and recurrence rates in vocal leukoplakia (a pre-cancerous laryngeal carcinoma lesion) over a 2-year period. Participants and methodSixty-one post-operative patients with vocal leukoplakia were enrolled in this prospective, observational study and genotyped for the IL-10 promoter gene (IL-10-1082 A/G, -819 T/C and -592 A/C) using pyrosequencing, and responded to a 2-year follow-up survey. Recurrence and canceration rates were used to evaluate the association between the genotype variants and the clinical outcome. ResultsThere was an increased canceration rate in the variant genotype group compared to that in the normal genotype group in the 2-year follow-up period (18.4% vs 0%,p-value = 0.038). Compared with the non-smoker group, the smoker group had a higher recurrence rate of vocal leukoplakia (29.3% vs 5%,p-value =0.044). Likewise, the recurrence rate in the alcohol consumption group was also higher (30.6% vs 8%,p-value =0.034). The percentage of cancerization in the alcohol consumption group was significantly higher than that in the non-alcohol consumption group (19.4% vs 0%,p-value =0.035). [ABSTRACT FROM PUBLISHER]

Conclusion:The study suggests that cancerous inhibitor of protein phosphatase 2A (CIP2A) expression and eosinophilia associate with chronic rhinosinusitis with nasal polyps with aspirin exacerbated respiratory disease (CRSwNP + AERD). Further studies with a larger sample size are needed to evaluate further the role of CIP2A and related pathways in CRSwNP + AERD. Objectives:Low prostaglandin E2 levels putatively associate with CRSwNP + AERD and decreased c-Myc levels. The aim of this study was to evaluate the expression and revision-predictive role of oncoprotein CIP2A, another c-Myc modulator, in CRSwNP with/without AERD, and in antrochoanal polyps. Method:Ninety retrospective archival objective glasses of nasal polyp tissue from CRSwNP or ACP patients were used for assessing mucosal eosinophilia. Of this population, 90 archival nasal polyp specimens were available for immunohistochemical staining with a polyclonal anti-CIP2A antibody, together with 19 control nasal mucosa specimens. CIP2A staining intensity and tissue eosinophilia were assessed by two blinded observers with a light microscope. Subject characteristics from 90 patients and 19 controls were obtained from patient records and additionally by a questionnaire from controls. The follow-up data was available from patient records of 84 patients and 16 controls. Results:The expression of epithelial CIP2A was detected both in control inferior turbinate mucosa and nasal polyps. The expression was significantly lower in the CRSwNP + AERD group compared to controls and CRSwNP without AERD (p < 0.01). High mucosal eosinophilia associated with CRSwNP (p < 0.01). Neither CIP2A nor eosinophilia predicted the need for revision surgery (p > 0.05), whereas previous surgery, allergic rhinitis, and use of corticosteroids did predict the need for revision surgery (p < 0.05). [ABSTRACT FROM PUBLISHER]

Conclusions:There was a difference in average score of thesensory organization test(SOT) of the case group (elderly instability) compared to the control group (healthy subjects). Cases had worse scores on thelimits of stability(LOS) than controls, but were only able to confirm statistically significant differences in the movement velocity. Objective:To study the LOS of elderly patients with instability vs healthy subjects of the same age to try to explain the increased risk of falls in elderly patients with instability. Methods:Fifty individuals ≥65 years, 30 cases (at least one of the next inclusion criteria: ≥1 fall in the last 12 months, >15 s or some support in thetimed up and go test, composite <68 in SOT, ≥1 fall during production of the SOT) compared to 20 controls. Postural study: SOT and LOS, Smart Equitest Neurocom®platform. Statistical analysis:t-Student test (p < 0.05). Result:Mean value of overall balance: patients with instability =56% vs controls =77.1% (p< 0.001). Movement velocity: cases =2243°/s vs controls =2860°/s (p = 0.029). The reaction time (cases =1217 s vs controls =1.077 s), excursion (56.95% vs 59.35%) and directional control (56.95% vs 59.35%) differences were not statistically significant. [ABSTRACT FROM PUBLISHER]

Objectives:This study used Tsumura Suzuki Obese Diabetes (TSOD) mice as a spontaneous type 2 diabetes model and Tsumura Suzuki Non-obesity (TSNO) mice as controls to investigate factors involved in the onset of hearing impairment. Method:Body weight, blood glucose levels, and auditory brainstem responses (ABRs) were measured. The cochleae were excised and evaluated histopathologically. Results:The TSOD mice showed significant hyperglycemia at 2–7 months and severe obesity at 5–10 months; significantly elevated ABR thresholds at 8–10 months; and the capillary lumens in the cochlea stria vascularis were narrower in the TSOD mice than in the TSNO mice. At 17 months, India ink vascular staining of the TSOD mice’s cochleae revealed decreased capillary density in the stria vascularis. The vascular area of capillaries in the stria vascularis and the vascular area were significantly smaller in TSOD mice. Histopathological analysis showed vessel wall thickening in the modiolus and narrowed capillaries in the stria vascularis, suggesting reduced blood flow to the inner ear. Conclusion:The diabetes mice model used in our study showed early age-associated hearing loss, and histopathology showed findings of vessel wall thickening in the modiolus, narrowing of capillaries in the stria vascularis, and chronically reduced blood flow in the cochlea. [ABSTRACT FROM PUBLISHER]

Conclusion:A significant association was found of oropharyngeal tularemia with SLC11A1 allele polymorphism (INT4 G/C) and MBL2 C + 4T (P/Q). These results indicate C allele and Q allele might be a risk factor for the development of oropharyngeal tularemia. Aim:This study aimed to investigate the relationship of SLC11A1, MBL, and P2X7gene polymorphism with oropharyngeal tularemia. Methods:The study included totally 120 patients who were diagnosed with oropharyngeal tularemia. Frequencies of polymorphisms in the following genes were analyzed both in the patient and control groups in the study: SLC11A1 (5’(GT)nAllele 2/3, Int4 G/C, 3’ UTR, D543N G/A), MBL (MBL2 C + 4T (P/Q), and P2X7(−762 C/T and 1513 A/C). Results:Among all polymorphisms that were investigated in this study, SLC11A1 gene showed a significance in the distriburtion of polymorphism allelle frequency at the INT4 region. Frequency of C allele was 54 (28%) in patients with oropharyngeal tularemia, and 31 (13%) in the control group (p = 0.006 and OR = 1.96 (1.21–3.20)). An association was detected between MBL2 C + 4T (P/Q) gene polymorphism and oropharyngeal tularemia (p < 0.005 and OR = 0.30 (0.19–0.48)). No significant relation was found between P2X7(−762 C/T and 1513 A/C) gene polymorphism and oropharyngeal tularemia in this study (p > 0.05). [ABSTRACT FROM PUBLISHER]

Conclusion:Although this study did not show higher risk of oropharyngeal malignancy in HIV patients overall, they still had much higher prevalence of NHL as well as HL than HIV negative patients. Presence of cervical lymphadenopathy is unreliable in differentiating malignant oropharyngeal tumours from benign lymphoid hyperplasia in HIV patients. Objectives:The aim of this study was to compare the histology of oropharyngeal masses between HIV positive and negative patients. Methods:A retrospective review of 119 patients who underwent oropharyngeal biopsies in a tertiary institution between 2007–2014 and whose HIV status was known (HIV positives =47; negatives =72). Results:Malignancies occurred in 63.8% of HIV patients and 65% of the negative group (p = 0.87). While non-Hodgkin’s lymphoma (NHL), squamous cell carcinoma (SCC), and Hodgkin’s lymphoma (HL) constituted 40%, 27%, and 17% of malignancies in HIV patients, respectively; in the HIV-negative group, it was 53%, 13%, and 2% for SCC, NHL, and HL, respectively (p = 0.039, 0.017, and 0.035, respectively). Reactive lymphoid proliferation accounted for 82.4% of the benign masses in the HIV positive group. Malignant tumours were recorded more in younger patient in the HIV positive than the negative group (p = 0.001). [ABSTRACT FROM PUBLISHER]

Conclusions: The results indicate that the injury of the marginal mandibular branch improved the recovery of the buccal branch in a rat model. Objective: The aim of this study was to investigate whether the injury or intactness of the marginal mandibular branch affects the regeneration of the facial nerve buccal branch in a rat model. Methods: This experiment was conducted on 30 adult rats, which were randomly and equally divided into two groups. The buccal branch of the facial nerve was transected and reconstructed, with the marginal mandibular branch damaged (group A) or intact (group B). The vibrissae movement of rats was assessed since the 4th week after operation. At the 8th and 12th week, compound muscle action potentials (CMAPs) and morphological changes of injured buccal branches were evaluated. Results: After the operation, vibrissae movement of rats was eliminated in group A, but it was similar to the health side in group B. CMAPs were recorded from regenerated buccal branches in group A since the 8th week, but no CMAPs could be recorded in group B at each time point. Additionally, the diameter of nerve fibers, the thickness of myelin sheath, and the density of regenerated fibers in group A were significantly larger than those in group B (p < 0.05). [ABSTRACT FROM PUBLISHER]

Objective: This investigation evaluated the associated factors with self-reported outcome in hearing aid users by adopting the Korean version of International Outcome Inventory for Hearing Aids (IOI-HA) and Hearing Handicap Inventory for the Elderly (HHIE). Methods: Two hundred and eight participants were enrolled in this study. Participants completed the HHIE at pre-fitting, HHIE and the IOI-HA at 1 and 3 months after fitting. The outcomes of both questionnaires were analyzed with regard to the variable factors reported or expected to be associated with the outcome of hearing aid use. Results: The hearing-related handicap evaluated by HHIE score at pre-fitting had significant associations with age and the severity of hearing impairment. The IOI-HA score with hearing aid use was significantly correlated with WRS and the severity of hearing impairment. The improvement of HHIE score showed a significant correlation with WRS. Conclusion: Word recognition score (WRS) is the most significantly associated factor for outcome of hearing aid use. In addition, audiometric configuration, previous experience of hearing aid use, and initial hearing handicap should be considered as associated factors with hearing aid outcome. [ABSTRACT FROM AUTHOR]

Conclusion: Long (GT)nrepeat polymorphisms in the heme oxygenase-1 (HO-1) gene promoter and decreased serum HO-1 levels are associated with a higher susceptibility to laryngeal squamous cell carcinoma (LSCC).Objective: In this case-control study, the association of HO-1 microsatellite (GT)nrepeat polymorphisms and serum levels with the risk of LSCC was investigated.Methods: A total of 142 LSCC patients, 54 vocal leukoplakia patients and 98 healthy controls, were examined for (GT)npolymorphisms by sequencing, and the serum HO-1 levels were detected in a sub-set from participants above by ELISA.Results: Compared with the controls, the LSCC group had significantly higher frequencies of L-allele (> 29 repeats) and L-allele carriers (p < 0.001, OR = 2.037 andp = 0.005, OR = 2.152, respectively). The frequencies of lymph node metastasis and of moderate or poor differentiation were significantly higher in L-allele carriers compared to non-L-allele carriers (p < 0.05). Significantly lower serum HO-1 levels were detected in LSCC patients (p < 0.001), and patients with lower serum HO-1 levels had more advanced cancer stage and a higher lymph node metastasis rate (p < 0.05). Furthermore, the L-allele carriers had lower serum HO-1 concentrations compared with the non-L-allele carriers (p = 0.019). [ABSTRACT FROM PUBLISHER]

Conclusions: The efficacy of uvulopalatopharyngoplasty (UPPP) can be achieved without application of an apposition suture of the palatopharyngeal arch and the palatoglossal arch.Objective: To compare the outcomes of two different methods of pharyngeal cavity reconstruction in UPPP.Methods: Forty-eight patients with obstructive sleep apnoea syndrome (OSAS) underwent UPPP (uvula-preserving). A classical pharyngeal cavity reconstruction was performed in 24 patients in group one, with plastic suture of the inferior nasopharynx and exposure of the tonsillar fossa in 24 patients in group two. The parameters evaluated were the subjective symptom score, the Epworth Sleepiness Scale (ESS), and polysomnography result. The mean operating times and complications of the post-operative pharyngeal cavity were investigated.Results: No significant difference was observed in surgical success (p = 0.54), subjective syndromes (snoring, sleep apnoea, morning headache, daytime sleepiness) (p = 0.16, 0.36, 0.79 and 0.52), ESS (p = 0.41), apnoea-hypopnoea index (AHI) (p = 0.32), and minimum SaO2(p = 0.13) between the two groups. In group one, the mean operating time was 54.72 ± 6.52 min, 11 suture dehiscence (45.8%), and five scar hypertrophy of the pharyngeal wall (20.8%) were observed post-operatively; while in group two was 38.78 ± 5.75 min, no suture dehiscence resulting from suture cutting of tissue, three scar hypertrophy were observed (12.5%). [ABSTRACT FROM PUBLISHER]

ConclusionIDO might be useful for predicting progression of primary tumor stage T2 and T3 in tongue squamous cell carcinoma (TSCC), but does not seem like a specific biomarker for diagnosing TSCC and predicting patient survival.ObjectivesIndoleamine 2,3-dioxygenase (IDO) is expressed in many cells and it catabolises the essential amino acid tryptophan to kynurenine. IDO acts as an immune modulator through suppression of T-cell immunity and other pathways. In cancer cells, IDO has been proposed to promote tumor progression by enabling malignant cells to escape from the immune system. The aim of this study was to evaluate the association and prognostic relevance of IDO expression in TSCC.MethodOne hundred and eight retrospective tongue and lymph node specimens were stained immunohistochemically with monoclonal antibody anti-indoleamine 2,3-dioxygenase. The relative abundance of IDO positive epithelial cells, IDO staining intensity, and inflammation were assessed semi-quantitatively with light microscopy.ResultsIDO was expressed stronger in tongue hyperplasia than in TSCC. However, IDO expression associated with poor survival in the sub-groups with primary tumor stage T2–T4 and in the sub-group with strong inflammation in tumors’ invasive front. [ABSTRACT FROM PUBLISHER]

ConclusionPG surgery provides sufficient radicality with a minimum of functional loss. Patient’s outcome is associated with the reliable estimation of the lesional entity/dignity. Diagnostic approaches are required to determine morphological aspects, avoid unnecessary surgery, and to reliable identify primary carcinomas/occult metastases.ObjectivesThe pre-operative assessment of parotid gland (PG) lesions is of major clinical impact, whilst surgery remains the diagnostic/therapeutic mainstay. There are still controversies about the distribution of entities, clinical course, functional outcome, and survival.MethodsIn total, 1211 patients were retrospectively analyzed for disease-related data. Differences were analyzed using the Chi-square/Fisher exact/unpaired student’st-test; survival by Kaplan-Meier.ResultsThere were 946 benign and 265 malignant tumours. In primary PG malignancy the disease-free/overall survival was 78/127 months. Metastases into the PG demonstrated a decreased survival (67 months). Extended surgery was associated with post-operative facial nerve alteration. Extracapsular dissection and superficial parotidectomy did not show differences in the facial palsy rate. [ABSTRACT FROM PUBLISHER]

ConclusionThe spindle and kinetochore-associated complex sub unit 1(SKA1) and matrix metalloproteinase-9 (MMP-9) are highly expressed in salivary adenoid cystic carcinoma (SACC), and SKA1 may be the novel, promising prognostic factor for clinical outcomes in head and neck adenoid cystic carcinoma patients.ObjectivesThis study aimed to investigate the expression of SKA1 and MMP-9 in SACC tissues and the clinical significance.MethodsSKA1 and MMP-9 expression in samples from 42 cases of SACC and 20 subjects with the normal tissue adjacent to carcinoma were detected by immunohistochemical analysis.ResultsThe positive rate of SKA1 and MMP-9 staining was 78.6% and 66.7% in SACC, respectively, significantly higher than in normal salivary gland tissues (p < 0.001). Chi-square test showed that there was no significant correlation between SKA1 expression and MMP-9 expression in SACC tissues. However, SKA1 and MMP-9 expression was positively associated with advanced stage and solid histological pattern of SACC (p < 0.05). In addition, SKA1 and MMP-9 expression was positively associated with recurrence and perineural invasion, and survival time, respectively. [ABSTRACT FROM PUBLISHER]

ConclusionsThis study suggests that long-term ventilation tube insertion is the first-choice surgical treatment for a ‘sniff-type’ patulous Eustachian tube (PET). When treating a refractory PET, it is important to determine whether the patient had a habitual sniff.ObjectivesPET patients were divided into two groups: patients with a habitual sniff (sniff-type PET) and those without a habitual sniff (non-sniff-type PET). This study examined the effects of ventilation tube insertion or silicone plug insertion in each group.MethodsSurgical procedures such as ventilation tube insertion or trans-tympanic silicone plug insertion were performed for these patients. Tubotympanoaero-dynamic graphy (TTAG) was also performed to determine the mechanisms underlying these treatments.ResultsThere were 11 cases (17 ears) of sniff-type PET and 20 cases (27 ears) of non-sniff-type PET. An improvement in symptoms was found in 72.7% of the patients who underwent silicone plug insertion (66.7% for sniff-type PET and 74.1% for non-sniff-type PET) and in 90.9% of the patients who underwent ventilation tube insertion for sniff-type PET. In TTAG assessments, many sniff-type PET patients showed significant synchronous changes at high levels of pressure (over 40 daPa) in the external auditory meatus and nasopharynx when performing a slight Valsalva manoeuvre (below 200 daPa). [ABSTRACT FROM PUBLISHER]

ConclusionsThe result suggested that mother tongue Japanese and non- mother tongue Japanese differ in their pattern of brain dominance when listening to sounds from the natural world—in particular, insect sounds. These results reveal significant support for previous findings from Tsunoda (in 1970). ObjectivesThis study concentrates on listeners who show clear evidence of a ‘speech’ brain vs a ‘music’ brain and determines which side is most active in the processing of insect sounds, using with near-infrared spectroscopy. MethodsThe present study uses 2-channel Near Infrared Spectroscopy (NIRS) to provide a more direct measure of left- and right-brain activity while participants listen to each of three types of sounds: Japanese speech, Western violin music, or insect sounds. Data were obtained from 33 participants who showed laterality on opposite sides for Japanese speech and Western music. ResultsResults showed that a majority (80%) of the MJ participants exhibited dominance for insect sounds on the side that was dominant for language, while a majority (62%) of the non-MJ participants exhibited dominance for insect sounds on the side that was dominant for music. [ABSTRACT FROM PUBLISHER]

Conclusions Patients with symptomatic perforations of the nasal septum had a high prevalence of S. aureus in the nasal mucosa. Pulsed field gel electrophoresis (PFGE) analysis revealed a high genetic heterogeneity of S. aureus among both patients and controls. This indicates that presence of different strains of S. aureus can maintain a chronic inflammation in symptomatic nasal septal perforations. Objective The purpose of this study was to investigate the microbial flora around nasal septal perforations in patients having severe symptoms regarding bleeding, obstruction, and crustation associated with their perforation. Methods Twenty-five patients with untreated symptomatic nasal septal perforations were included. For culture, swabs around the perforations were collected. Bacteria were identified with standard laboratory techniques including a MALDI-TOF mass spectrometer. Epidemiological analysis was done using PFGE protocols. Bacteriological data were compared with data from a healthy control group. Results Staphylococcus aureus was present in the mucosa surrounding the nasal perforation significantly more often (p < 0.0001) in the patients (88%) compared to a control group (13%). Corynebacterium spp. and Propionibacterium spp. were significantly more frequently identified in the control group. The PFGE analysis of S. aureus strains revealed a high genetic heterogeneity and no specific S. aureus genotypes were associated with septal perforation. [ABSTRACT FROM AUTHOR]

Conclusion The melanoma-associated antigens A1, -A9, -A11 (MAGE-A1, -A9, -A11) are relatively tumor-specific in laryngeal squamous cell carcinoma (LSCC), and could be ideal antigens for LSCC immunotherapy. In addition, MAGE-A9 probably is a poor prognostic marker for LSCC patients. Objective The MAGE-A family belongs to Cancer/testis antigens (CTA). However, the expression pattern of MAGE-A1, MAGE-A9, and MAGE-A11 in LSCC is still unclear. This study aims to evaluate the expression and possible prognostic role of MAGE-A1, MAGE-A9, and MAGE-A11 in LSCC patients. Methods The expression of MAGE-A1, MAGE-A9, and MAGE-A11 in LSCC specimens was investigated by immunohistochemistry, and the association of their expression and the clinical parameters and the survival of LSCC patients were analyzed by chi-square test, Kaplan-Meier survival and Cox regression analysis. Results The expression rates of MAGE-A1, MAGE-A9, and MAGE-A11 in LSCC were 54.7%, 46.2%, and 51.9%, respectively. The expression of MAGE-A1, MAGE-A9, and MAGE-A11 in LSCC was correlated with clinical stage, lymph node metastasis, and tumor size. The overall survival of LSCC patients with positive MAGE-A1, MAGE-A9, or MAGE-A11 expression was lower than the patients without MAGE-A1, MAGE-A9, or MAGE-A11 expression. Cox's multivariable analysis showed that MAGE-A9 expression was an independently poor prognostic factor for LSCC patients. [ABSTRACT FROM AUTHOR]

ConclusionsSampling surgical margins in trans-oral laser microsurgery for early glottic squamous cell carcinoma (SCC) may allow for increased local control rate, although with no difference in local control by endoscopic treatment alone.ObjectiveTo further delineate the role of routinely sampling separate surgical margins, in patients with early glottic SCC undergoing endoscopic laser resection.MethodsA retrospective case control study. One hundres and two early glottic cancer patients staged Tis-T2 underwent endoscopic laser surgery with curative intent as the primary treatment. Separate margins from the surgical bed were sampled following complete tumor resection in 64 patients; in 38 patients no margins were sampled.ResultsMargin sampling showed a tendency towards reduced risk for local recurrence, adjusted HR = 0.439 (p-value = 0.096). However, there was no difference in local control by endoscopic treatment alone. The patients with sampled margins were further divided based on margins’ status: 39 (61%) had negative margins, and 25 (39%) had positive margins. Compared with negative margins, patients with positive margins showed increased risk for recurrence, adjusted HR = 8.492 (p = 0.008). When margins were not sampled the risk for local recurrence was increased compared to negative margins (adjusted HR = 7.875,p-value = 0.008), and relatively comparable to what was observed when sampled margins were positive (adjusted HR = 0.927,p-value = 0.88). [ABSTRACT FROM PUBLISHER]

Conclusion Multi-level surgeries for the nasal cavity and palate can reduce the severity of obstructive sleep apnea with major narrowing above the retropalatal airway and reduce the carotid intima-media thickness, which can provide cardiovascular benefits to patients. Objective To evaluate the outcomes of moderate-to-severe obstructive sleep apnea syndrome by surgeries and the change of internal carotid artery intima-media thickness after surgeries. Subjects and methods Sixty-four patients with obstructive sleep apnea, narrowing at the nasal cavity, and retropalatal airways were enrolled in this study. Fifty-two patients underwent nasal surgery and modified uvulopalatopharyngoplasty. Twelve patients who refused surgeries and continuous positive airway pressure treatment received only conservative treatment. All patients were evaluated within 1 month before and 6 months after treatment using polysomnography, upper airway endoscopy, and B mode ultrasound. Results The success rate was 61.5% (32/52 patients) in the surgery group. There were significant differences between the surgery group and non-surgery group 6 months after treatment in the apnea hypopnea index, minimum and mean oxygen saturation, blood pressure, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and internal Carotid intima-media thickness. The changes in the oxygen saturation and the apnea hypopnea index showed significant correlations with the changes in the intima-media thickness. [ABSTRACT FROM AUTHOR]

ConclusionThis is the first controlled study of balloon sinuplasty’s long-term efficacy with the follow-up time over 5 years. The results are in accordance with a previous 2-year-follow-up study. Both techniques retained the efficacy and patient satisfaction on average 6 years after the surgery. BackgroundEndoscopic sinus surgery (ESS) and balloon sinuplasty are considered as a treatment for chronic rhinosinusitis (CRS) after a failure of conservative therapy. High cost and lack of long-term follow-up studies restrain the use of balloon sinuplasty. ObjectiveThe aim of this study was to compare long-term efficacy and satisfaction in CRS patients who had undergone maxillary sinus operation with either balloon sinuplasty or ESS technique. Previous or additional sinonasal operations were exclusion criteria. Materials and methodsStudy patients were recruited from 208 CRS-patients who underwent either ESS or balloon sinuplasty. Patients with nasal polyposis (gradus ≥ 2), previous sinonasal surgery, unilateral disease, or immune deficiency were excluded. Altogether 45 patients in the ESS group and 40 patients in the balloon group were included. Of these, 30 and 28, respectively, answered to a phone interview held on average 6 years after primary surgery. Symptom reduction and long-term satisfaction were evaluated by using symptom scores of 19 parameters altogether. ResultsBoth groups experienced improvement in symptoms and were equally satisfied with the operation. The number of patient-reported acute exacerbations was higher among the balloon dilated patients. Also, the reduction of thick nasal discharge was less evident in the balloon sinuplasty group. Four patients in the balloon sinuplasty group underwent revision surgery. There were no revisions in the ESS group. [ABSTRACT FROM PUBLISHER]

ConclusionThe Th17 cell frequency in peripheral blood and levels of IL-17 showed significant differences between patients with laryngeal squamous cell carcinoma and those with vocal cords polyps. Serum levels of IL-17 were correlated with laryngocarcinoma staging.ObjectivesTo investigate associations among the frequency of Th17 cells, levels of IL-17, and laryngeal squamous cell carcinoma.MethodEighty in-patients with laryngeal squamous cell carcinoma and 114 in-patients with polypus of the vocal cord were enrolled. Th17 cell frequencies in peripheral blood and serum levels of IL-17 were measured by flow cytometry and enzyme-linked immunosorbent assay, respectively. The tissue expression levels of IL-17 mRNA transcripts and protein were measured using quantitative RT-PCR or immunohistochemical detection, respectively.ResultsTh17 cell frequencies in peripheral blood and serum concentrations of IL-17 were significantly higher in patients with laryngocarcinoma compared with those in patients with polyps (p < 0.01 for both Th17 cells and IL-17 levels). Serum concentrations of IL-17 were significantly higher in patients with advanced laryngocarcinoma than in patients with early laryngocarcinoma (p < 0.01). The mRNA and protein levels of IL-17 were significantly higher in laryngocarcinoma tissues than in adjacent normal tissues (p < 0.01 for mRNA levels,p < 0.05 for protein levels). [ABSTRACT FROM PUBLISHER]

Conclusions BMI-1 is an upstream repressor of tumor suppressor p16 and their inverse expression patterns have been linked with patient survival in OPSCC. In this material only p16 remained a relevant prognostic marker in OPSCC. Objectives HNSCC tumors carry variable phenotypes and clinical outcomes depending on their anatomical location. In OPSCC, expression of tumor suppressor p16 is used as a surrogate marker of HPV infection and has prognostic value. There are no good prognostic biomarkers for HNSCC tumors of other anatomical locations. Aim To study the expression patterns of p16 and BMI-1 in not only oropharyngeal but also oral, hypopharyngeal, and laryngeal squamous cell carcinomas and to clarify their putative connections with clinical parameters, survival, and each other. Method Hospital records on 130 patients (59 OPSCC, 18 OSCC, 20 HPSCC, and 33 LSCC) diagnosed between 1997–2008 at the Helsinki University Hospital, Finland, were reviewed. BMI-1 and p16 expressions were studied by immunohistochemistry. Results Sixty-eight per cent of OPSCC expressed p16 and expression correlated with lower age, lower T- and higher N-category, and with improved OS and DFS. BMI-1 expression was most prevalent in OPSCC and LSCC, but had no clinical correlations. No correlation between p16 and BMI-1 expression was found. [ABSTRACT FROM AUTHOR]

ConclusionSentinel lymph node biopsies (SLNBs) can be performed safely and with reasonable accuracy in HNM patients. The outcome provides important prognostic information concerning DFS and further treatment. However, one must recognize that SLNB is a multidisciplinary procedure with a learning curve for all.ObjectivesTo evaluate efficacy of performing SLNBs in a series of consecutive patients with cutaneous head and neck melanoma (HNM) ≥ T1b from introduction of the procedure and 10 years onward.MethodEnd-points comprised of SLNB outcome, disease-free survival (DFS), and overall survival (OS).ResultsSNs were harvested in 128 of 160 patients (median Breslow = 2.0 mm, 29% ulcerated); success rate = 80.0%, or 92.1% if excluding patients where SLNBs were omitted due to non-localization on pre-operative imaging or because of SN-location in the parotid basin. Ten patients (7.8%) had positive SLNBs and were offered early completion neck dissections. Of the 146 patients available for follow-up (median = 27 months), 15.8% had recurrent disease. The risk of a regional nodal recurrence after a negative SLNB was 7.5%. SN-negative patients had improved DFSc.f.SN-positive patients (p < 0.001). A positive SLNB was the most important prognostic predictor of decreased DFS (hazard ratio = 5.70;p < 0.005), but had no significant impact on OS. [ABSTRACT FROM PUBLISHER]