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Background The purpose of this study was to present our focus on the lymph node status in the central compartment and evaluate the relevant factors and disease recurrence. Methods Between January 2004 and December 2009, 1040 patients were diagnosed with papillary thyroid carcinoma (PTC) and underwent surgery. Results The number of metastatic lymph nodes was a significant predictor for recurrence conferring a hazard ratio of 1.36 (confidence interval = 1.103–1.680; p = .004). The receiver operating characteristic (ROC) curve was calculated to determine the cutoff number of lymph nodes that predicted recurrence with the highest sensitivity and specificity (area under the ROC curve, 0.794; SE, 0.077; p = .001). The sensitivity/specificity of >3 metastatic lymph nodes for predicting recurrence was 63.6%/77.0%, respectively. Conclusion The number of metastatic lymph nodes in the central compartment was a statistical significant predictive factor associated with disease recurrence. Further study is required to confirm the relationship between the number of lymph nodes and disease recurrence. © 2015 Wiley Periodicals, Inc. Head Neck, 2015

Background The purpose of this study was to determine if hyperinsulinemia and/or insulin resistance are/is associated with the prevalence of papillary thyroid cancer (PTC) in Korean women. Methods This study included 735 female patients with PTC and 537 female non-PTC control subjects. Multiple logistic regression analysis was performed to evaluate the associations between hyperinsulinemia/insulin resistance and the occurrence of PTC. Results The prevalence of PTC was significantly correlated with increased insulin, glucose levels, and a high homeostasis model of assessment-insulin resistance (HOMA-IR). The multivariate adjusted odds ratios for the prevalence of PTC in the highest quartile groups for insulin, glucose, and HOMA-IR were 2.88, 9.32, and 4.07 (all p < .001), respectively, compared with the lowest quartile groups. Pathological analyses revealed that increased serum glucose, insulin levels, and a higher HOMA-IR were associated with the multifocality of PTC. Conclusion Hyperinsulinemia and/or insulin resistance may be associated with the development of PTC, but not disease severity in Korean women. © 2015 Wiley Periodicals, Inc. Head Neck 38: 66–71, 2016

Background The purpose of this study was to determine whether the maximum standardized uptake value (SUVmax) of the primary tumor on pretreatment 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) has prognostic significance in patients with adenoid cystic carcinoma (ACC) of the head and neck. Methods A retrospective review was carried out on 34 patients with ACC of the head and neck who underwent pretreatment 18F-FDG PET imaging from June 2005 through July 2009. All patients underwent surgery with curative intent, and 26 of them received adjuvant radiotherapy (RT). Results When subjects were stratified into 2 groups according to a cutoff value for SUVmax of 4.15, the risk of distant metastasis was significantly high in patients with high SUVmax (p = .014). Multivariate analysis showed that high SUVmax and histologic grade 3 were independent poor prognostic factors for distant metastasis-free and disease-free survival. Conclusion Pretreatment SUVmax of the primary tumor is an independent prognostic factor in patients with ACC of the head and neck. © 2015 Wiley Periodicals, Inc. Head Neck, 2014

Background Lateral cervical lymph node metastasis without central lymph node (CLN) metastasis is not infrequent in papillary thyroid cancer (PTC). This study was designed to investigate the frequency and pattern of skip metastasis in PTC. Methods We reviewed 131 patients who underwent total thyroidectomy with CLN dissection and selective lymph node dissection. Tumor location was classified in 3 areas (upper, middle, and lower third) based on preoperative ultrasonographic findings. Results All skip metastases occurred in patients whose tumors had been on the upper part of the thyroid (p

Background. The purpose of this study was to eval- uate the usefulness of tumor characteristics on ultrasonography for predicting the pathologic stage of papillary thyroid carcinoma. Methods. We evaluated 354 patients who underwent sur- gery for papillary thyroid carcinoma (� 2 cm). We analyzed the preoperative ultrasonography findings such as tumor size, shape, margin, echogenicity, calcification, vascularity, and contact with the capsule. Results. Tumor size, echogenicity, and contact with the capsule were predictive for the presence of extrathyroid exten- sion. Size and echogenicity were significantly associated with central lymph node metastasis in the multivariate analysis. Some ultrasonography characteristics such as round shape, well-defined margin, and isoechoic echogenicity were negative predictive factors for extrathyroid extension and central lymph node metastasis. Conclusion. Preoperative tumor characteristics on ultrasono- graphy correlated with several prognostic factors for papillary thy- roid carcinoma and may serve as preoperative supplementary markers for determining the optimal extent of surgery. V

Background The aim of this study was to evaluate the influence of coexistent Hashimoto's thyroiditis with papillary thyroid carcinoma on lymph node metastasis. Methods The coexistent Hashimoto's thyroiditis group was defined by the presence of thyroid autoantibodies or pathologic confirmation. The control group did not have autoantibodies, disease, or ultrasound findings of Hashimoto's thyroiditis. Results For the Hashimoto's thyroiditis group, only central lymph node metastasis had a lower frequency and the mean number of central metastatic lymph nodes was lower than in the control group after adjustment. With regard to lateral lymph node involvement, there was no significant difference between the 2 groups. The multivariate analysis showed a negative association between the coexistence of Hashimoto's thyroiditis and central lymph node metastasis. Conclusions Coexisting Hashimoto's thyroiditis in patients with papillary thyroid carcinoma was identified as a negative independent predictive factor for central lymph node metastasis. © 2010 Wiley Periodicals, Inc. Head Neck, 2010

Background. First bite syndrome is the develop- ment of pain in the parotid region after the first bite of each meal and can be seen after surgery of the parapharyngeal space. The purpose of this study is to evaluate the efficacy of intraglandular injection of botulinum toxin type A (BTA) in patients with first bite syndrome. Methods. Five patients with first bite syndrome developed after head and neck surgery were treated by injection of BTA into parotid gland. All patients completed a 4-item quality-of- life survey with a 10-point response scale designed to measure outcome of intraglandular injection of BTA. Results. The first bite syndrome without or with sialogogue and degree of interference with daily activity with or without eating or drinking improved significantly at 1 and 3 month after injection (p < .05). Conclusion. The BTA injection into affected parotid gland produces a decrease in the severity of first bite syndrome and improves the patient's quality of life. V C 2009 Wiley Peri- odicals, Inc. Head Neck 31: 989-993, 2009