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BACKGROUND Optical coherence tomography (OCT) is a noninvasive imaging modality that may reproduce the microarchitecture of tissues in real-time. This study examines whether OCT can render distinct images of thyroid, parathyroid glands, adipose tissue, and lymph nodes in both healthy and pathological states. METHODS Twenty-seven patients undergoing thyroidectomy, parathyroidectomy, and/or neck dissection for thyroid cancer were recruited prospectively for imaging prior to histopathological analysis. RESULTS Based on 122 imaged specimens, qualitative OCT descriptions were derived for healthy thyroid, parathyroid gland, adipose tissue, and lymph node. The frequencies at which distinguishing features were present for each tissue type were 88%, 83%, 100%, and 82%. OCT appearance of pathological specimens were also described. CONCLUSIONS Healthy neck tissues have distinct OCT appearances, which could facilitate parathyroid identification during thyroidectomies. However, images of parathyroid adenomas could be confused with those of lymph nodes, and benign and malignant thyroid nodules could not be differentiated.

Objectives:1) Evaluate systematic testing of human papillomavirus (HPV) and p16 status on head and neck cancer in North America. 2) Assess if HPV or p16 status is used to influence treatment in this population.Methods:An online survey was sent to three professional associations: the American Head & Neck Society, the Canadian Society of Otolaryngology, and the Quebec Association of Otolaryngology. Inclusion criteria were physicians practicing in North America. Incomplete surveys were disregarded. Chi-square analyses were conducted.Results:There was a response rate of 20% with a total of 216 complete responses. Most respondents were otolaryngologists (196; 90.7%), English-speaking (178; 82.4%), and practicing in an academic setting (138; 63.9%). Routine HPV or p16 testing was performed by 146 respondents for the oropharynx, 69 for oral cavity, and 44 for other subsites. Most physicians (113; 77.4%) test for both HPV and p16, while 58.3% indicated that HPV/p16 status influences their treatment approach for o...

Objective: 1) To evaluate p16 status as a predictor of quality of life (QOL) in oral and oropharyngeal squamous cell carcinoma (OSCC). 2) To identify independent predictive factors of QOL in OSCC.Methods: 1) We conducted a cross-sectional study on 156 OSCC patients. Patients were evaluated using 3 validated QOL questionnaires (EORTC QLQ-C30, EORTC QLQ-HN35, HADS). HPV status was determined using p16 status on immunohistochemistry staining on paraffin blocks. Using chi-square and t test analyses, we identified the value of p16 as a predictor of QOL. 2) Patient factors, tumor factors, risk factors, and treatment factors were then identified on medical record review. Bivariate analyses identified predictors of QOL, and multivariate regression analyses identified factors with independent significance.Results: QOL data were collected for 156 patients. Mean and median follow-up times were 63.2 and 35.0 months. Pretreatment tumor p16 status was available for 88 patients. Pretreatment p16 status did not significa...

an ethically approved prospective study conducted at a tertiary referral endocrine center in the UK. Intra-operative outcome measures included procedure time and blood loss. Postoperative measures included biochemical and histopathological assessment. Patient-reported outcome measures (PROMS) included subjective assessment of pain and scar cosmesis using Visual analogue scores, Voice Disability Index 2 and EQ5 HD quality of life assessment recorded 1 day, 2 weeks, 3 and 6 months postoperatively. RESULTS: In all cases the parathyroid adenoma was successfully identified and removed. Blood loss was negligible (5 ml). The recurrent laryngeal nerve (RLN) was identified and preserved in all cases. Mean robot docking and closure times plateaued to 19 minutes and 24 minutes respectively. The mean robotic console time was 65 minutes (range 25-105 minutes). Factors determining the console time were body habitus, size of the parathyroid adenoma and surgical access. Postoperative pain was minimal in the post-op period and disappeared thereafter. Subjective voice assessment showed no change in voice quality. All EQ5 HD quality of life parameters significantly improved (p0.05). Patients were discharged on the 1st post operative day. Mean time to return to daily activities was 3.4 days. CONCLUSION: Robotic assisted parathyroidectomy represents a novel targeted “scar-less in the neck” surgical approach. Preliminary results suggest improved patient satisfaction, minimal postoperative pain and rapid return to daily activities.

ObjectiveDetermine the value of fine-needle aspiration biopsies (FNAB), and stratify the risk of malignancy within the indeterminate FNAB diagnostic category at our institution.MethodsThe preoperative FNABs of 115 consecutive patients who underwent thyroidectomy at a teaching hospital between 2005 and 2007 were reviewed and categorized into 4 groups: negative for malignancy, positive or suspicious for malignancy, indeterminate, and nondiagnostic. The final histopathological diagnosis was then compared with the FNAB result. FNABs reported as follicular or Hurthle cell lesions were considered indeterminate diagnoses, and malignancy rates were calculated within this category.ResultsThe FNAB results were as follows: 17% negative for malignancy, 35% positive or suspicious for malignancy, 40% indeterminate, and 8% nondiagnostic. The sensitivity of FNAB in detecting thyroid malignancy was 83%, specificity 92% and accuracy 85%. There were 9 discrepant cases giving a false negative rate of 17% and a false positive...