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Objective: To better understand possible mechanisms involved in the dysregulation of gene expression unique to oral squamous cell carcinoma (OSCC) metastasis, the investigators examined the differential expression of microRNAs (miRNAs) in OSCC metastasis and their functional impact on target gene expression.Study Design: Observational assessment of DNA copy number, miRNA, and RNA expression in primary and metastatic OSCC.Setting: University of Washington Medical Center and affiliated hospitals.Subjects: Tumor samples were taken from patients with primary incident OSCC; cells were laser-capture microdissected from 17 nonmetastatic primary tumors and 20 metastatic lymph nodes.Methods: DNA copy number aberrations and gene expression profiles were previously determined using Affymetrix 250K Nsp I SNP arrays and HU133 plus 2.0 expression arrays. miRNAs were interrogated with Exiqon's Ready-to-Use PCR Panels assessing the expression of 368 human miRNAs.Results: Investigators found 31 miRNAs differentially expressed between metastatic and nonmetastatic samples (false discovery rate <0.4; 26 overexpressed and 5 underexpressed in metastatic samples). Expression of 7 of these miRNAs was significantly associated with their DNA copy numbers, and expressions of 8 of these miRNAs were significantly associated with their target genes. Among these unique miRNAs, miR-140-3p, miR-29c, and miR-29a were differentially expressed in metastasis versus nonmetastatic samples and had a strong positive correlation with their DNA copy numbers and a negative correlation with the expression of their target genes.Conclusion: Results suggest that DNA copy number aberration may play a role in the dysregulation of some differentially expressed miRNAs in OSCC metastasis, warranting further investigation. [ABSTRACT FROM AUTHOR]

Objective: To determine the role of human papillomavirus (HPV) status on quality of life (QOL) in patients with oral cavity and oropharyngeal squamous cell carcinoma (OSCC). Since OSCC that are associated with high-risk HPV have an improved response to treatment and survival, we hypothesized that patients with these tumors would have better QOL trajectories.Study Design: Prospective cohort study.Setting: Tertiary care academic medical center and 2 affiliated hospitals.Subjects and Methods: Head and neck-specific QOL was determined using the University of Washington Quality of Life scale version 4 in patients with newly diagnosed invasive OSSC (N = 228).Results: Pretreatment QOL was higher in patients with high-risk HPV-associated tumors compared with patients with HPV-negative or low-risk HPV-associated tumors (P = .015). Patients with high-risk HPV-associated tumors had larger decreases in QOL from pretreatment to immediate posttreatment compared with patients with HPV-negative or low-risk HPV-associated tumors (P = .041). There was no association between HPV status and 1-year posttreatment QOL.Conclusion: Among OSCC patients, high-risk HPV-associated tumors were associated with higher pretreatment QOL and a larger decrease in QOL from pretreatment to immediate posttreatment, suggesting that treatment intensity in this unique population may adversely affect QOL. [ABSTRACT FROM AUTHOR]

Objective. To determine the role of human papillomavirus (HPV) status on quality of life (QOL) in patients with oral cavity and oropharyngeal squamous cell carcinoma (OSCC). Since OSCC that are associated with high-risk HPV have an improved response to treatment and survival, we hypothesized that patients with these tumors would have better QOL trajectories.Study Design. Prospective cohort study.Setting. Tertiary care academic medical center and 2 affiliated hospitals.Subjects and Methods. Head and neck–specific QOL was determined using the University of Washington Quality of Life scale version 4 in patients with newly diagnosed invasive OSSC (N = 228).Results. Pretreatment QOL was higher in patients with high-risk HPV-associated tumors compared with patients with HPV-negative or low-risk HPV-associated tumors (P = .015). Patients with high-risk HPV-associated tumors had larger decreases in QOL from pretreatment to immediate posttreatment compared with patients with HPV-negative or low-risk HPV-associated tumors (P = .041). There was no association between HPV status and 1-year posttreatment QOL.Conclusion. Among OSCC patients, high-risk HPV-associated tumors were associated with higher pretreatment QOL and a larger decrease in QOL from pretreatment to immediate posttreatment, suggesting that treatment intensity in this unique population may adversely affect QOL. [ABSTRACT FROM PUBLISHER]

Involvement of the larynx and trachea by lymphoma is an uncommon problem that can cause life-threatening airway obstruction. High grade obstruction, involvement of the soft tissues of the neck, and tracheal deviation can make intubation and tracheotomy hazardous, if not impossible. Tracheotomy can be ineffective with obstruction of the distal trachea. The clinical presentation and treatment of eight patients with lymphoma involving the larynx or trachea are presented with emphasis on airway management. Dramatic tumor response with relief of airway symptoms was achieved with a regimen of radiotherapy, chemotherapy, corticosteroids, helium-oxygen mixtures, humidity, and intensive care unit monitoring. Direct airway intervention, including tracheotomy, was usually successfully and safely avoided. [ABSTRACT FROM AUTHOR]

A retrospective review of 4 years experience with over 32 epistaxis patients requiring hospitalization and using a standard medical or surgical therapy for control is presented. Medical therapy included the use of anterior nasal packing alone or in association with intranasal and nasopharyngeal balloon tamponade. Surgical therapy, for the most part, consisted of ethmoid and/or internal maxillary artery ligations. Most patients were treated initially with packing and balloons. Fifty-two percent of the group failed this therapy and required ligations for control. The patients who did not come to operation had fewer complications, a shorter average hospital stay, and lower average cost of hospitalization without increased risk of future epistaxis. An analysis is made comparing the results, complications, and financial implications of these two approaches. [ABSTRACT FROM AUTHOR]

Objective: To determine the role of human papillomavirus (HPV) status on quality of life (QOL) in patients with oral cavity and oropharyngeal squamous cell carcinoma (OSCC). We hypothesized that high risk HPV (HPV‐16, 18, 35, 45) tumors would be associated with better QOL trajectory. Method: Head and neck‐specific QOL was determined using the University of Washington Quality of Life (UW‐QOL) scale version 4 in patients with newly diagnosed invasive OSSC (n = 296). Results: Pre‐treatment QOL was higher in patients with high risk HPV tumors compared with patients with HPV negative or low risk HPV (HPV‐11, 32, 53, 66) tumors (P =. 004). This association remained in multivariate analysis. Patients with high risk HPV tumors had larger decreases in QOL from pre‐treatment to immediate posttreatment compared with patients with HPV negative or low risk HPV tumors (P =. 032). There was no association between HPV status and QOL 1 year posttreatment. Conclusion: Among patients with OSCC, high risk HPV was independently associated with higher pretreatment QOL. The data did not support our hypothesis that patients whose tumors contain high risk HPV have better QOL trajectory. Research exploring patient expectations, treatment effects, and psychiatric comorbidity may provide insight into this finding. [ABSTRACT FROM AUTHOR]

Objective: Better understand possible mechanisms involved in the dysregulation unique to OSCC metastasis, we examined whether DNA copy number aberrations (CNAs) are associated with differential expression of miRNA that are found in OSCC metastasis. Method: Tumor cells were laser capture microdissected from 17 nonmetastatic primary tumors and 20 metastatic lymph nodes. CNAs and gene expression profiles were previously determined using Affymetrix 250K Nsp I SNP Arrays and HU133 plus 2.0 expression profiles. MiRNAs were interrogated with Exiqon's Ready‐to‐use PCR Panels. Results: We found 155 miRNAs expressed in >80% of metastatic or nonmetastatic samples with 31 of them differentially expressed in metastatic tumor cells (FDR<0.4; 27 over‐expressed, 4 under‐expressed). We found the expression of 11 miRNAs to be significantly associated with their DNA copy numbers (p < 0.5) and 7 of these were among the differentially expressed miRNAs. Among these, miR‐140‐3p, miR‐29c, and miR‐29a showed a correlation between their expression and corresponding DNA copy number. These miRNAs were also associated with the down‐regulation of their target genes in the MAP/ERK oncogenic pathway. Conclusion: Our results suggest that DNA copy number aberration may play a role in the dysregulation of miRNA in OSCC metastasis and that copy number driven miRNAs warrant further investigation. [ABSTRACT FROM AUTHOR]

Objective: To introduce and outline the advantages of an endoscopic coblation-assisted debulking of advanced juvenile nasopharyngeal angiofibroma (JNA). Study Design: Two case reports. Setting: Tertiary referral center. Subjects and Methods: Two male patients undergoing an endoscopic debulking of the intranasal extension of their advanced JNA tumors were reviewed. Their tumors contained orbital, infratemporal fossa, and intracranial extensions with cavernous sinus invasion (Fisch stage IVb and Radowski's stage IIIb). Embolization of tumor-feeding vessels was performed before surgery. The tumors were then partially coblated via an endoscopic approach using a Coblator II System with Evac 70 Plasma Wand in conjunction with an image-guided navigation system. Results: Both patients achieved symptomatic remission of their nasal obstruction with removal of the intranasal extent of their tumor. Coblation provided a controlled and relatively bloodless debulking of the JNAs without requiring the timely usage of multiple instruments, including bipolar and suction cautery, laser, and microdebrider. Conclusions: Although less morbid than open approaches, contemporary endoscopic techniques to remove intranasal extensions of large JNAs may require a frustrating number of instruments and cause a higher frequency of intralesional hemorrhage and unnecessary injury to healthy tissue. Our review is the first to describe image-guided endoscopic coblation of JNA tumors. We show this technique may be a safe and effective minimally invasive approach to assist removal of intranasal portions of advanced JNA tumors. [ABSTRACT FROM AUTHOR]