Aongus J. Curran

Submental artery island flap

We describe the use of a new island flap based on the submental artery, which is ideal for the reconstruction of lower facial defects. Numerous cervical flaps have been reported, yet most are associated with limited mobility, disappointing results, and unacceptable donor site scarring.Q Many local flaps have also been used, but the search for the ideal flap continues. Large facial defects must be repaired by a flap suitably matched with the contour, color, and tissue texture of the face. Martin et al.3 recently described a submental artery flap from an anatomic study based on 24 cadaveric dissections. Initial reports indicate that the flap is a reliable source of skin for facial resurfacing and leaves a well-hidden donor site.4

Levels of oxidative damage and lipid peroxidation in thyroid neoplasia

This study assessed the presence of oxidative damage and lipid peroxidation in thyroid neoplasia.

Telomerase activity is upregulated in laryngeal squamous cell carcinoma.

Objective/Hypothesis The immortalizing enzyme telomerase has been linked to carcinogenesis and is being targeted as a novel molecular marker. This study investigated telomerase expression in patients with laryngeal squamous cell carcinoma and correlated telomerase activity with conventional prognostic parameters.

An evaluation of Merocel and Series 5000 nasal packs in patients following nasal surgery: a prospective randomised trial

Objective:  The primary objective of this study was to compare postoperative pain levels between Merocel and Series 5000 nasal packs.

Surgical salvage after failed radiation for paranasal sinus malignancy

Objective: To comment on the role of surgical salvage following failed initial treatment for paranasal sinus malignancy. Design: A retrospective analysis of one hundred eighty patients treated at The Princess Margaret Hospital, Toronto, from 1976 to 1993. Materials and Methods: Thirty‐four of 95 patients (36%) who failed initial treatment underwent surgical salvage. Initial therapy in this group was radiation only (n = 27) and combined therapy (n = 7). Patient, tumor, and surgical data were recorded. There were 23 T4, three T3, six T2, and two T1 carcinomas. Survival, recurrence rates, and the influence of a variety of variables on outcome were analyzed. Results: Two‐ and 5‐year overall actuarial survival calculated from the date of diagnosis was 54% and 35%, respectively. Two‐ and 5‐year overall actuarial survival calculated from the date of salvage surgery was 44% and 22%, respectively. Advanced age (P <.004), patients with T4 category disease (P <.04), and squamous cell carcinomas (P <.049) correlated with poorer outcome on univariate analysis. Local failure was the most common cause of death (n = 13; 65%). Conclusion: Salvage surgery has a limited role in the management of persistent or progressive disease following failure of initial treatment. Careful postradiation surveillance with endoscopic biopsy under general anesthesia and immediate surgical resection when appropriate may improve the salvage rate. Laryngoscope, 108:1618–1622, 1998

Levels of Oxidative Damage in Thyroid Neoplasia

Problem To assess levels of oxidative damage: DNA adduct (8 oxo dG) and lipid peroxidation (4HNE) in follicular carcinomas (FTC), papillary carcinomas (PTC) and follicular adenomas (FTA) and their corresponding matched normal tissue. Methods Using tissue microarrays and immunohistochemistry, we examined expression levels of nuclear and cytoplasmic (mitochondrial) 8 oxo dG and 4HNE in matched tumor and normal tissues from 16 FTCs, 15 PTCs and 39 FTAs. Results There were higher levels of mitochondrial 8 oxo dG expression in the FTA, FTC and PTC tissue compared to matched normal tissue (p values <0.001, <0.001, <0.03, respectively). This trend remained significant for the levels of mitochondrial 4HNE expression in these groups. (All p values < 0.01.) The levels of nuclear 4HNE expression were elevated in FTA and FTC compared to matched normal tissue (p values <0.001, <0.01, respectively). In contrast, the levels of nuclear 8 oxo dG expression was only statistically significant in the FTA group compared to matched normal tissue. Comparing all three groups to each other, there were higher levels of nuclear 8 oxo dG expression in FTA compared to FTC (p<0.01). This difference was not detected for 4HNE expression. Conclusion Oxidative stress is a key feature of benign and malignant thyroid neoplasms. Interestingly, levels of oxidative damage are higher in adenoma compared to the carcinoma groups. Significance The higher levels of oxidative damage in thyroid adenoma compared to carcinoma groups indicates the accumulation of this damage is an early event which could promote further genomic instability with subsequent risk of mutational events.