Arjun K. Parasher

The presentation and outcomes of mucosal melanoma in 695 patients

Most data on sinonasal mucosal melanoma come from small institutional studies, and therefore optimal treatment methods are not well understood. The purpose of this study was to analyze the association between treatment and survival in sinonasal mucosal melanoma.

Racial, ethnic, and socioeconomic disparities in pituitary surgery outcomes

To investigate the association of race, ethnicity, socioeconomic status, and hospital volume with outcomes in pituitary surgery.

Clinical characteristics and outcomes of oropharyngeal carcinoma related to high-risk non–human papillomavirus16 viral subtypes

The majority of human papillomavirus (HPV)‐related oropharyngeal carcinomas (OPCs) are associated with HPV genotype 16; however, OPC can be associated with other high‐risk non‐HPV16 genotypes.

Treatment modalities in sinonasal undifferentiated carcinoma: an analysis from the national cancer database.

Sinonasal undifferentiated carcinoma (SNUC) is a rare, aggressive malignancy of unknown etiology with a poor overall prognosis. Its relative rarity has made it difficult to determine the impact of different treatment modalities on survival.

Laryngeal Electromyographic findings in patients with vocal fold motion asymmetry

Vocal fold motion asymmetry (VFMA) is often attributed to vocal fold paresis or an anatomical variant. Although laryngeal electromyography (LEMG) may be used to evaluate patients with vocal fold paresis, electrodiagnostic findings in VFMA have not been well defined.

Analysis of laryngoscopic features in patients with unilateral vocal fold paresis.

The diagnosis of paresis in patients with vocal fold motion impairment remains a challenge. More than 27 clinical parameters have been cited that may signify paresis. We hypothesize that some features are more significant than others.

An unusual presentation of NK/T-cell lymphoma, nasal-type in the United States.

INTRODUCTION NK/T-cell lymphoma (NKCL), nasal-type is rare in the United States, representing only 1.5% of non-Hodgkin lymphomas. Classically, patients initially present with nasal obstruction (70%), caused by invasion of the localized lesion into the sinuses and nasal cavities. Initial presentation with persistent sore throat and odynophagia due to oropharyngeal tumor extension is rare, and thus, is often overlooked as viral or bacterial pharyngitis. By studying a case of NKTCL nasal type, we emphasize the need to apply high clinical suspicion for NKTCL, nasal type for early diagnosis and improved survival. METHODS A case report of a rare presentation of NKTCL, nasal-type is discussed. A literature review is provided to define clinical signs crucial for early diagnosis, appropriate work-up, and expedient treatment of this aggressive, rapidly progressive malignancy. RESULTS In the present case, a 25year-old healthy male presented with a 2-week history of sore throat and odynophagia. On exam, the patient had an ulcerative lesion of the soft palate, an enlarged uvula, and tonsillar exudate with tender submandibular lymphadenopathy. After the patient failed to respond to antibiotic therapy for presumptive pharyngitis, a biopsy of the oropharyngeal tissue was completed, which identified necrotizing sialometaplasia. High clinical suspicion led to repeat deep-tissue biopsy, where a final diagnosis of NKTCL, nasal type was made. The patient then began definitive treatment with chemotherapy and radiation. CONCLUSIONS High clinical suspicion is key to early diagnosis and improved survival of NKTCL, nasal-type. Otolaryngologists who encounter prolonged, complicated cases of pharyngitis or necrotizing sialometaplasia should consider a diagnosis of NKTCL, nasal-type, in order to prevent rapid disease progression.

Improved delivery of sinus irrigations after middle turbinate resection during endoscopic sinus surgery: Sinus irrigation and middle turbinate resection

Improvement in topical delivery to nasal mucosa is a fundamental goal of endoscopic sinus surgery (ESS). This study compares the penetration of irrigation before and after middle turbinate resection (MTR) to assess the efficacy of topical delivery.

Patient, disease, and treatment factors associated with overall survival in esthesioneuroblastoma

Esthesioneuroblastomas (ENB) are uncommon and data regarding outcomes are often limited to single‐institution series. The National Cancer Database (NCDB), which contains outcomes information from treatment centers across the United States, represents an opportunity to evaluate outcomes for rare diseases such as ENB across multiple institutions.

High-resolution microendoscope imaging of inverted papilloma and normal sinonasal mucosa: evaluation of interobserver concordance

High‐resolution microendoscopy (HRME) enables real‐time imaging of epithelial tissue. The utility of this novel imaging modality for inverted papilloma has not been previously described. This study examines the ability of otolaryngologists to differentiate between images of inverted papilloma and normal sinonasal mucosa obtained with a HRME.