Eric E. Berg

Radiation Fibrosis of the Vocal Fold: From Man to Mouse

To characterize fundamental late tissue effects in the human vocal fold following radiation therapy. To develop a murine model of radiation fibrosis in order to ultimately develop both treatment and prevention paradigms.

Office-based sclerotherapy for benign parotid lymphoepithelial cysts in the HIV-positive patient.

To determine the efficacy of sodium morrhuate injection therapy in the control of benign lymphoepithelial cysts of the parotid gland.

Pathologic effects of external-beam irradiation on human vocal folds

Objectives: We sought to better characterize pathologic changes that occur in the human vocal fold after radiotherapy for head and neck cancer. Methods: In a blinded, controlled study of archived tissue, we evaluated postirradiation salvage laryngectomy vocal fold tissue without evidence of malignant disease. Clinical and demographic patient data were collected. In a blinded fashion, irradiated tissue was compared to nonirradiated, benign control tissue. Histomorphometric analysis was used to assess muscle and collagen organization, superficial lamina propria (SLP) and vocal ligament thickness, vocalis muscle fiber area, collagen content, and hyaluronic acid content. Immunohistochemical analysis was used to assess the content of type I collagen, type IV collagen, vimentin, fibronectin, α–smooth muscle actin, matrix metalloproteinase 9, and laminin. Results: Twenty irradiated vocal folds were evaluated and compared to control specimens. Collagen and muscle disorganization was noted in the irradiated specimens. The SLP and vocal ligament thicknesses and the mean muscle fiber diameters did not differ significantly. The SLP fibronectin and the vocalis muscle and SLP collagen content were significantly increased in the irradiated vocal folds, and the SLP collagen content increased significantly with time between irradiation and resection. The laminin content of irradiated vocalis muscles was significantly decreased. Conclusions: Radiotherapy results in significant vocal fold tissue changes. Having more precisely defined these changes, we plan continued investigation seeking targeted preventive and therapeutic interventions for improved vocal quality following radiotherapy.

The use of lipid microtubes as a novel slow-release delivery system for laryngeal injection†‡§

The potential utility of direct injection of bioactive substances in the treatment of vocal fold tissue fibrosis is limited by rapid clearance from the injection site. The objective of this study is to evaluate the potential of a lipid‐based microtube delivery system to preserve the biological activity of injected substances and prolong their duration of pharmacological effects in the larynx.

Management of Mandibular Fractures from Penetrating Trauma

Gunshot wound injuries to the face result in a varied scope of traumatic injuries. Mandible fractures may occur through this mechanism of injury, however when caused by firearms, the patterns of fracture and overall composite defects resulting are unique. The velocity of the weapon and the distance from which the injury occurred often determines the extent of injury produced from the penetrating force. A review of the management of mandibular fractures from penetrating trauma is presented. Operative and reconstructive options including advantages and disadvantages are discussed for consideration to produce the optimal result for rehabilitation of the injured patient.