Motoharu Fukazawa

Human papillomavirus as a risk factor for head and neck cancers--a case-control study.

A retrospective, case-control study was conducted to examine the relationship between the presence of human papillomavirus types 16 and 18 (HPV16/18) DNA and the risk of head and neck cancers. Twelve out of 74 (16.2%) head and neck cancers contained HPV16/18 DNA, while 3 out of 70 (4.2%) non-cancer controls showed HPV16/18 positivity by polymerase chain reaction. The presence of HPV16/18 DNA was associated with an increased risk of head and neck cancer formation, showing an odds ratio of 4.32, with a 95% confidence interval of 1.26-14.78. Although its epidemiological impact might be smaller than that of other factors like cigarette smoking, the presence of HPV16/18 DNA in the aerodigestive tract is suggested to be a risk factor for human head and neck cancers.

Osteoma with cholesteatoma in the external auditory canal

We report an unusual case of a 13-year-old girl with a benign osteoma associated with a cholesteatoma in the external auditory canal and serous otitis media. The osteoma was located in the antero-inferior wall of the right external auditory canal. A cholesteatoma was present between the osteoma and the tympanic membrane. Computed tomography revealed a soft tissue density within the external auditory canal and in the middle ear cleft. The shadow in the middle ear cleft was considered to represent the serous otitis media. Surgical removal of the osteoma and cholesteatoma proved successful, and no recurrences or complications have occurred in the first year postoperatively.

Malignant fibrous histiocytoma of the parotid gland

Primary malignant fibrous histiocytoma (MFH) arising in a major salivary gland is rare. We encountered a case of MFH affecting the parotid gland. The patient was a 54-year-old man diagnosed as having pleomorphic type of MFH after extended total parotidectomy. Examination of the resected specimen revealed the tumor had not been completely removed. Accordingly treatment consisted in the resection of MFH and radiotherapy in combination with chemotherapy using carboplatin (CBDCA). This postoperative therapy was effective in controlling the growth of the remaining tumor tissue. As the patient showed no signs of local recurrence and distant metastasis for 5 years, plastic surgery was performed to improve the serious deformation of the face with a free anterolateral thigh flap. Our literature review yielded 17 cases of parotid MFH and the 2-year survival rate was 33%.

Bilateral congenital cholesteatoma

We report a case of bilateral congenital cholesteatoma in a 6-year-old boy. Cholesteatoma was present in both ears around the tympanic isthmus (the only open passage from the tympanic cavity to the attic), extending to behind the horizontal portion of the facial nerve. This patient underwent a total of three canal wall up operations on each side to remove the cholesteatoma completely and improve hearing. This case fulfills the criteria proposed by Derlacki and Clemis in 1965. Bilateral congenital cholesteatoma is a rare condition, but the incidence of congenital cholesteatoma in children has increased recently for the following reasons: Reassessment of the criteria, the introduction of computed tomography, and increased awareness of congenital cholesteatoma. When operating on patients with bilateral cholesteatoma, the best method for preservation of hearing should be chosen. We discuss these problems in the present report.