Theresa A. Gurney

Adenoid cystic carcinoma of the major salivary glands treated with surgery and radiation.

Objective: To examine patient characteristics, pathologic features, and treatment outcomes of adenoid cystic carcinoma of the major salivary glands.

Otolaryngologic manifestations of human immunodeficiency virus infection

The otolaryngologist is uniquely positioned to detect and pursue manifestations of HIV in the head and neck. The presentation of problems subsequent to HIV infection is quite varied, but close investigation will often reveal treatable problems.

Predictors of quality of life after treatment for oral cavity and oropharyngeal carcinoma

BACKGROUND: Treatment for head and neck cancer, including surgery, radiation, and chemotherapy, can impact quality of life. DESIGN: Patients seen at an academic institution and treated for oral cavity and oropharyngeal carcinoma were asked to participate. The standardized University of Michigan Head and Neck Specific Quality of Life questionnaire was distributed. RESULTS: Eighty-seven patients completed the questionnaire. The majority had squamous cell carcinoma (94%), stage III or IV disease (53%), and a history of tobacco or alcohol dependence (59%), and were male (62%). Eighteen percent had free-tissue transfer (fibula free flap in 8% and radial forearm free flap in 10%). Predictors of worse quality of life included advanced stage, gastrostomy-tube dependence, complication, or recurrence. CONCLUSION: Stage, gastrostomy-tube dependence, complication, recurrence, and treatment modality influence quality of life. A better understanding of the impact of oral cavity and oropharyngeal cancer treatment on quality of life will enable us to better advise our patients.

Embolization for the treatment of idiopathic posterior epistaxis.

Background The goal of this study was to examine safety and efficacy of transarterial embolization for the treatment of idiopathic posterior epistaxis. Methods A retrospective chart review was conducted to characterize the underlying conditions of eighty-one consecutive patients for whom complete records were available presenting with posterior epistaxis, the associated risk factors for patients with idiopathic posterior epistaxis, and the success rate of embolization in this patient population. Results One hundred consecutive patients undergoing embolization for epistaxis were identified and 81 patients were included in the analysis. Nineteen patients did not have sufficient and retrievable medical records to be included in the study. Idiopathic posterior epistaxis was the most common underlying etiology of patients with refractory posterior epistaxis (34%). Hypertension, vascular disease, and diabetes were frequently detected comorbid diseases. Patients were equally as likely to be hypertensive as normotensive at the time of presentation (45 and 55%, respectively). Most patients (83%) had failed at least one prior treatment modality. Few patients had a recurrence of epistaxis within 72 hours (three patients [12%]) or had an adverse effect associated with embolization (three patients [12%]). Conclusion Embolization for the treatment of posterior epistaxis is a safe and effective treatment modality.

Otolaryngological Manifestations of Cleidocranial Dysplasia, Concentrating on Audiological Findings†

Objectives/Hypothesis Cleidocranial dysplasia is an autosomal dominant skeletal syndrome characterized by open skull sutures and clavicular hypoplasia or aplasia. It results from mutations in the transcription factor CBFA1 required for osteoblast differentiation and normal bone formation. Therefore, mutations in CBFA1 would be expected to cause conductive or sensorineural hearing loss, or both. The objective of the study was to evaluate the auditory function and head and neck manifestations of patients with cleidocranial dysplasia.

Otolaryngologist-Head and Neck Surgeon-Performed Ultrasonography for Parathyroid Adenoma Localization

Objective: To demonstrate the efficacy of otolaryngologist–head and neck surgeon‐performed ultrasonography (US) for the preoperative localization of parathyroid adenomas.

09:02: Quality of Life Following Head and Neck Cancer Treatment

lymph node (SLN) biopsy for accurate staging of oral cavity squamous cell carcinomas (SCC) with clinically and radiologically N0 necks. 2. Discuss SLN biopsy as the only tool to accurately identify early extracapsular spread (ECS). 3. Be able to discuss the potential limitations of selective neck dissection (SND) in the absence of SLN biopsy. METHODS: Retrospective review evaluating 14 consecutive patients with stage I or II oral cavity SCC undergoing SND without evidence of nodal or distant metastatic disease from January 1997 to December 2006. Prior to SND, patients underwent preoperative lymphoscintigraphy and SLN mapping with technetium-99 sulfur colloid. Intraoperatively, SLNs were marked with suture and resected with the en bloc lymphadenectomy specimen. SLNs were subsequently analyzed via standard H&E stains, immunohistochemistry, and serial sectioning for evidence of metastases. RESULTS: Preoperative lymphoscintigraphy showed one or more SLNs in all patients. Three patients had SLNs in two nodal basins and one patient had SLNs in multiple basins. At the conclusion of SND, no SLNs were left in the neck. Three patients had micrometastases and two of these three had ECS in nodes that otherwise appeared normal clinically, grossly, and radiographically. CONCLUSIONS: Combined with standard SND, SLN biopsy may optimize clinical outcomes in patients with oral cavity SCC with clinically negative necks. Microscopic ECS may be missed through routine pathologic analysis of neck dissection specimens for early stage oral cavity cancers. SLN biopsy enables more accurate planning of SND with less likelihood of missing disease-harboring nodal basins.