Analytic and clinical validity of thyroid nodule mutational profiling using droplet digital polymerase chain reaction.

Background: Recent guidelines for the management of thyroid nodules incorporate mutation testing as an adjunct for surgical decision-making, however current tests are costly with limited accuracy. Droplet digital PCR (ddPCR) is an ultrasensitive method of nucleic acid detection that is particularly useful for identifying gene mutations. This study aimed to assess the analytic and clinical validity of RAS and BRAF ddPCR mutational testing as a diagnostic tool for thyroid fine needle aspirate biopsy (FNAB).

Transoral robotic surgery with radial forearm free flap reconstruction: case control analysis.

Background: The resection of large oropharyngeal tumors traditionally involves a lip-splitting mandibulotomy for adequate margin visualization and free flap reconstruction of the surgical defect. Transoral robotic surgery (TORS) has emerged as a technique that can resect large and complex oropharyngeal tumors, avoiding a lip-splitting approach. The aim of this study is to compare the lip-splitting mandibulotomy approach versus TORS for the management of advanced stage oropharyngeal carcinomas.

Ultrasensitive detection of oncogenic human papillomavirus in oropharyngeal tissue swabs.

Background: The incidence of oropharyngeal squamous cell carcinoma (OPSCC) caused by oncogenic human papillomavirus (HPV) is rising worldwide. HPV-OPSCC is commonly diagnosed by RT-qPCR of HPV E6 and E7 oncoproteins or by p16 immunohistochemistry (IHC). Droplet digital PCR (ddPCR) has been recently reported as an ultra-sensitive and highly precise method of nucleic acid quantification for biomarker analysis.

Investigation of EZH2 pathways for novel epigenetic treatment strategies in oropharyngeal cancer.

Background: In recent decades, the incidence of oropharyngeal squamous cell carcinoma (OPSCC) has been rising worldwide as a result of increasing oncogenic human papillomavirus (HPV) infections in the oropharynx. EZH2 is an epigenetic regulatory protein associated with tumor aggressiveness and negative survival outcomes in several human cancers. We aimed to determine the role of EZH2 as a potential therapeutic epigenetic target in HPV-positive and negative OPSCC.

Detection of human papillomavirus type 16 in oropharyngeal squamous cell carcinoma using droplet digital polymerase chain reaction.

Background: The incidence of oropharyngeal squamous cell carcinoma caused by oncogenic HPV (HPV-OPSCC) is rising worldwide. HPV-OPSCC is commonly diagnosed by RT-qPCR of HPV-16 E6 and E7 oncoproteins or by cyclin-dependent kinase inhibitor 2A, multiple tumor suppressor 1 (p16) immunohistochemistry (IHC). Droplet digital PCR (ddPCR) has been recently reported as ultra-sensitive and highly precise method of nucleic acid quantification for biomarker analysis.

Brief electrical stimulation after facial nerve transection and neurorrhaphy: a randomized prospective animal study.

Background: Recent studies have examined the effects of brief electrical stimulation (BES) on nerve regeneration, with some suggesting that BES accelerates facial nerve recovery. However, the facial nerve outcome measurement in these studies has not been precise or accurate. The objective of this study is to assess the effect of BES on accelerating facial nerve functional recovery from a transection injury in the rat model.

Sanna Classification and Prognosis of Cholesteatoma of the Petrous Part of the Temporal Bone: A Retrospective Series of 81 Patients.

Objective: To determine how classification of petrous bone cholesteatomas (PBCs) using the 5-point Sanna classification can predict major structural involvement, facial nerve outcomes, hearing outcomes, postoperative complications, and disease recurrence.

Study Design: Retrospective case series.

Setting: Tertiary referral center in Bergamo, Italy.

Acoustic rhinometry and video endoscopic scoring to evaluate postoperative outcomes in endonasal spreader graft surgery with septoplasty and turbinoplasty for nasal valve collapse.

Background: Nasal obstruction is a common complaint seen by otolaryngologists. The internal nasal valve (INV) is typically the narrowest portion of the nasal cavity, and if this area collapses on inspiration the patient experiences significant symptoms of nasal obstruction. The nasal obstruction is further compounded if the INV is narrower than normal.

Immunoglobulin G4-related diseases in the head and neck: a systematic review.

Background: Immunoglobulin G4 related disease (IgG4-RD) is a poorly understood chronic inflammatory disorder affecting the middle-aged and elderly that can present to the otolaryngologist. We aim to summarize the current literature regarding the manifestations and management of IgG4-RD in the head and neck.

Methods: Pubmed and EMBASE were searched using the term relevant search algorithm utilizing keywords such as: IgG4 related disease, head and neck, orbit, salivary glands, sialadenitis, Kuttner, angiocentric eosinophilic fibrosis, submandibular, lacrimal, thyroid, dacryoadenitis, nasal, sinus, and Mikulicz's.

Optimal site for facial nerve transection and neurorrhaphy: a randomized prospective animal study.

Background: Since the first facial allograft transplantation was performed, several institutions have performed the procedure with the main objectives being restoration of the aesthetic appearance and expressive function of the face. The optimal location to transect the facial nerve during flap harvest in transplantation to preserve facial movement function is currently unknown. There are currently two primary methods to perform facial nerve neurorrhaphy between the donor and recipient-one protocol involves transection and repair of the facial nerve at the main trunk while the another protocol advocates for the neurorrhaphy to be performed distally at the main branches.

Role of primary surgery in the treatment of advanced oropharyngeal cancer.

Background: The purpose of this study was to compare survival outcomes of patients with advanced stage oropharyngeal squamous cell carcinoma (SCC) according to surgical and nonsurgical treatments, when stratified by smoking and p16 status.

Methods: We conducted a prospective longitudinal population-based study of 279 patients diagnosed with advanced oropharyngeal SCC. Patients were stratified by smoking and p16 status.

Survival outcomes of First Nations patients with oral cavity squamous cell carcinoma (Poliquin 2014).

Background: Oral cavity squamous cell carcinoma (OCSCC) is the most common head and neck cancer, affecting approximately 2000 Canadians yearly. Analysis of Canadian Cancer Registry data has shown that the incidence of oral cavity cancer is decreasing and survival outcomes are improving. There are significant health disparities in First Nations (FN) people in Canada.

Validation of pharyngeal findings on sleep nasopharyngoscopy in children with snoring/sleep disordered breathing.

Objective: To validate the pharyngeal findings in sleep nasopharyngoscopy (SNP) of children with snoring - sleep disordered breathing (S-SDB).

Design: Prospective agreement diagnostic study on retrospective data.

Methods: We conducted an inter-and intra-rater agreement study on video documentations of SNP performed on children (non-syndromic, complex, or operated upon) who presented with S-SDB.

Can a multisensory teaching approach impart the necessary knowledge, skills, and confidence in final year medical students to manage epistaxis?

Objective: The purpose of this study is to evaluate the efficacy of a multisensory teaching approach in imparting the knowledge, skills, and confidence to manage epistaxis in a cohort of fourth year medical students.

Methods: One hundred and thirty four fourth year medical students were recruited into the study from Aug 2011 to February 2012 in four groups. Students listened to an audio presentation (PODcast) about epistaxis and viewed a video presentation on the technical skills (VODcast).

Molecular predictors of locoregional and distant metastases in oropharyngeal squamous cell carcinoma.

Background: The incidence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing due to fundamental changes in oncogenesis related to effects of the human papilomavirus (HPV). Virally-mediated tumours behave and respond to treatment differently than their classic, carcinogenically-mediated counterparts despite similar stage and grade of disease. This difference in behaviour has lead to investigation of etiologies of OPSCC at the molecular level.

Association between allergic rhinitis and asthma in a Northern Alberta cohort.

Background: Many published epidemiologic studies confirm a marked increase in the prevalence of asthma and allergic rhinitis. The link between allergic rhinitis and asthma has been extensively studied and approximately 75% of patients with asthma have allergic rhinitis. The proportion of patients with asthma in populations of allergic rhinitis patients has not been well studied.

Teaching cricothyrotomy: a multisensory surgical education approach for final-year medical students.

Objective: This study sought to evaluate the efficacy of a multisensory teaching approach in imparting the necessary knowledge, technical skills, and confidence to perform a cricothyrotomy to a cohort of fourth-year medical students.

Methods: One hundred twenty students were recruited into the study. Subjects commenced by viewing an upper airway obstruction vodcast.

Intravenous tranexamic acid and intraoperative visualization during functional endoscopic sinus surgery: a double-blind randomized controlled trial.

Background: Bleeding during endoscopic sinus surgery (ESS) can hinder surgical progress and may be associated with increased complications. Tranexamic acid is an antifibrinolytic that is known to reduce operative bleeding. The current study was designed to assess the effect of adjunctive intravenous tranexamic acid on intraoperative bleeding and the quality of the surgical field during ESS.

Outcomes of free flap reconstruction in the elderly.

Background: The reconstructive surgeon is often faced with the dilemma of offering free flap reconstruction to the elderly after surgical extirpation in the head and neck due to the perception that this population tolerates these procedures poorly.

Methods: A 42-month retrospective review of all microvascular free flap reconstruction cases from a large head and neck oncology program was reviewed. A series of 278 patients met inclusion criteria and were stratified into 2 age groups: 45 to 64.

Electric shock ear torture: a rare cause of tympanic membrane perforation and mixed hearing loss.

Summary of case report findings: Picana (electric shock torture) is a globally used form of torture. This is the first documented case of picana applied to the tympanic membrane. Two other types of ear torture have been documented, including picana of the helix and telefono.

Oropharyngeal squamous cell carcinoma and human papillomavirus-associated cancers in women: epidemiologic evaluation of association.

Objective: Human papillomavirus (HPV) is a well-established etiologic factor in oropharyngeal squamous cell carcinoma (OPSCC). The objective of this study was to evaluate the association between OPSCC and HPV-related cancerous lesions of the cervix.

Methods: Demographic, survival, and pathologic data on all female patients diagnosed with OPSCC in Alberta between 1998 and 2008 were collected.

Triamcinolone-impregnated nasal dressing following endoscopic sinus surgery: a randomized, double-blind, placebo-controlled study.

Objectives/hypothesis: To evaluate the impact of steroid-impregnated absorbable nasal dressing on wound healing and surgical outcomes after endoscopic sinus surgery (ESS).

Study Design: A prospective, randomized, double-blinded, placebo-controlled trial.

Methods: Chronic rhinosinusitis patients with polyposis who were to undergo bilateral endoscopic sinus surgery were recruited and randomized to receive triamcinolone-impregnated bioresorbable dressing (Nasopore; Stryker Canada, Hamilton, Ontario, Canada) in one nasal cavity and saline-impregnated dressing contralaterally.

Steel scalpel versus electrocautery blade: comparison of cosmetic and patient satisfaction outcomes of different incision methods.

Objective: To determine which method of skin incision has superior cosmetic and patient satisfaction outcomes.

Methods: Consenting patients undergoing bilateral neck dissection who met the inclusion criteria were prospectively enrolled. Each side of the neck was randomly assigned into one of the following two groups: scalpel incision and electrocautery incision.

Double free-flap reconstruction: indications, challenges, and prospective functional outcomes.

Objective: To investigate the increasing use of double free flaps in the reconstruction of large head and neck defects.

Design: A 5-year retrospective medical record review in a large tertiary care head and neck oncology program. Prospectively collected functional data were also analyzed.