[Long term follow-up results of Chinese prescription "Shen Yang" in the combined and sequential treatment of oral squamous cell carcinoma].

Objective: To evaluate the long term therapeutic effect of Chinese prescription "Shen Yang" in the combined and sequential therapy for oral squamous cell carcinoma cases.

Methods: There are 238 cases with oral squamous cell carcinoma. They were divided into two groups randomly as "Shen Yang" experiment group and control group (placebo).

Polymorphisms of GSTT1 and related genes in head and neck cancer risk.

Background: Glutathione S-transferase T1 detoxifies some environmental carcinogens while activating others and is deleted in 15% to 38% of humans. We sought to determine whether GSTT1 genotype and genotypes of several related genes are associated with risk of squamous cell carcinoma of the head and neck (HNSCC).

Methods: Somatic genotypes for GSTT1, GSTM1, GSTP1, and CYP1A1 were determined in 283 individuals with HNSCC and 208 population-based controls.

Metallic tracheal stents: complications associated with long-term use in the upper airway.

The use of metallic airway stents for the treatment of benign airway stenosis is increasingly advocated; however, the long-term safety and efficacy of these devices has not been established. Three case studies involving late but significant proximal tracheal stent complications are reported: 1 related to proximal mechanical stent failure and 2 related to obstructing granulation tissue and stenosis at the proximal stent orifice. Placement of these stents in close proximity to the cricotracheal junction is thought to be primarily responsible for these complications as a result of the excess shearing forces created at the stent-mucosal interface by the differential motion of the stent relative to the rigid subglottic airway and the more distensible trachea.

Zenker's diverticulostomy with cricopharyngeal myotomy: the endoscopic approach.

Background: The gold standard for the surgical treatment of Zenker's diverticulum is diverticulectomy and cricopharyngeal myotomy by an external approach. Unfortunately, many of the patients who present with this entity are elderly and have significant comorbidities that increase operative risk. Traditional minimally invasive approaches have not met with widespread success.

The relative value of fine-needle aspiration and imaging in the preoperative evaluation of parotid masses.

Background: To establish the sensitivity, specificity, and accuracy of imaging and fine-needle aspiration (FNA), alone or in combination, in distinguishing benign from malignant histologic findings for parotid lesions.

Methods: Retrospective blinded review of preoperative imaging and FNA studies of parotid masses and comparison with histologic findings after excision.

Results: Forty-eight patients were identified (13 with CT, 35 with MRI); 23 (48%) of the lesions were malignant, 25 (52%) were benign.

Genetic polymorphisms in head and neck cancer risk.

Objective: To assess whether genetic polymorphisms implicated as risk factors for other tobacco-associated malignancies are associated with altered risk of head and neck squamous cell carcinoma.

Design: Case-control study.

Subjects: One hundred sixty patients with head and neck squamous cell carcinoma recruited from a university-based head and neck oncology clinic and 149 population-based controls.

Microvascular reconstruction and tracheotomy are significant determinants of resource utilization in head and neck surgery.

Background: Successful "critical pathway" design and implementation are dependent on appropriate patient stratification according to those factors that are primary determinants of resource utilization.

Objectives: To test the validity of our previously reported critical pathway design and to determine whether tracheotomy and microvascular reconstruction (MR) are primary determinants of resource utilization.

Design: Cost-effectiveness analysis.

Sensory changes associated with selective neck dissection.

Objective: To evaluate sensory changes in the head and neck region associated with selective neck dissection with or without preservation of cervical root branches.

Design: Retrospective cohort study.

Setting: University tertiary referral hospital and a Veterans Affairs hospital.

Acid/pepsin promotion of carcinogenesis in the hamster cheek pouch.

Objective: While clinical observation has suggested an association between gastroesophageal reflux and laryngeal carcinoma, the nature of this relationship has yet to be defined. The purpose of this study is to determine the carcinogenic potential of acid and pepsin mixtures in the hamster cheek pouch animal model.

Design: A blinded intervention study.

Congenital laryngeal webs: surgical management and clinical embryology.

Laryngeal webs are uncommon congenital anomalies. The formation of a laryngeal web represents anomalous embryologic development of the larynx. The extent of airway involvement varies which ultimately affects surgical management.

The long-term indwelling tracheoesophageal prosthesis for alaryngeal voice rehabilitation.

Objective: To analyze the initial experience at Oregon Health Sciences University, Portland, with the use of long-term indwelling tracheoesophageal voice prostheses.

Design: Retrospective case series.

Setting: Tertiary referral academic medical center.

Fourth branchial arch sinus: clinical presentation, diagnostic workup, and surgical treatment.

Objectives/hypothesis: Abnormalities of the fourth branchial arch are much less common than those of the second arch and present in a different manner. The authors report their experience with five cases of fourth arch sinuses.

Methods: Retrospective chart review of patients at a tertiary care center.

Early postoperative calcium levels as predictors of hypocalcemia.

Objective: Early, safe postoperative hospital discharge has become a priority in the current environment of cost containment and managed care. One determinant for this following operations of the thyroid or parathyroid glands is a stable postoperative calcium level. This study sought to determine whether early postoperative calcium levels could safely predict hypocalcemia following operations of the thyroid or parathyroid glands.

Appropriate timing and velocity of infusion for the selective staining of parathyroid glands by intravenous methylene blue.

Background: Intraoperative parathyroid gland (PTG) identification by selective staining using methylene blue dye (MB) infusion has been shown effective but the degree of gland staining is inconsistent.

Methods: The effect of timing and rate of MB infusion on gland uptake was investigated in a canine model by infusing MB either rapidly over 3 to 5 minutes (n = 8) or slowly over 30 minutes (n = 4). The pattern of dye uptake in an exposed PTG was determined by standardized serial photography.

Nodal disease in purely glottic carcinoma: is elective neck treatment worthwhile?

Objective: Although there is a generalized understanding of the relatively low overall incidence of nodal disease from purely glottic carcinoma, the exact role for elective neck treatment in the management of this disease remains controversial. The purpose of this study was to identify the incidence of occult nodal disease (including paratracheal) in patients who have glottic carcinoma without significant extraglottic extension and to identify which patients are at risk for this. A retrospective chart review of 92 such patients who had either undergone neck dissection or been observed for a minimum of 2 years was performed.

Preoperative evaluation of patients with primary hyperparathyroidism: role of high-resolution ultrasound.

Unilateral parathyroid exploration with adenoma removal and identification of a normal parathyroid gland is an accepted surgical approach for the treatment of patients with primary hyperparathyroidism. This study prospectively evaluated the ability of high-resolution sonography to localize adenomas preoperatively and the effect of this localization on operative time and cost in 37 previously untreated patients undergoing surgical treatment for primary hyperparathyroidism. The sensitivity and positive predictive value of the sonographic examination were 84% and 90%, respectively.

Midline mandibular osteotomy: an analysis of functional outcomes.

Although the oncologic validity and perioperative complications of midline mandibular osteotomy are well described, little attention has been directed toward the long-term functional problems that may be associated with its use. Thirty-one patients who had undergone this procedure were examined to assess postoperative sensation, temporomandibular joint (TMJ) function, occlusion, and cosmesis. The majority (27 of 31) patients had some sequelae but these were minor in nature.

Endovascular management of hemorrhage in patients with head and neck cancer.

Objective: To present selective endovascular embolization as a therapeutic alternative to surgical ligation in the management of hemorrhage in patients with head and neck squamous cell carcinoma.

Design: Retrospective chart review of patients with head and neck cancer and significant hemorrhage who were treated with selective endovascular embolization.

Setting: A university medical center.

Critical pathways for head and neck surgery. Development and implementation.

Objective: To design, implement, and study the effectiveness of 4 new critical pathways relevant to head and neck oncological care.

Design: Before-after trial.

Setting: Tertiary referral academic institution.

Selective neck dissection and the management of the node-positive neck.

Objective: To assess the oncologic effectiveness of the selective neck dissection (SND) in patients with both clinically and pathologically proven regional metastases.

Methods: A 4-year retrospective medical chart review was conducted in an academic tertiary care referral center. Twenty-nine patients with a newly diagnosed upper aerodigestive tract squamous cell carcinoma, and both clinically and histologically proven cervical metastases who underwent 36 SND, had their records reviewed.

Near-total laryngectomy. Patient selection and technical considerations.

Objectives: To investigate the speech and swallowing outcomes of patients undergoing near-total laryngectomy and to determine those perioperative factors that are associated with success.

Design And Setting: Retrospective analysis of a case series obtained from a hospital-based academic tertiary care center.

Participants And Intervention: Records of all patients who underwent near-total laryngectomy at this institution were reviewed.

[A randomized clinical trial for the evaluation of head and neck squamous cell carcinoma treating with traditional Chinese medicine].

This paper described the research design,research process and statistical analysis of randomized clinical trial by treatment with traditional Chinese medicine in patients with squamous cell carcinoma of the head and neck.At first we found there was no significant difference between treating group and contral group(P>0.05) using log-rank test on Kaplan-Meier survival curves.

Intravenous fluid administration and urine output during radical neck surgery.

This study examines perioperative urine output (UO) and hemodynamics in 24 patients who underwent radical head and neck surgery. The hypothesis tested was that "UO was not important in patients with normal renal function as long as hemodynamics were maintained." Intraoperatively, a "wet" group (13 patients) had generous amounts of intravenous (IV) fluid administered during surgery receiving 1,018 +/- 58 mL.