HPV-associated Sinonasal Squamous Cell Carcinoma.

Human papillomavirus (HPV)-associated sinonasal squamous cell carcinoma (SNSCC) (HPV+ SNSCC) is a recently recognized entity that accounts for up to one-third of SNSCC. Although at present these cancers are not routinely tested for HPV, the incidence is increasing and HPV+ SNSCC is associated with superior survival outcomes compared with HPV- SNSCC. Here, we present the case of a patient with HPV+ SNSCC treated with endoscopic resection followed by postoperative radiation and review the literature summarizing epidemiology and management of this disease, with emphasis on the importance of HPV testing in SNSCC.

Neutrophil-to-Lymphocyte Ratio and Pembrolizumab Outcomes in Oral Cavity Squamous Cell Carcinoma.

Objective: To determine the relationship between pretreatment neutrophil-to-lymphocyte ratio (NLR) and 6-month progression-free survival (PFS)/2-year overall survival (OS) among patients with recurrent or metastatic (R/M) oral cavity cancer on pembrolizumab.

Study Design: This study was a retrospective, observational study performed at a tertiary care academic center.

Setting: Participants included patients with oral cavity squamous cell carcinoma (OCSCC) who began pembrolizumab treatment at the University of California, San Francisco between May 2016 and May 2022.

Preoperative predictors of biochemical remission in somatotroph adenoma resections: a single-institution retrospective review.

Objective: There is persistent debate in the literature surrounding the true predictors of biochemical remission after resection of somatotroph adenoma. A multimodal analysis of a large number of patients is needed to better understand which patients may be at higher or lower risk for remission failure after surgery.

Methods: A retrospective review was performed on patients undergoing somatotroph adenoma resection.

Prognostic risk factors of buccal squamous cell carcinoma: A case-control study.

Objectives: To describe the clinicopathologic presentation of buccal squamous cell carcinoma and identify risks factors for recurrence and overall survival.

Methods: This is a retrospective case-control study of patients with oral cavity squamous cell carcinoma (OCSCC) treated at a single tertiary care center between 2010 and 2022. All patients with buccal subsite OCSCC treated during this time frame were included and paired with a randomly selected age and gender matched patient with non-buccal OCSCC.

Sinonasal (Schneiderian) Tumors in the Temporal Bone: Case Series and Systematic Review.

Background: Neoplasms derived from the sinonasal epithelium are a rare finding in the temporal bone, and their origins are controversial.

Purpose: To review the characteristics of sinonasal epithelial (previously known as Schneiderian) tumors occurring in the temporal bone.

Data Source: This was a 2-center case series and systematic review of MEDLINE, EMBASE, and the Web of Science through May 2021.

The neutrophil-to-lymphocyte ratio in salivary gland cancers treated with pembrolizumab.

Background: A minority of patients with recurrent/metastatic (R/M) salivary gland cancers (SGCs) benefit from immune checkpoint inhibitors (ICIs), necessitating reliable biomarkers for ICI response prediction.

Methods: Retrospective observational study of R/M SGC patients treated with pembrolizumab between 2016 and 2022, with a primary outcome of 6-month progression-free survival (PFS) and secondary outcome of 2-year overall survival (OS). Univariate and multivariable Cox proportional hazards models were employed.

Superior Hypophyseal Artery Intraoperative Indocyanine Green Angiogram as a Predictor of Postoperative Visual Function After Endoscopic Endonasal Surgery.

Background And Objectives: To date, there are no tools to intraoperatively predict postoperative visual function after endoscopic endonasal surgery (EES) for suprasellar lesions. The objective of this study was to retrospectively evaluate the utility of indocyanine green (ICG) angiography as an intraoperative tool to measure optic chiasm perfusion and determine its relationship with postoperative visual function.

Methods: Videos of patients undergoing EES for resection of suprasellar lesions were reviewed, where 5 mg of ICG was diluted in 10 mL of saline and administered.

Common Carotid-Greater Saphenous-M2 Bypass for Myoepithelial Carcinoma Encasing the Carotid Artery.

Revascularization of the anterior circulation using a high-capacitance graft is sometimes necessary for treatment of cervical tumors encasing the internal carotid artery (ICA). In this surgical video, we aim to demonstrate the technical nuances of high-flow extra-to-intracranial bypass using a saphenous vein graft. The patient is a 23-year-old female who presented with a 4-month history of an enlarging left-sided neck mass, dysphagia, and 25-lb weight loss.

Patterns of Postoperative Trismus Following Mandibulectomy and Fibula Free Flap Reconstruction.

The factors that contribute to postoperative trismus after mandibulectomy and fibula free flap reconstruction (FFFR) are undefined. We retrospectively assessed postoperative trismus (defined as a maximum interincisal opening ≤35 mm) in 106 patients undergoing mandibulectomy with FFFR, employing logistic regression to identify risk factors associated with this sequela. The surgical indication was primary ablation in 64%, salvage for recurrence in 24%, and osteonecrosis in 12%.

A Minimalistic Technique for Neural Tissue Preservation and Neuroanatomical Education: Quantitative Study of the Elnady Technique on Human Cadaveric Specimens.

Cadaveric shortages have been a challenge to anatomy education; as access remains low in many parts of the world, institutions are relying on plastinated specimens. Plastination typically requires the use of complex equipment and patented chemicals. While models solve cost and toxicity issues, in neuroanatomical education, the rigidity prevents deep-brain structure exploration and visual-spatial learning.

Immersive Surgical Anatomy of the Far-Lateral Approach.

The far-lateral (FL) approach is a classic neurosurgical technique that enables access to the craniocervical junction, which includes the lower clivus, the anterior foramen magnum, and the first two cervical vertebrae. The FL approach also provides access to the inferior cranial nerves (i.e.

RNA Sequencing and Gene Ontology Analysis in Acute Invasive Fungal Sinusitis.

Background: Acute invasive fungal sinusitis (AIFS) is an aggressive and dangerous disease of the paranasal sinuses with high morbidity and mortality. The immune response at the level of the nasal mucosa, the site of entry, has not been previously evaluated.

Objective: To evaluate differential gene expression in the sinonasal mucosa of AIFS patients as compared to control patients using RNA sequencing.

Correlation between tumor volume and serum prolactin and its effect on surgical outcomes in a cohort of 219 prolactinoma patients.

Objective: Prolactinoma is the most common pituitary adenoma and can be managed medically or surgically. The authors assessed the correlation between tumor volume and prolactin level and its effect on surgical outcomes.

Methods: The authors reviewed 219 patients who underwent transsphenoidal prolactinoma resection at a single institution from 2012 to 2019.

Formal Closure of Endoscopic Endonasal Skull Base Defects With a "Bow Tie" Tri-Layer Graft.

Objective: Risk factors for a postoperative cerebrospinal fluid leak (CSF) after surgery include an intraoperative high flow of CSF, elevated body mass index, defect size, and defect site. In our prior series, a high postoperative CSF leak rate for tumors of the central skull base (planum, sella, and clivus) appeared to be due to graft migration. We changed our closure technique from a single layer of collagen +/- fat graft to a novel graft, termed a "Bow tie" (a tri-layer fat graft with two pieces of collagen matrix), and report our results in this study.

Socioeconomic predictors of case presentations and outcomes in 225 nonfunctional pituitary adenoma resections.

Objective: Clinical presentations and outcomes of nonfunctional pituitary adenoma (NFPA) resections can vary widely, and very little prior research has analyzed this variance through a socioeconomic lens. This study sought to determine whether socioeconomic status (SES) influences NFPA presentations and postoperative outcomes, as these associations could aid physicians in understanding case prognoses and complications.

Methods: The authors retrospectively analyzed 225 NFPA resections from 2012 to 2019 at their institution.

A prospective study of patient-reported xerostomia-related outcomes after parotidectomy.

Objective: There is a paucity of data on patient-reported outcome measures regarding xerostomia after parotidectomy surgery. Although salivary flow rates after parotidectomy have been previously studied, they do not correlate with subjective xerostomia. This study was designed to evaluate if unilateral parotidectomy increases patient-reported xerostomia.

Presentation and management of post-operative cerebrospinal fluid leaks after sphenoclival expanded endonasal surgery: A single institution experience.

While surgical approaches and techniques of expanded endonasal approach (EEA) surgery have been well described, little data exist regarding management of post-operative cerebrospinal fluid (CSF) leaks. In this study, we examined a surgeon's continuous 12-year experience with failed closure of sphenoclival skull base defects. We conducted a retrospective case series of patients identified with post-operative CSF leaks after EEA of the sphenoclival axis, managed by a single otolaryngologist at a minimally invasive skull base center.

Immersive Surgical Anatomy of the Retrosigmoid Approach.

The retrosigmoid approach (RS) approach is the workhorse of the posterolateral neurosurgical techniques to access various posterior fossa structures and even extends into the middle fossa. Many studies have detailed two-dimensional (2D) descriptions of the RS technique from either the lateral or posterior view. This study is the first to provide a comprehensive analysis of the RS technique, soft tissue, extracranial landmarks, and intracranial structures of the posterolateral region using interactive three-dimensional (3D) volumetric models (VMs).

Impact of Smoking and Primary Tumor Subsite on Recurrence in HPV-Associated Oropharyngeal Squamous Cell Carcinoma.

Objective: To describe risk of recurrence and recurrence characteristics between ever- and never-smoking patients with human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPV+ OPSCC) when stratified by primary tumor subsite.

Study Design: Retrospective observational study.

Setting: Tertiary care center.

Use of Ultrasound for Navigating the Internal Carotid Artery in Revision Endoscopic Endonasal Skull Base Surgery.

While the use of image-guided navigation is an excellent adjunct to the use of anatomical landmarks, dynamic changes that may occur in the position of critical structures are not accounted for during and after tumor resection. Unlike navigation, Doppler ultrasonography provides real-time imaging of the anterior skull base and can be used to accurately identify the location of vital structures during skull base surgery. A 56-year-old female initially presented with new onset left eye visual deficits.