Current update on established and novel biomarkers in salivary gland carcinoma pathology and the molecular pathways involved.

This review aims to take stock of the new information that has accumulated over the past decade on the molecular pathology of salivary gland cancer. Emphasis will be placed on established and novel immunohistochemical markers, the pathways involved, and on findings of prognostic importance as well as new therapeutic concepts. Whenever reasonable, analogies to tumors of better explored, histologically related glandular organs such as pancreas and breast are established.

Second-look microlaryngoscopy to detect residual carcinoma in patients after laser surgery for T1 and T2 laryngeal cancer.

Conclusions: The presented concept of second-look microlaryngoscopy in patients treated with transoral laser surgery (TLS) for early glottic carcinoma is promising and warrants further studies to evaluate its benefits.

Objectives: Clear surgical margins at the primary site influence the course of the disease in patients with laryngeal carcinoma who undergo TLS. Several factors may lead to a reduced sensitivity in detecting tumor remnants at the time of the initial procedure.

Survivin and epidermal growth factor receptor expression in surgically treated oropharyngeal squamous cell carcinoma.

Background: The epidermal growth factor receptor (EGFR) and the inhibitor of apoptosis protein survivin play important roles in the regulation of cellular proliferation and survival in squamous cell carcinomas. Their correlation in oropharyngeal squamous cell carcinoma (OSCC) has not been evaluated yet.

Methods: In this multicenter study, we analyzed the expression of survivin and EGFR in tissue specimens from 73 selected patients with OSCC using immunohistochemistry.

[Dysphagia as a presenting symptom of a cervical neurofibroma].

A 33-year-old, otherwise healthy female nursing student presented to the ear-, nose-, and throat- (ENT) outpatient clinic with a globus sensation that had been progressing for 6 months. Tomographic imaging revealed a neck mass extending from the 4th vertebrum to the subclavicular region and apex of the left lung. A surgical resection with histopathological examination exposed a neurofibroma.

Alterations in the p53 pathway and their association with radio- and chemosensitivity in head and neck squamous cell carcinoma.

Chemotherapy and/or radiotherapy are established measures in treatment protocols of head and neck squamous cell carcinoma (HNSCC). However, we still lack reliable predictive markers for the response to radio- and chemotherapy. The p53 pathway is involved in stress response and thus might influence chemo-/radiosensitivity.

Patterns of lymph node spread and its influence on outcome in resectable parotid cancer.

Aim: To assess the metastatic topography of intraparotideal and neck lymph nodes in parotid cancer and its influence on tumour recurrence and survival.

Methods: The lymph node spread of 142 patients with primary parotid carcinoma treated from 1986 to 2006 was analysed. Disease-free survival (DFS) and overall survival (OS) were calculated.

Transoral laser surgery for laryngeal cancer: outcome, complications and prognostic factors in 275 patients.

Aim: Curative treatment options for laryngeal carcinoma include primary radiation therapy, open surgical techniques and transoral laser surgery (TLS). In the last decade, TLS has become an important tool in the treatment of laryngeal cancer and has become the standard approach in many institutions. The aim of this study was to review the experience of a single center institution with TLS for early and advanced laryngeal cancer.

Nuclear survivin expression is associated with HPV-independent carcinogenesis and is an indicator of poor prognosis in oropharyngeal cancer.

The relationship between expression of the inhibitor of apoptosis protein survivin and the presence of high-risk human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OSCC) remains unclear. This also accounts for its role as a predictor of survival. Therefore, we conducted a multicentre retrospective study on 106 consecutive oropharyngeal cancer patients.

Accessory parotid gland lesions: case report and review of literature.

There are numerous causes for chronic cheek swelling, including masseteric hypertrophy, lymphadenopathy, diffuse inflammatory changes and neoplasia. We report an unusual case of a recurrent swelling as the result of sialolithiasis of an accessory parotid gland, which lay isolated from the main parotid gland along the Stensen's duct. The calculi developed in the accessory salivary tissue whereas all major salivary glands presented without sialolithiasis.

Long-term results of surgical treatment for recurrent respiratory papillomatosis.

Conclusions: The presented results add further support to the observation that laser microsurgery is the preferential surgical treatment for recurrent respiratory papillomatosis (RRP). A meticulous follow-up for early recognition of local recurrence and malignant transformation is recommended.

Objectives: Endoscopic microsurgery continues to be the treatment of choice for RRP.

Results of a European survey on current controversies in otology.

Objective: Various topics in otology cause controversy among otologists internationally. The resulting variety of diagnostic and surgical concepts reflects differences between surgical schools and the lack of structured studies in the field.

Interventions: During the "Third Instructional Workshop of the European Academy of Otology and Neuro-Otology," we interviewed 100 invited instructors using a written questionnaire on 13 controversial topics in otology.

Submandibular gland excision: 15 years of experience.

Purpose: The surgical management of submandibular gland diseases has always been a challenge because it carries a considerable risk of nerve injury. The aim of this study was to review a single institution's experience of a nonselected case series of submandibular gland excision over 15 years.

Materials And Methods: We retrospectively analyzed 258 unselected submandibular excisions of a tertiary university center for the histopathologic diagnosis and postoperative morbidity; 119 patients (46%) with sialolithiasis, 88 patients (34%) with sialadenitis, and 51 patients (20%) with submandibular tumors were operated.

Combined analysis of HPV-DNA, p16 and EGFR expression to predict prognosis in oropharyngeal cancer.

Molecular prognostic indicators for oropharyngeal squamous cell carcinoma (OSCC), including HPV-DNA detection, epidermal growth factor receptor (EGFR) and p16 expression, have been suggested in the literature, but none of these are currently used in clinical practice. To compare these predictors, 106 newly diagnosed OSCC for the presence of HPV-DNA and expression of p16 and EGFR were analyzed. The 5-year disease-free survival (DFS) and overall survival (OS) were calculated in relation to these markers and a multivariate Cox analysis was performed.

Long-term results of the combined modality therapy for advanced cervical metastatic head and neck squamous cell carcinoma.

Aim: A consensus treatment strategy for advanced cervical metastatic head and neck squamous cell carcinoma has not been established. The aim of this retrospective study was to investigate the outcome of these patients uniformely using a strategy which consists of surgery for the primary tumor and the neck metastases followed by postoperative radio(chemo)therapy.

Methods: We included a selected series of 518 patients with previously untreated head and neck squamous cell carcinoma.

An analysis of surgical complications, morbidity, and cost calculation in patients undergoing multimodal treatment for operable oropharyngeal carcinoma.

Objective/hypothesis: Tumor control and survival are considered the most important measures of treatment efficacy for patients with primary oropharyngeal squamous cell carcinoma. Furthermore, multimodal treatment protocols should be judged by their complication rates, morbidity, and therapy costs.

Study Design: The results of a combined approach of primary surgery and neck dissection with postoperative radio(chemo)therapy were analyzed in retrospective chart review.

Outcome of multimodal treatment for oropharyngeal carcinoma: a single institution experience.

The clinical management of patients with primary oropharyngeal squamous cell carcinoma remains controversial. The results of a combined approach involving surgery for the primary tumor, neck dissection, and postoperative radiotherapy were reviewed. A retrospective review was carried out for 211 patients meeting the inclusion criteria of resectable squamous cell carcinoma of the oropharynx.

Risk of facial palsy and severe Frey's syndrome after conservative parotidectomy for benign disease: analysis of 610 operations.

Conclusions: Advanced age, long operation time and large specimen volume were significant risk factors for transient facial palsy after conservative parotidectomy. Revision operation was the only risk factor for development of a permanent palsy. Risk factors for Frey's syndrome were not found.

[Vallecular cyst as a rare cause of progressive inspiratory stridor].

Background: Vallecular cysts are frequently observed, benign masses of the upper aerodigestiv tract. Usually they appear as harmless and asymptomatic and go unnoticed by the patient. In rare cases, obstructions of the upper airway due to monstrous vallecular cysts may become life threatening.

Low prevalence of transfusion transmitted virus (TTV)-like DNA sequences in cystadenolymphoma and pleomorphic adenoma of the salivary glands.

Titers of transfusion transmitted virus (TTV)-like DNA in saliva samples have been reported 100-1,000 times higher than those of the corresponding sera, suggesting viral transmission by saliva droplets. The present study was conducted to determine whether TTV-like DNA sequence elements play a role in the pathogenesis of cystadenolymphoma or pleomorphic adenoma and if the parotid or the submandibular gland is a major source of TTV persistence. Sixty-two archival salivary gland samples (16 cystadenolymphomas, 13 pleomorphic adenomas, and 33 controls) and 23 corresponding saliva samples were examined using a polymerase chain reaction (PCR) for TTV DNA.

A rare differential diagnosis in dysphagia: wound botulism.

The incidence of wound botulism is increasing dramatically among intravenous drug users. Efficient intensive care and early treatment with antitoxin is essential to avoid lethal courses. The clinical picture of botulism is of descending, symmetric, flaccid paralysis.

Parotidectomy for benign parotid disease at a university teaching hospital: outcome of 963 operations.

Objective/hypothesis: The objective of this study was to analyze the perioperative and long-term complications after standardized lateral and total parotidectomy for benign parotid tumors and chronic parotitis with special regard on the training skill of the surgeons at a university teaching center. All teaching operations were performed under strict microscopic control and supervision of experienced surgeons.

Study Design: The authors conducted a retrospective unicentric study in a tertiary university center.

T cells specific for HPV16 E7 epitopes in patients with squamous cell carcinoma of the oropharynx.

Squamous cell carcinomas of the oropharynx (SCCO) are often infected with oncogenic human papilloma virus (HPV) subtype 16. To determine the frequency of T cells specific for human leukocyte antigen (HLA)-A2.1 restricted HPV16 E7 protein-derived epitopes, tetramer analysis was performed using peripheral blood lymphocytes of 20 HLA-A2.