Stathmin as a surrogate marker of phosphatidylinositol-3-kinase pathway activity: Towards precision medicine in HPV-negative head & neck squamous cell carcinoma.

In order to assess Stathmin as an immunohistochemical (IHC) indicator of phosphatidylinositol 3-kinase (PI3K) pathway activity in HPV-negative head & neck squamous cell carcinoma (HNSCC), we compared Stathmin IHC to expression of other pathway components. We also evaluated the relationship between Stathmin IHC and the mutational status of four key pathway genes. Finally, we ascertained whether Stathmin IHC correlates with tumor grade or primary site.

Oncogenic PIK3CA mutation and dysregulation in human salivary duct carcinoma.

Salivary duct carcinoma (SDC) is an aggressive malignant tumor with a high mortality, which resembles high-grade breast ductal carcinoma in morphology. The parotid gland is the most common location. Its molecular genetic characteristics remain largely unknown.

Topical Application of Green Tea Polyphenol (-)-Epigallocatechin-3-gallate (EGCG) for Prevention of Recurrent Oral Neoplastic Lesions.

Objective: A preliminary study was conducted to investigate feasibility of using an oral cancer chemopreventive agent (-)-epigallocatechin-3-gallate (EGCG), the most biologically active component in the green tea extract, in a form of 'swish-and-spit' mouthwash. Such application of EGCG is beneficial as it maximizes exposure of the oral mucosa to the agent but minimizes systemic side effect.

Study Design: The study was conducted on individuals suspected to have oral field cancerization who are at a high risk for developing recurrent oral precancerous and carcinomatous lesions.

Multiple tumor-suppressor genes on chromosome 3p contribute to head and neck squamous cell carcinoma tumorigenesis.

Head and neck squamous cell carcinoma (HNSCC) remains a significant cause of morbidity and mortality. There has been a great interest in finding specific genomic changes which contribute to HNSCC tumorigenesis, especially within the chromosome 3p area, where high frequency of LOH (loss of heterozygosity) has been reported. However, tumor-suppressor genes that may account for the frequent LOH remain to be identified.

Looking around the corner: a review of the past 100 years of frontal sinusitis treatment.

Over the past 100 years, developments in imaging studies, endoscopic evaluation, medical treatment, and surgical techniques, particularly those employing endoscopic approaches, have led to improvements in our ability to treat frontal sinusitis. Providing "around the corner" views of the frontal recess, 30 degrees and 45 degrees endoscopes have allowed the meticulous preservation of the mucoperiosteum and restoration of normal sinus physiology, even in difficult areas of the frontal sinus outflow tract. Rarely is it necessary to perform radical or obliterative frontal sinus procedures, although the osteoplastic flap obliteration approach advocated by Montgomery continues to be the gold standard for treatment of frontal sinusitis, which has failed medical treatment and endoscopic approaches, at least in the minds of many prominent surgeons.

Image-guided endoscopic orbital decompression for Graves' orbitopathy.

Objectives: We studied the efficacy and safety of image-guided balanced orbital decompression for Graves' orbitopathy.

Methods: The data of 24 patients (45 orbits) were reviewed for demographics, ophthalmologic outcomes, and complications in regard to image-guided (18 orbits) versus non-image-guided surgery (27 orbits).

Results: Overall, all patients had a reduction in proptosis (mean reduction, 6.

Novel mutant-enriched sequencing identified high frequency of PIK3CA mutations in pharyngeal cancer.

We previously reported 4 PIK3CA mutations in 38 head and neck cancer samples, 3 of which were identified in 6 pharyngeal cancer samples. To determine the mutation frequency of PIK3CA in pharyngeal cancer, we studied 24 additional cases of pharyngeal squamous cell carcinoma in this study. Using both direct genomic DNA sequencing and novel mutant-enriched sequencing methods developed specifically for the 3 hot-spot mutations (H1047R, E545K and E452K) of PIK3CA, we detected 5 mutations of PIK3CA in the 24 pharyngeal cancers (20.

Synechia formation after endoscopic sinus surgery and middle turbinate medialization with and without FloSeal.

Background: The aim of this study was to determine the incidence, outcomes, and risk factors for synechia formation after endoscopic sinus surgery (ESS) and middle turbinate medialization with and without FloSeal.

Methods: A retrospective review was performed of patients who underwent primary ESS with middle turbinate medialization, with or without the placement of FloSeal. Medialization was performed with the placement of an absorbable conchopexy suture and silastic splint.

Quality of life and complications following image-guided endoscopic sinus surgery.

Objectives: To compare the quality of life (QOL) outcome and incidence of complications following image-guided versus non-image-guided endoscopic sinus surgery (ESS).

Study Design: The operative, office, and hospital charts of patients who underwent primary ESS for chronic sinusitis by a single surgeon with (2002-2005) or without (1997-2002) image guidance were reviewed for patient demographics, incidence of complications, and revision procedures. A telephone survey was used to administer the QOL survey to both cohorts.

PIK3CA mutations in head and neck squamous cell carcinoma.

Purpose: Recent studies have reported high frequencies of somatic mutations in the phosphoinositide-3-kinase catalytic alpha (PIK3CA) gene in several human solid tumors. Although gene amplifications of PIK3CA have been reported in head and neck squamous cell carcinoma (HNSCC), small mutation of the gene has not been evaluated in HNSCC previously. In this study, we examined the mutation frequency of PIK3CA in HNSCC.

Endoscopic approach to orbital apex lesions.

Purpose: To examine the role of transnasal and transantral endoscopic surgical approaches in the management of apical orbital lesions.

Methods: Retrospective case series.

Results: Three patients underwent combined orbital and endoscopic surgery for treatment of apical orbital lesions.

Endoscopic Lothrop procedure: when should it be considered?

Purpose Of Review: The endoscopic Lothrop procedure has proved to be an effective intranasal approach to the treatment of frontal sinus disorders. When successful, the operation re-establishes normal or near-normal frontal sinus function (especially physiologic evacuation of frontal sinus contents). Recently, several authors have proposed the use of this procedure for the treatment of several disease processes in addition to chronic frontal sinusitis.

"Balanced" orbital decompression for severe Graves' orbitopathy: technique with treatment algorithm.

Background: Graves' orbitopathy can produce proptosis, compressive optic neuropathy, and extraocular motility abnormalities; symptoms result from an increase in orbital volume due to expansion of intraorbital fat, with or without extraocular muscle involvement.

Study Design: We conducted a chart review of patients who underwent orbital decompression to treat Graves' orbitopathy. Twenty-two orbits (13 patients) underwent orbital bone decompression, of which 17 orbits (9 patients) underwent the combined medial and lateral "balanced" decompression.

Laryngopharyngeal manifestations of reflux: diagnosis and therapy.

Acid reflux--most often associated with heartburn--may also cause a wide range of laryngopharyngeal symptoms, including laryngitis and chronic cough. Symptoms of laryngopharyngeal reflux (LPR), like those of gastrooesophageal reflux disease, result from abnormal exposure of tissues to acid refluxate. Deranged sensorimotor function of the upper oesophageal sphincter appears to play a key role in the aetiology of LPR, but the disease is not completely understood.

Combined modality treatment of Ewing's sarcoma of the maxilla.

Background: Primary bone sarcomas arising in osseous structures of the head and neck are rare. These tumors are often incompletely resected and treated with radiotherapy for local control.

Methods: We report a case of a 9-year-old girl with a maxillary Ewing's sarcoma.

Laryngeal adductor reflex and pharyngeal squeeze as predictors of laryngeal penetration and aspiration.

Objectives: The contribution of laryngopharyngeal (LP) sensory deficits to the outcome of swallowing and the relationship between sensory and motor deficits in the laryngopharynx is unclear. The study purpose is to determine if patients with LP sensory and motor deficits are at increased risk for laryngeal penetration and aspiration during swallowing, and to determine the relationship between pharyngeal motor weakness and LP sensory deficits.

Materials And Methods: Endoscopic evaluation of swallowing with sensory testing was performed on 122 dysphagic patients who were prospectively divided into two groups.