The Clinical Utility and Cost of Routine Staging Exam under Anesthesia for Oral Cavity Squamous Cell Carcinoma.

Introduction: The standard complete evaluation of patients with head and neck squamous cell carcinoma (HNSCC) has included a staging exam under anesthesia (EUA) since the 1970s. The EUA for all sites of HNSCC has historically consisted of panendoscopy for the purpose of diagnostic biopsy, accurate staging of primary disease, and identification of second primary tumors. However, due to the accessibility of the oral cavity, the sole purpose of EUA for tumors of this site is to identify second primary tumors.

Outcomes After Tracheostomy for Patients With Respiratory Failure due to COVID-19.

Objective: To evaluate the utility and safety of tracheostomy for patients with respiratory failure from COIVD-19 and describe patient clinical characteristics and process of management.

Methods: Case series of the first 24 COVID-19 patients who underwent tracheostomy at our institution, a single-center tertiary care community hospital intensive care/ventilator weaning unit. The patients all had respiratory failure from COVID-19 and required endotracheal intubation and mechanical ventilation.

Thromboprophylaxis in Head and Neck Microvascular Reconstruction.

Head and neck patients undergoing microvascular reconstruction are at high risk for thromboembolism. While the prevention of thromboembolism has become an essential aspect of care, within the field of microsurgery, concern for anastomotic complications have hindered the creation of an accepted regimen. The aim of this review was to evaluate the risks and benefits of prophylactic agents for thromboprophylaxis.

Gene master regulators of papillary and anaplastic thyroid cancers.

We hypothesize that distinct cell phenotypes are governed by different sets of gene master regulators (GMRs) whose strongly protected (by the homeostatic mechanisms) abundance modulates most cell processes by coordinating the expression of numerous genes from the corresponding functional pathways. Gene Commanding Height (GCH), a composite measure of gene expression control and coordination, is introduced to establish the gene hierarchy in each phenotype. If the hypothesis is true, than one can selectively destroy cancer nodules from a heterogeneous tissue by altering the expression of genes whose GCHs are high in cancer but low in normal cell phenotype.

Multiflap closure of scalp defects: Revisiting the orticochea flap for scalp reconstruction.

Reconstruction of the scalp following oncologic resection is a challenging undertaking owing to the variable elasticity of the soft tissue overlying the calvarium and the limited amount of tissue available for recruitment. Defect size, location, and skin characteristics heavily influence the reconstructive options available to the surgeon. Reconstruction options for scalp defects range from simple direct closure, to skin grafting, to adjacent tissue transfer with local flaps, and ultimately to free tissue transfer.

Cyclin D1 and FADD as biomarkers in head and neck squamous cell carcinoma.

Objective: Cyclin D1 and FADD (Fas-associated protein with death domain) regulate the cell cycle and apoptosis, respectively, and are located on chromosome 11q13, which is frequently amplified in head and neck squamous cell carcinoma (HNSCC). This study evaluates these proteins as predictors of clinical outcomes for HNSCC.

Study Design: Historical cohort study.

VEGFR-2 expression in human melanoma: revised assessment.

Vascular endothelial growth factor (VEGF) is an angiogenic factor that also functions as an autocrine growth factor for VEGF receptor (VEGFR)-2(+) melanomas. In multiple studies, VEGFR-2 was detected by immunostaining in 78-89% of human melanoma cells, suggesting that most patients with melanoma would benefit from anti-VEGF therapy. Here, we evaluated 167 human melanoma specimens in a tissue microarray to verify the presence of VEGFR-2, but found disparities in staining with commercial antibodies A-3 and 55B11.

Oral cavity and oropharyngeal squamous cell cancer: key imaging findings for staging and treatment planning.

The imaging findings in squamous cell carcinoma (SCC) of the oral cavity and oropharynx vary widely, depending on the site of origin of the primary tumor and the extent of its involvement of other regions. Knowledge of the complex anatomy of the oral cavity and oropharynx, as well as the most common routes by which SCC spreads from various anatomic sites, allows the radiologist to accurately determine the extent of disease and help clinicians plan appropriate treatment. SCCs that originate in the oral cavity tend to behave differently than those that originate in the oropharynx, with the latter group exhibiting more aggressive growth.

Injectable tissue-engineered cartilage using a fibrin sealant.

Objective: To investigate a commercially available fibrin sealant as a vehicle for developing injectable tissue-engineered cartilage.

Methods: Fibrin glue was mixed with autogenous chondrocytes from rabbits (n = 15). This isolate was injected along their nasal dorsa using 1 of 3 different fibrin glue concentrations.

Steroid injection for sinonasal polyps: the University of Virginia experience.

Background: Sinonasal polyps are treated with topical steroids, systemic oral steroids, surgical excision, and intrapolyp steroid injection. Use of steroid injection is not widespread because of reported complications. The objective of this study was to evaluate the complications of intrapolyp steroid injections and compare it to the complications of surgical removal of polyps.

Rethinking auricular trauma.

Objectives/hypothesis: An unrecognized auricular hematoma can lead to a disfiguring deformity, the cauliflower ear, but it can be prevented with prompt and comprehensive management. Fine needle aspiration with pressure bandages remains the mainstay treatment but will occasionally fail. We review our experience with recurrent or recalcitrant auricular hematomas in terms of their pathophysiology and revision surgery.