Publications by authors named "Richard Chan Woo Park"
Neck Dissection in cT3/T4 Mucoepidermoid Carcinoma of the Oral Cavity and Oropharynx.
Indian J Otolaryngol Head Neck Surg
October 2024
Previous research has reported high occult nodal metastases rates for T3/T4 mucoepidermoid carcinoma (MEC) of the oropharynx (OP) and oral cavity (OC). Our study evaluates if there is a benefit of neck dissection (ND) in these patients. The 2004-2016 National Cancer Database was queried for cases of adult MEC of the OC and OP.
View Article and Find Full Text PDFObjectives: Changing location of postoperative radiotherapy (PORT) after treatment at a high-volume facility (HVF) is associated with worse survival in various head and neck cancers. Our study investigates this relationship in salivary gland cancer (SGC).
Methods: The 2004-2016 National Cancer Database was queried for all cases of adult SGC treated with surgery and PORT with or without adjuvant chemotherapy.
Background And Importance: Surgery of jugular foramen tumors (JFTs) often requires vascular control by means of ligating the internal jugular vein and sigmoid sinus (SS) to allow intrabulbar access. Occlusion of the SS traditionally involves presigmoid and retrosigmoid durotomies allowing introduction of ligature devices, predisposing to cerebrospinal fluid (CSF) leakage and pseudomeningoceles. We describe a simple and novel endoluminal sigmoid sinus occlusion (ESSO) technique with Gelfoam that is entirely extradural.
View Article and Find Full Text PDFElective Neck Dissection for cT1-4 N0M0 Head and Neck Verrucous Carcinoma.
Otolaryngol Head Neck Surg
November 2023
Objective: To investigate the survival benefit of elective neck dissection (END) over neck observation in cT1-4 N0M0 head and neck verrucous carcinoma (HNVC).
Study Design: Retrospective cohort study.
Setting: The 2006 to 2017 National Cancer Database.
Background: The impact of obesity on outcomes after open laryngeal surgery has not been well-described.
Methods: The NSQIP database was queried for all open laryngeal surgeries including total laryngectomies between 2005 and 2018. Outcomes of patients identified as obese or nonobese by BMI were compared.
Introduction: To assess the association between time to surgery (TTS) and survival in sinonasal squamous cell carcinoma patients (SSCC).
Methods: We queried the 2004-2016 National Cancer Database for all cases of adult SSCC undergoing primary surgical treatment. Patients with missing TTS information were excluded.
Background: Opioids are commonly used to manage the pain of head and neck (HN) cancer patients.
Methods: Retrospective cohort of graduates from American Head and Neck Society accredited fellowships from 1997 to 2018. The Center for Medicare and Medicaid Services Part D Provider Utilization and Payment database 2014-2019 was cross-referenced with provider names to identify opioid prescription trends.
Background: To analyze the impact of facility volume on survival for human papilloma virus positive oropharyngeal squamous cell carcinoma (HPV+ OPSCC) patients.
Methods: Patients treated for HPV+ OPSCC from 2010 to 2017 were queried from the National Cancer Database. Facilities of average annual case volume <50th percentile were categorized as low-volume (LV) and >95th percentile as high-volume (HV).
Background: Using a population-based database, this study investigates the risk factors, epidemiology, and outcomes of basal cell adenocarcinoma (BCAC) of the head and neck.
Methods: The Surveillance, Epidemiology, and End Results database was analyzed for all patients with BCAC of the head and neck from 1973 to 2015.
Results: Three hundred and twenty-two cases of BCAC of the head and neck were identified.
Background: The objective was to assess the association of mental health disorders with in-hospital complication and mortality rates in patients undergoing head and neck cancer surgery.
Methods: In this exploratory retrospective study, the Nationwide Inpatient Sample was queried from 2003 to 2014 for all patients with a diagnosis of head and neck cancer who underwent surgery. Univariate cross-tabulation, logistic regression, and propensity score matching (PSM) were used to compare demographics, procedure-related variables, and in-hospital postoperative complications and mortality between patients with and without selected comorbid mental health disorders.
Background: Giant cell sarcomas (GCS) are rare head and neck neoplasms.
Methods: The Surveillance, Epidemiology, and End Results (SEER) database was analyzed for all patients who have been diagnosed with GCS from 1973 to 2014.
Results: Four hundred and forty cases of GCS of the head and neck were identified.
Purpose: This study was done to determine the direct impact implementation of the Affordable Care Act (ACA) on patients with Head and Neck Cancer (HNCA) in states that chose to expand Medicaid compared to in states that did not, as well as assess whether this impact varied among different demographic groups.
Materials And Methods: The Surveillance, Epidemiology, and End Results (SEER) database was queried for cases of HNCA diagnosed from 2011 to 2014. Rates of uninsured status were compared before and after Medicaid expansion and contrasted between states that did and did not expand coverage, stratified by patient and tumor characteristics, and assessed via multivariate regression.
Objectives: Carotid body tumors (CBT) are rare paragangliomas of the carotid body at the carotid bifurcation. The purpose of this study was to determine the effect of hypertension on outcomes in carotid body tumor surgery.
Study Design: A retrospective database review.
Objectives/hypothesis: To evaluate the "July effect," as a possible risk factor for perioperative complications in otolaryngology microvascular reconstruction during the transitional period in the academic calendar.
Study Design: Retrospective database review.
Methods: Microvascular reconstruction outcomes in the National Surgical Quality Improvement Program (2005-2016) database were compared between the first academic quarter (July-September) to the last academic quarter (April-June).
Article Synopsis
- This study analyzes the development of second primary lung malignancies (SPLMs) in patients with head and neck squamous cell carcinoma (HNSCC) and found that 8% of HNSCC patients later developed SPLMs.
- The study used data from a large cancer database spanning multiple decades to calculate the risk of lung cancer in these patients and identified specific head and neck sites that had higher risks for lung cancer.
- Results showed that lung cancers following HNSCC were predominantly squamous cell carcinoma, with variations in histology based on the primary head and neck tumor site, indicating distinct risk factors and potential underlying causes.
Objectives/hypothesis: The authors used the Surveillance, Epidemiology, and End Results (SEER) database to analyze epidemiological features of patients presenting with supraglottic squamous cell carcinoma (SCCa) and to evaluate treatment trends and outcomes.
Methods: The SEER database was queried for patients with supraglottic SCCa from 1973 to 2013. Information on demographics; tumor size; histologic grade; American Joint Committee on Cancer (AJCC) stage; SEER local, regional, distant stage; and treatment modality were analyzed.
Importance: Smoking is a highly prevalent risk factor among patients with head and neck cancer. However, few studies have examined the association of this modifiable risk factor on postoperative outcomes following microvascular reconstruction of the head and neck.
Objective: To analyze the risk associated with smoking in patients undergoing free flap surgery of the head and neck.
Objectives: Parotidectomies have become a common outpatient procedure, but their impact on postoperative complications as compared to inpatient procedures has not been evaluated in a multi-institutional study.
Study Design: The aim of this retrospective analysis was to evaluate the differences in outcomes using a standardized cohort of patients undergoing outpatient or inpatient parotidectomies.
Methods: The National Surgical Quality Improvement Program database was queried for parotidectomies between 2005 and 2014.
Background: The impact of radiotherapy (RT) modality and dose on survival in hypopharyngeal cancer managed with definitive RT is unclear.
Methods: The National Cancer Database was queried for patients with hypopharyngeal squamous cell carcinoma (HPSCC) treated with definitive RT. Intensity-modulated radiotherapy (IMRT) was compared with other RT techniques.
Objectives/hypothesis: To assess the impact of resident duty-hour restrictions (DHR) in otolaryngology via comparison of postoperative outcomes between otolaryngology teaching hospitals (Oto-TH) and nonteaching hospitals (NTH) before and after complete implementation.
Study Design: Retrospective database review.
Methods: The Nationwide Inpatient Sample was queried for all major head and neck cases between 2000 and 2002 (n = 34,064) and 2008 and 2010 (n = 33,094).
Understanding Risk Factors Associated With Unplanned Reoperation in Major Head and Neck Surgery.
JAMA Otolaryngol Head Neck Surg
November 2018
Importance: Understanding the preoperative, intraoperative, and postoperative risk factors of reoperation is the optimal way to approach decreasing its incidence.
Objective: To identify risk factors of unplanned reoperation following major operations of the head and neck.
Design, Setting, And Participants: This retrospective cohort study queried the American College of Surgeons National Surgical Quality Improvement Program database and identified 2475 cases of major operations of the head and neck performed between 2005 and 2014.
Objectives/hypothesis: To investigate the risk factors for refusal of recommended surgery in head and neck squamous cell carcinoma (HNSCC) treatment STUDY DESIGN: Retrospective review of a national database.
Methods: The Surveillance, Epidemiology, and End Results database was queried for all cases of HNSCC from 1989 to 2014. Patients who underwent recommended surgery (N = 98,270) were identified and compared to patients who refused recommended surgery (N = 3,582).
Background: Resident duty hour restrictions can limit the frequency of resident flap checks at smaller institutions with "home" call. Institutions are compensating with adjuvant nursing flap checks as well as incorporating technology; however, this management remains controversial.
Methods: A prospective cohort of 122 free flaps for reconstruction of the head and neck by a single surgeon.