Aggressive Salivary Malignancies at Early Stage: Outcomes and Implications for Treatment.

Background: Few studies have examined whether the use of adjuvant treatment impacts survival for early stage high-grade salivary tumors.

Methods: A retrospective review of the SEER database between 1973 and 2012 was performed. Patients with high-grade major salivary gland tumors including salivary duct carcinoma, carcinoma ex-pleomorphic adenoma, high-grade mucoepidermoid carcinoma, or adenocarcinoma, NOS were identified.

Genetic variants in the peripheral auditory system significantly affect adult cochlear implant performance.

Background: Cochlear implantation is an effective habilitation modality for adults with significant hearing loss. However, post-implant performance is variable. A portion of this variance in outcome can be attributed to clinical factors.

Audioprofile Surfaces: The 21st Century Audiogram.

Objective: To present audiometric data in 3 dimensions by considering age as an addition dimension.

Methods: Audioprofile surfaces (APSs) were fitted to a set of audiograms by plotting each measurement of an audiogram as an independent point in 3 dimensions with the x, y, and z axes representing frequency, hearing loss in dB, and age, respectively.

Results: Using the Java-based APS viewer as a standalone application, APSs were pre-computed for 34 loci.

Utilizing ethnic-specific differences in minor allele frequency to recategorize reported pathogenic deafness variants.

Ethnic-specific differences in minor allele frequency impact variant categorization for genetic screening of nonsyndromic hearing loss (NSHL) and other genetic disorders. We sought to evaluate all previously reported pathogenic NSHL variants in the context of a large number of controls from ethnically distinct populations sequenced with orthogonal massively parallel sequencing methods. We used HGMD, ClinVar, and dbSNP to generate a comprehensive list of reported pathogenic NSHL variants and re-evaluated these variants in the context of 8,595 individuals from 12 populations and 6 ethnically distinct major human evolutionary phylogenetic groups from three sources (Exome Variant Server, 1000 Genomes project, and a control set of individuals created for this study, the OtoDB).

Advancing genetic testing for deafness with genomic technology.

Background: Non-syndromic hearing loss (NSHL) is the most common sensory impairment in humans. Until recently its extreme genetic heterogeneity precluded comprehensive genetic testing. Using a platform that couples targeted genomic enrichment (TGE) and massively parallel sequencing (MPS) to sequence all exons of all genes implicated in NSHL, we tested 100 persons with presumed genetic NSHL and in so doing established sequencing requirements for maximum sensitivity and defined MPS quality score metrics that obviate Sanger validation of variants.

AudioGene: predicting hearing loss genotypes from phenotypes to guide genetic screening.

Autosomal dominant nonsyndromic hearing loss (ADNSHL) is a common and often progressive sensory deficit. ADNSHL displays a high degree of genetic heterogeneity and varying rates of progression. Accurate, comprehensive, and cost-effective genetic testing facilitates genetic counseling and provides valuable prognostic information to affected individuals.

Prediction of cochlear implant performance by genetic mutation: the spiral ganglion hypothesis.

Background: Up to 7% of patients with severe-to-profound deafness do not benefit from cochlear implantation. Given the high surgical implantation and clinical management cost of cochlear implantation (>$1 million lifetime cost), prospective identification of the worst performers would reduce unnecessary procedures and healthcare costs. Because cochlear implants bypass the membranous labyrinth but rely on the spiral ganglion for functionality, we hypothesize that cochlear implant (CI) performance is dictated in part by the anatomic location of the cochlear pathology that underlies the hearing loss.

Sentinel node biopsy for head and neck desmoplastic melanoma: not a given.

Objectives: Determine the frequency of, the characteristics predictive of, and potential associated survival benefit from sentinel lymph node biopsy in a population of patients with desmoplastic melanoma of the head and neck.

Study Design: Analysis of a national database.

Setting: The 17-registry Surveillance, Epidemiology, and End Results (SEER) database.

Leiomyosarcoma of the head and neck: a population-based analysis.

Objectives: To describe the characteristics of head and neck leiomyosarcoma and to identify factors associated with survival.

Design: Retrospective population-based study.

Patients: The 17-registry Surveillance, Epidemiology, and End Results database was used to identify 578 patients with leiomyosarcoma of the head and neck.

Genetic disorders of the vestibular system.

Purpose Of Review: This review highlights the current body of literature related to the genetics of inherited vestibular disorders and provides a framework for the characterization of these disorders. We emphasize peripheral causes of vestibular dysfunction and highlight recent advances in the field, point out gaps in understanding, and focus on key areas for future investigation.

Recent Findings: The discovery of a modifier gene that leads to a more severe Usher syndrome phenotype calls into question the assumption that Usher syndrome is universally a monogenic disorder.

Mechanical compression versus subcutaneous heparin therapy in postoperative and posttrauma patients: a systematic review and meta-analysis.

Background: The risk of postoperative venous thromboembolic disease is as high as 30%, with an associated fatality risk of 1%. Therefore, prophylaxis is essential, but the optimal regimen remains controversial. This study was designed to systematically review and quantitatively summarize the impact of mechanical compression versus subcutaneous heparin on venous thromboembolic disease and posttreatment bleeding in postsurgical and posttrauma patients.

Cervical vestibular evoked myogenic potentials (cVEMPs) in patients with superior canal dehiscence syndrome (SCDS).

Objective: To determine the usefulness of both amplitude and threshold data from tone-burst cervical vestibular evoked myogenic potential (cVEMP) testing for the evaluation of superior canal dehiscence syndrome (SCDS).

Study Design: Case series with chart review.

Subjects And Methods: Sixty-seven patients underwent cVEMP testing.

Surgeon volume impacts hospital mortality for pancreatic resection.

Objective: Improved outcomes after pancreatic resection (PR) by high volume (HV) surgeons have been reported in single center studies, which may be confounded with potential selection and referral bias. We attempted to determine if improved outcomes by HV surgeons are reproducible when patient demographic factors are controlled at the population level.

Methods: Using the Nationwide Inpatient Sample, discharge records with surgeon identifiers for all nontrauma PR (n = 3581) were examined from 1998 to 2005.

High volume and outcome after liver resection: surgeon or center?

Introduction: In a case controlled analysis, we attempted to determine if the volume-survival benefit persists in liver resection (LR) after eliminating differences in background characteristics.

Methods: Using the Nationwide Inpatient Sample (NIS), we identified all LR (n = 2,949) with available surgeon/hospital identifiers performed from 1998-2005. Propensity scoring adjusted for background characteristics.