Publications by authors named "Stuart Archibald"

Despite universal healthcare in Canada, low socioeconomic status (SES) has been associated with worse survival in oral cavity squamous cell carcinoma (OCSCC) patients. However, the relationship between SES and outcomes during the acute postoperative period is poorly defined. Hamilton, Ontario, presents a unique population with widely varying SES within the same geography.

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Objective To determine whether there is an association between cannabis use and developing a second primary cancer in head and neck cancer patients, as well as determining the prevalence of cannabis use amongst head and neck cancer patients. Study design This retrospective cohort study investigated patients from the Hamilton Region Head and Neck Cancer Database who were enrolled prospectively between 2011 and 2015, with follow-up data up to November 2018. Patients were contacted to confirm current cannabis and tobacco smoking status.

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Objectives/hypothesis: To determine the effect of a modified Thyroid Imaging and Reporting Data System (TIRADS) in predicting malignancy in surgically treated nodules.

Study Design: Retrospective review.

Methods: This study was carried out at a tertiary care center from July 2016 to July 2017.

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Background: Oropharynx squamous cell carcinoma (OPSCC) has become the predominant subsite for head and neck mucosal cancers (HNC) due to the rise of human papillomavirus (HPV) related disease. Previous studies have suggested an association between marijuana use and HPV-related OPSCC. Despite this, no study has examined the potential relationship between marijuana use and survival in this subset of patients.

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Background: Marijuana is the most widely used illicit substance in Canada. To date, no conclusive study has looked at the epidemiologic basis of marijuana use and head and neck cancer (HNC). Due to the imminent recreational legalization of marijuana in Canada, the epidemiologic relationship between marijuana use and HNC is becoming increasingly important.

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Importance: Cannabis sativa, the most widely used illicit substance in Canada, has a unique ability to facilitate relaxation and relieve anxiety while reducing pain. However, no study to date has examined quality of life (QOL) and psychosocial issues in relation to the use of this drug among patients with newly diagnosed head and neck cancer (HNC).

Objective: To examine the differences in QOL and psychosocial outcomes between marijuana users and nonusers with newly diagnosed HNC.

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Article Synopsis
  • * In this study, various non-histopathologic tests (COBAS®, Cervista®, and saliva analysis) were evaluated against the standard p16 staining method for diagnosing HPV-related tumors.
  • * Results show that COBAS® FNA and saliva tests accurately identify HPV status, potentially reducing the need for invasive diagnostic procedures and aiding in the diagnosis of cases with unknown origins.
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Background: The osteocutaneous radial forearm free flap (OC-RFFF) remains a useful tool in head and neck reconstruction; however, it can be challenging to harvest sufficient bone for large reconstructions. The extended OC-RFFF is a modification that involves harvest of the distal border of the radius to the tip of the styloid. This increases the length of the bone flap by 2 cm to 3 cm, and the inherent contour of the styloid can be used to reconstruct the anterior curvature of the mandible or maxilla without additional osteotomies that may reduce blood supply.

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Background: Thyroid nodules are common but only a minority are malignant. Molecular testing can assist in helping determine whether indeterminate nodules are suspicious for malignancy or benign. The objective of the study was to determine if the analysis of mutations (BRAF, NRAS, KRAS and HRAS) using readily available molecular techniques can help better classify indeterminate thyroid nodules.

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This article discusses the role of the randomized controlled trial (RCT) in plastic surgery. There are unique challenges in the execution of an RCT in plastic surgery, including: (1) surgical equipoise, (2) the surgical learning curve, (3) differential care, (4) randomization, (5) concealment, (6) expertise-based design, (7) blinding, (8) intention-to-treat analysis, (9) loss to follow-up, and (10) treatment effect and implications for sample size calculations. The RCTs conducted in plastic surgery to date are generally of poor quality in design and reporting, are fraught with bias, and have small sample sizes, thus this article attempts to help future investigators perform better quality RCTs.

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Reconstructive head and neck surgery is not unlike other surgical fields in its paucity of clinical research. Difficulties exist in the design and execution of surgical studies, and there are many challenges and limitations that must be addressed. In this article, the types of studies that make up head and neck reconstructive literature are reviewed, as well as the evolution toward the use of quality-of-life scales, which measure patients' satisfaction with their state of health and function.

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Background: Papillary thyroid adenocarcinoma (PTA) is the most common type of thyroid malignancy. Distant metastatic spread is relatively rare, most commonly affecting the lungs and bone. Brain metastases are very uncommon.

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Patients with advanced-stage hypopharyngeal or cervical esophageal carcinoma have a poor prognosis and may require a pharyngolaryngo-cervical esophagectomy. This treatment is usually palliative. In the past, the localized defect after resection has been reconstructed using many techniques.

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This article considers the particular demands of reconstruction of this complex region of the head and neck in terms of its functional and aesthetic requirements. It presents a classification system that may assist in the selection of the appropriate reconstruction. Finally, the authors discuss some of the more common techniques and flaps that should be considered when planning microsurgical management, and they review the outcomes they have seen in terms of speech, diet tolerance, oral continence, and survival.

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Midface defects pose the most difficult of the facial reconstruction problems. Current reconstruction relies heavily on microsurgical techniques, among which there are numerous possibilities. Although midface defects frequently extend to the upper and lower face, often an awareness of the midface subunits most involved can be of critical importance.

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