Detecting Residual/Recurrent Head Neck Squamous Cell Carcinomas Using PET or PET/CT: Systematic Review and Meta-analysis.

Detecting Residual/Recurrent Head Neck Squamous Cell Carcinomas Using PET or PET/CT: Systematic Review and Meta-analysis.

Otolaryngol Head Neck Surg. 2015 Dec 29;

Authors: Cheung PK, Chin RY, Eslick GD

Abstract
OBJECTIVE: To evaluate the diagnostic accuracy of positron emission tomography (PET) and PET/computed tomography (CT) for detecting residual and/or recurrent local and regional disease and distant metastases in patients with head and neck squamous cell carcinomas (HNSCCs) following radiotherapy with or without chemotherapy.
DATA SOURCES: A systematic review with no language restrictions was conducted using PREMEDLINE, MEDLINE, EMBASE, and Google Scholar.
REVIEW METHODS: Only prospective studies with histopathological and/or clinical follow-up that assessed the diagnostic accuracy of PET and PET/CT in detecting residual and/or recurrent disease following radiotherapy with or without chemotherapy in patients with HNSCCs were included.
RESULTS: Twenty-seven studies were identified. The pooled sensitivity and specificity of PET and PET/CT for detecting residual or recurrent disease at the primary site was 86.2% and 82.3%, respectively. For residual and recurrent neck disease, the sensitivity and specificity were 72.3% and 88.3%, while for distant metastases, the values were 84.6% and 94.9%.
CONCLUSIONS: PET and PET/CT are highly accurate in detecting residual and/or recurrent HNSCC. PET/CT is more specific than PET alone. Specificity is also greater for scans performed more than 12 weeks after radiotherapy with or without chemotherapy. The authors support the use of PET/CT after 12 weeks posttreatment for the assessment of residual or recurrent disease.

PMID: 26715675 [PubMed - as supplied by publisher]

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Nasal angiosarcoma metastatic to the larynx: Case report and systematic review of the literature.

Nasal angiosarcoma metastatic to the larynx: Case report and systematic review of the literature.

Head Neck. 2015 Dec 30;

Authors: Qualls HE, Mitchell RM, Deubner H, Moe KS, Sardesai M

Abstract
BACKGROUND: Laryngeal angiosarcoma is rare and the prognosis is poor. The purpose of this study was to describe the first case of cutaneous angiosarcoma metastatic to the larynx and systematically review all cases of laryngeal angiosarcoma.
METHODS: A 61-year-old man presented with an alar lesion diagnosed as angiosarcoma and was treated with wide local resection and radiation. Six years later, he presented with a laryngeal mass histologically similar to the initial tumor. A systematic review of reported cases of angiosarcoma of the larynx was performed.
RESULTS: Eighteen cases were identified. Mean age of presentation was 64.3 years. Men represented 66.7%. Mean follow-up was 34.1 months. Forty-seven percent died with disseminated disease at a mean of 18.4 months. Our patient did well with serial resection.
CONCLUSION: To the best of our knowledge, this case represents the first documented case of cutaneous angiosarcoma metastatic to the larynx and suggests that serial resection with long-term surveillance may be of benefit in some cases. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26717551 [PubMed - as supplied by publisher]

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Merkel cell carcinoma: Do you know your guidelines?

Merkel cell carcinoma: Do you know your guidelines?

Head Neck. 2015 Dec 30;

Authors: Miles BA, Goldenberg D, Education Committee of the American Head and Neck Society (AHNS)

Abstract
BACKGROUND: Merkel cell carcinoma (MCC) is a cutaneous neuroendocrine malignancy that exhibits clinically aggressive features and is associated with a poor prognosis. The incidence of MCC seems to be increasing for reasons unknown, and is estimated to be 0.32/100,000 in the United States.
METHODS: This article will review the current literature and National Comprehensive Cancer Network practice guidelines in the treatment of MCC.
RESULTS: Resection of MCC with negative margins remains the mainstay of therapy. Positive nodal disease should be treated with neck dissection and adjuvant radiotherapy. High-risk patients should undergo adjuvant radiotherapy, which improves oncologic outcomes. The role of chemotherapy is less clear and is currently reserved for advanced-stage MCC and palliative therapy.
CONCLUSION: The pathogenesis of MCC has recently been impacted with the discovery of the Merkel cell polyomavirus (MCPyV). Research to establish targeted and immunologic therapeutic options are ongoing. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26716756 [PubMed - as supplied by publisher]

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External-beam radiotherapy for differentiated thyroid cancer locoregional control: A statement of the American Head and Neck Society.

External-beam radiotherapy for differentiated thyroid cancer locoregional control: A statement of the American Head and Neck Society.

Head Neck. 2015 Dec 30;

Authors: Kiess AP, Agrawal N, Brierley JD, Duvvuri U, Ferris RL, Genden E, Wong RJ, Tuttle RM, Lee NY, Randolph GW

Abstract
The use of external-beam radiotherapy (EBRT) in differentiated thyroid cancer (DTC) is debated because of a lack of prospective clinical data, but recent retrospective studies have reported benefits in selected patients. The Endocrine Surgery Committee of the American Head and Neck Society provides 4 recommendations regarding EBRT for locoregional control in DTC, based on review of literature and expert opinion of the authors. (1) EBRT is recommended for patients with gross residual or unresectable locoregional disease, except for patients <45 years old with limited gross disease that is radioactive iodine (RAI)-avid. (2) EBRT should not be routinely used as adjuvant therapy after complete resection of gross disease. (3) After complete resection, EBRT may be considered in select patients >45 years old with high likelihood of microscopic residual disease and low likelihood of responding to RAI. (4) Cervical lymph node involvement alone should not be an indication for adjuvant EBRT. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26716601 [PubMed - as supplied by publisher]

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Recurrent giant mandibular ameloblastoma in young adults.

Recurrent giant mandibular ameloblastoma in young adults.

Head Neck. 2015 Dec 30;

Authors: Gravvanis A, Koumoullis HD, Anterriotis D, Tsoutsos D, Katsikeris N

Abstract
BACKGROUND: The purpose of the study was to define the most appropriate management of the giant mandibular ameloblastoma (GMA) in young adults.
METHODS: A retrospective study was performed on patients with GMA <30 years old. The data collected included initial treatment, tumor margins, reconstruction, and follow-up. Patients evaluated speech, chewing, swallowing, and facial appearance after definitive treatment.
RESULTS: Thirteen patients were identified with recurrent solid/multicystic disease requiring further treatment. Definitive treatment involved segmental mandibulectomy and reconstruction with free fibular flap in all patients. Seven patients had immediate reconstruction (group A) and 6 had secondary (group B). Mandibular resection was planned at least 2 cm beyond the radiological limit, free margins were achieved in all patients, and all flaps were transplanted successfully. In group A, functional score was 13.7 ± 0.45 and facial appearance score was 4.5 ± 0.49, whereas in group B were 11.16 ± 0.37 and 3.3 ± 0.5, respectively (both p < .05).
CONCLUSION: Aggressive resection of the GMA and immediate reconstruction is strongly advised. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26716398 [PubMed - as supplied by publisher]

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Microsurgery with or without Neuroendoscopy in Petroclival Meningiomas.

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Microsurgery with or without Neuroendoscopy in Petroclival Meningiomas.

Turk Neurosurg. 2015;25(2):231-8

Authors: Zhou QJ, Liu B, Geng DJ, Fu Q, Cheng XJ, Kadeer K, DU GJ, Wang YX, Luan XP

Abstract
AIM: This study aimed to investigate the operative procedure for neuroendoscope-assisted microscopic resection of petroclival meningioma to improve prognosis.
MATERIAL AND METHODS: Twelve patients with petroclival meningioma who had undergone neuroendoscope-assisted microscopic resection at the Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University were selected. In addition, 12 patients with petroclival meningioma who had undergone microscopic surgery were used as control. Clinical data from the 24 cases of petroclival meningioma were analyzed.
RESULTS: For the neuroendoscope-assisted group, six, five, and one cases were respectively subjected to total resection, subtotal resection, and most resection. For the microscopic surgery group, two, three, and seven cases were respectively subjected to total resection, subtotal resection, and most resection. Both the total and subtotal resection rates of petroclival meningioma in the neuroendoscope-assisted group were significantly higher than those in the microscopic surgery group (p < 0.05). No difference was observed for short-term and long-term complications (p > 0.05) between the two groups.
CONCLUSION: Neuroendoscope-assisted microscopic resection for petroclival meningioma can improve the total and subtotal resection rates of the tumor. Moreover, this method does not increase postoperative short-term and long-term complications.

PMID: 26014005 [PubMed - indexed for MEDLINE]

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Intracranial plasmacytoma with hypoglossal nerve palsy in multiple myeloma.

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Intracranial plasmacytoma with hypoglossal nerve palsy in multiple myeloma.

Postgrad Med J. 2015 Mar;91(1073):174-5

Authors: Sin WY, Grant I

PMID: 25740318 [PubMed - indexed for MEDLINE]

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Comparison of lateral microsurgical preauricular and anterior endoscopic approaches to the jugular foramen.

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Comparison of lateral microsurgical preauricular and anterior endoscopic approaches to the jugular foramen.

J Laryngol Otol. 2015 Mar;129 Suppl 2:S12-20

Authors: Komune N, Komune S, Matsushima K, Rhoton AL

Abstract
INTRODUCTION: This project compares access to the anterolateral part of the jugular foramen provided by the lateral microsurgical preauricular and the anterior endoscopic approaches, and defines the important landmarks involved in each approach.
STUDY DESIGN: Cadaveric study.
RESULTS: The endoscopic transnasal/transmaxillary transpterygoid corridor provides a less invasive route for selected lesions in the jugular foramen than the traditional open route through the preauricular subtemporal infratemporal fossa approach. However, the anterior endoscopic approach provides a smaller channel to the jugular foramen than the preauricular approach.
CONCLUSIONS: The anterior endoscopic approach to the anterolateral part of the jugular foramen is a useful alternative to the lateral microsurgical preauricular approach in carefully selected cases. The vaginal process of the tympanic part of the temporal bone provides a valuable landmark to aid in accessing the jugular foramen in both procedures and can be drilled to open the foramen in the preauricular approach.

PMID: 25706154 [PubMed - indexed for MEDLINE]

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Infiltration with lidocaine and adrenaline instead of normal saline does not improve the septoplasty procedure.

Infiltration with lidocaine and adrenaline instead of normal saline does not improve the septoplasty procedure.

Eur Arch Otorhinolaryngol. 2015 Dec 29;

Authors: Gungor V, Baklaci D, Kum RO, Yilmaz YF, Ozcan M, Unal A

Abstract
The aim of this study was to determine whether infiltration of local anesthetics with adrenaline improved septoplasty procedure when compared to normal saline. Eight-two patients undergoing septoplasty were randomized into two groups. In group 1, septal mucoperichondrium was infiltrated with lidocaine with adrenaline, and normal saline was used in group 2. Presence of intra-operative septal mucosal injuries, the amount of bleeding, arterial blood pressure, operation time as well as the quality of the surgical field and the convenience of finding the correct surgical plane as determined by the surgeon using a 5-point scale were compared between two groups. There were no significant differences for the amount of blood loss, mean arterial pressure, operation time, or scores for convenience of finding the correct surgical plane between the two groups. There was no significant difference for intra-operative simple (P = 0.631) and total (simple+severe) (P = 0.649) septal mucoperichondrial injuries between groups 1 and 2, either. However, severe mucoperichondrial injury rate was higher in the patients infiltrated with lidocaine and adrenaline (P = 0.026), and the quality of the surgical field was worse in the patients injected with normal saline (P = 0.0179). Infiltration of septal mucoperichondrium with lidocaine and adrenaline instead of normal saline was not advantageous in terms of objective parameters tested, including bleeding amount and duration of surgery as well as the of the total mucosal injury rate in septoplasty procedure.

PMID: 26714803 [PubMed - as supplied by publisher]

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The influence of multilevel upper airway surgery on CPAP tolerance in non-responders to obstructive sleep apnea surgery.

The influence of multilevel upper airway surgery on CPAP tolerance in non-responders to obstructive sleep apnea surgery.

Eur Arch Otorhinolaryngol. 2015 Dec 29;

Authors: Azbay S, Bostanci A, Aysun Y, Turhan M

Abstract
The aim of this study was to evaluate the influence of multilevel upper airway surgery on subsequent continuous positive airway pressure (CPAP) use and tolerance in patients with moderate to severe obstructive sleep apnea (OSA). The study cohort enrolled 67 consecutive patients, who underwent septoplasty plus modified uvulopharyngopalatoplasty (mUPPP) with or without modified tongue base suspension (mTBS) due to CPAP intolerance, and who had residual OSA requiring CPAP therapy [non-responders to surgery, apnea-hypopnea index (AHI) >15 events/h] that had been confirmed by control polysomnography at the sixth month postoperatively. A questionnaire including questions on postoperative CPAP use, problems faced during CPAP use after the surgery, change in OSA symptoms, and satisfaction with the surgery was designed, and filled through interviews. Seventeen (25.4 %) patients had septoplasty plus mUPPP and 50 (74.6 %) had septoplasty plus mUPPP combined with mTBS. Postoperatively, mean AHI (45.00 ± 19.76 vs. 36.60 ± 18.34), Epworth sleepiness scale (ESS) score (18.00 ± 4.45 vs. 13.00 ± 4.72), oxygen desaturation index (ODI) (48.98 ± 16.73 vs. 37.81 ± 17.03), and optimal CPAP level (11.80 ± 1.40 vs. 8.96 ± 1.20) were decreased (p < 0.001 for all parameters). Fifty-nine percent of patients reported that they fairly satisfied with the surgery and 49.2 % reported that their symptoms were completely resolved. While none of the cases could tolerate CPAP before surgery, almost half (47.8 %) of the cases used CPAP without problems postoperatively. Postoperative CPAP users had significantly higher postoperative AHI (p = 0.001), supine AHI (p = 0.009), ESS (p = 0.019), and ODI (p = 0.014), and significantly lower postoperative minimum O2 saturation (p = 0.001) compared with non-users. Multilevel upper airway surgery with less invasive techniques may improve CPAP tolerance in well-selected patients.

PMID: 26714802 [PubMed - as supplied by publisher]

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Vestibular functions of hereditary hearing loss patients with GJB2 mutations.

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Vestibular functions of hereditary hearing loss patients with GJB2 mutations.

Audiol Neurootol. 2015;20(3):147-52

Authors: Tsukada K, Fukuoka H, Usami S

Abstract
OBJECTIVES: Mutations in the GJB2 gene have been of particular interest as it is the most common causative gene for congenital deafness in all populations. Detailed audiological features, including genotype-phenotype correlations, have been well documented. However, in spite of abundant gene as well as protein expression in the vestibular end organs, neither vestibular symptoms nor vestibular functions have yet been elucidated. In the present study, vestibular functions were evaluated in patients diagnosed with GJB2-related deafness.
SUBJECTS AND METHODS: Vestibular functions were evaluated by caloric test and cervical vestibular evoked myogenic potential (cVEMP) testing in 24 patients with biallelic GJB2 mutations.
RESULTS AND DISCUSSION: Twenty-one of 23 patients (91.3%) had normal caloric responses and significantly lower cVEMP amplitudes than the control subjects. In the patients who were able to undergo vestibular testing, the mostly normal reactions to caloric testing indicated that the lateral semicircular canal was intact. However, the majority of GJB2 patients showed low cVEMP reactions, indicating a saccular defect.

PMID: 25824904 [PubMed - indexed for MEDLINE]

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Selective otolith dysfunctions objectively verified.

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Selective otolith dysfunctions objectively verified.

J Vestib Res. 2014;24(5-6):365-73

Authors: Manzari L, MacDougall HG, Burgess AM, Curthoys IS

Abstract
Vertigo and vigorous horizontal spontaneous nystagmus in a presenting patient is usually taken to indicate unilaterally reduced horizontal canal function. However here we report results which question that presumption. In three such patients with an acute vestibular syndrome, complete testing of all peripheral vestibular sense organs using new tests of canal and otolith function (vHIT and VEMPs) showed that semicircular canal function was normal, but that there were unilateral otolithic deficits which probably caused their acute syndrome.

PMID: 25564079 [PubMed - indexed for MEDLINE]

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Thyroid hormone receptors are differentially expressed in granulosa and cervical cells of infertile women.

Thyroid hormone receptors are differentially expressed in granulosa and cervical cells of infertile women.

Thyroid. 2015 Dec 30;

Authors: López E, Ortega FJ, Francisco-Busquets E, Sabater-Masdeu M, Álvarez E, Ricart W, Fernández-Real JM

Abstract
BACKGROUND: Thyroid hormones are known to exert an important role in reproduction. The objective of this study is to evaluate the expression of thyroid hormone receptors (TR) in granulosa (GC) and cervical cells (CC) of infertile euthyroid women.
METHODS: In a cross-sectional study, we investigated 31 consecutive infertile and 18 fertile women undergoing oocyte retrieval procedures. The expression of TRα1, TRα2 and TRβ was evaluated in GCs and uterine CC from infertile and fertile euthyroid women. β2 adrenergic receptor (ADRβ2) mRNA levels and the expression of genes linked to fertility such as gremlin-1 (GREM1), hyaluronan synthase 2 (HAS2), and prostaglandin-endoperoxide synthase 2 (PTGS2) were also evaluated.
RESULTS: In GCs, the expression of the thyroid hormone receptor TRα2, which exerts a dominant negative effect, increased with age in all women tested. TRα2 mRNA was increased in infertile vs. fertile women, in parallel to decreased ADRβ2 mRNA. As expected, the expression of genes associated with fertility (i.e. GREM1 and PTGS2) was downregulated in infertile women, in parallel to decreased ADRβ2 mRNA and increased TRα2 mRNA. In uterine CCs, a positive association of ADRβ2 mRNA with TRα1:TRα2 ratio was observed. Importantly, GCs from infertile women whose oocytes did not result in pregnancy had increased expression of TRα2 (p=0.017), and lower ADRβ2 (p=0.008), GREM1 (p=0.003) and PTGS2 (p=0.002) mRNAs than fertile women whose oocytes resulted in pregnancy. Infertile women also showed more TRα2 (p=0.033) mRNA in CCs than fertile women whose oocytes resulted in pregnancy.
CONCLUSIONS: The expression of different markers of intracellular thyroid function is linked to fertility status.

PMID: 26715425 [PubMed - as supplied by publisher]

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Cost-Effectiveness of Diagnostic Lobectomy Versus Observation for Thyroid Nodules Greater than 4 cm.

Cost-Effectiveness of Diagnostic Lobectomy Versus Observation for Thyroid Nodules Greater than 4 cm.

Thyroid. 2015 Dec 30;

Authors: Lee L, Mitmaker EJ, Chabot JA, Lee JA, Kuo JH

Abstract
BACKGROUND: The management of thyroid nodules >4 cm with benign cytology after fine-needle aspiration (FNA) is controversial. FNA is associated with a high false-negative rate in this setting and may result in a delayed diagnosis and management of thyroid cancer. However, the majority of these nodules are benign. Therefore the objective was to determine the cost-utility of observation versus surgical management for thyroid nodules >4 cm with benign cytology after FNA.
METHODS: A microsimulation model comparing routine thyroid lobectomy versus observation for low-risk patients with >4cm thyroid nodules with benign FNA cytology was constructed. Costs, quality-adjusted life years (QALYs), and life-years gained were calculated over a lifetime time horizon from a US Medicare perspective.
RESULTS: The proportion of patients undergoing thyroid lobectomy for benign final pathology was 40% in the observation strategy versus 66% in the surgical strategy (p<0.001). Overall, the surgical strategy was associated with higher lifetime costs compared to the observation strategy (incremental difference: +12992 US$; 95% CI 13042, 13524), but also more QALYs (+0.12 QALYs; 95% CI 0.02, 0.24) and longer life expectancy (+1.67 years; 95% CI 1.00, 2.41). Incremental lifetime costs were lower for patients <55 years versus those >=55 years (+11181 vs +14811, p<0.001). The probability of cost-effectiveness of the surgical strategy was 49% at a $100k/QALY threshold or 65% at a $100k/life-year gained threshold.
CONCLUSIONS: Routine thyroid lobectomy is associated with improved outcomes at an acceptable cost compared to observation for thyroid nodules >4cm with benign cytology after FNA. Surgical resection may be a cost-effective strategy to rule out malignancy in these nodules.

PMID: 26715288 [PubMed - as supplied by publisher]

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Nasal angiosarcoma metastatic to the larynx: Case report and systematic review of the literature.

Nasal angiosarcoma metastatic to the larynx: Case report and systematic review of the literature.

Head Neck. 2015 Dec 30;

Authors: Qualls HE, Mitchell RM, Deubner H, Moe KS, Sardesai M

Abstract
BACKGROUND: Laryngeal angiosarcoma is rare and the prognosis is poor. The purpose of this study was to describe the first case of cutaneous angiosarcoma metastatic to the larynx and systematically review all cases of laryngeal angiosarcoma.
METHODS: A 61-year-old man presented with an alar lesion diagnosed as angiosarcoma and was treated with wide local resection and radiation. Six years later, he presented with a laryngeal mass histologically similar to the initial tumor. A systematic review of reported cases of angiosarcoma of the larynx was performed.
RESULTS: Eighteen cases were identified. Mean age of presentation was 64.3 years. Men represented 66.7%. Mean follow-up was 34.1 months. Forty-seven percent died with disseminated disease at a mean of 18.4 months. Our patient did well with serial resection.
CONCLUSION: To the best of our knowledge, this case represents the first documented case of cutaneous angiosarcoma metastatic to the larynx and suggests that serial resection with long-term surveillance may be of benefit in some cases. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26717551 [PubMed - as supplied by publisher]

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Mast cell tryptase and carboxypeptidase A expression in body fluid and gastrointestinal tract associated with drug-related fatal anaphylaxis.

Mast cell tryptase and carboxypeptidase A expression in body fluid and gastrointestinal tract associated with drug-related fatal anaphylaxis.

World J Gastroenterol. 2015 Dec 21;21(47):13288-93

Authors: Guo XJ, Wang YY, Zhang HY, Jin QQ, Gao CR

Abstract
AIM: To investigate the expression of mast cell tryptase and carboxypeptidase A in drug-related fatal anaphylaxis.
METHODS: The expression of mast cell tryptase and carboxypeptidase A in 15 autopsy cases of drug-related fatal anaphylaxis and 20 normal autopsy cases were detected. First, the expression of mast cell tryptase was determined in stomach, jejunum, lung, heart, and larynx by immunofluorescence. Different tissues were removed and fixed in paraformaldehyde solution, then paraffin sections were prepared for immunofluorescence. Using specific mast cell tryptase and carboxypeptidase A antibodies, the expression of tryptase and carboxypeptidase A in gastroenterology tract and other tissues were observed using fluorescent microscopy. The postmortem serum and pericardial fluid were collected from drug-related fatal anaphylaxis and normal autopsy cases. The level of mast cell tryptase and carboxypeptidase A in postmortem serum and pericardial fluid were measured using fluor enzyme linked immunosorbent assay (FEIA) and enzyme linked immunosorbent assay (ELISA) assay. The expression of mast cell tryptase and carboxypeptidase A was analyzed in drug-related fatal anaphylaxis cases and compared to normal autopsy cases.
RESULTS: The expression of carboxypeptidase A was less in the gastroenterology tract and other tissues from anaphylaxis-related death cadavers than normal controls. Immunofluorescence revealed that tryptase expression was significantly increased in multiple organs, especially the gastrointestinal tract, from anaphylaxis-related death cadavers compared to normal autopsy cases (46.67 ± 11.11 vs 4.88 ± 1.56 in stomach, 48.89 ± 11.02 vs 5.21 ± 1.34 in jejunum, 33.72 ± 5.76 vs 1.30 ± 1.02 in lung, 40.08 ± 7.56 vs 1.67 ± 1.03 in larynx, 7.11 ± 5.67 vs 1.10 ± 0.77 in heart, P < 0.05). Tryptase levels, as measured with FEIA, were significantly increased in both sera (43.50 ± 0.48 μg/L vs 5.40 ± 0.36 μg/L, P < 0.05) and pericardial fluid (28.64 ± 0.32 μg/L vs 4.60 ± 0.48 μg/L, P < 0.05) from the anaphylaxis group in comparison with the control group. As measured by ELISA, the concentration of carboxypeptidase A was also increased more than 2-fold in the anaphylaxis group compared to control (8.99 ± 3.91 ng/mL vs 3.25 ± 2.30 ng/mL in serum, 4.34 ± 2.41 ng/mL vs 1.43 ± 0.58 ng/mL in pericardial fluid, P < 0.05).
CONCLUSION: Detection of both mast cell tryptase and carboxypeptidase A could improve the forensic identification of drug-related fatal anaphylaxis.

PMID: 26715811 [PubMed - in process]

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Does airway intervention before primary nonsurgical therapy for T3/T4 laryngeal squamous cell carcinoma impact on oncological or functional outcomes?

Does airway intervention before primary nonsurgical therapy for T3/T4 laryngeal squamous cell carcinoma impact on oncological or functional outcomes?

Swiss Med Wkly. 2015;145:w14213

Authors: Schariatzadeh R, Pezier T, Studer G, Schmid S, Huber G

Abstract
QUESTIONS UNDER STUDY: Even today, some patients with laryngeal cancer present with airway obstruction necessitating an intervention in the form of either a tracheostomy or transoral laser debulking (TOL). Controversy exists as to whether such an intervention is a risk factor for poor oncological or functional outcome in patients who then undergo primary (chemo)radiotherapy.
METHODS: Retrospective chart review of all patients undergoing primary curative nonsurgical treatment for T3/T4 laryngeal squamous cell cancer at the University Hospital Zurich between 1981 and 2011.
RESULTS: A total of 29/114 patients had an airway intervention before initiation of (chemo)radiotherapy (21/29 tracheostomies, 8/29 TOL). Kaplan-Meier analysis showed no statistical difference in oncological outcomes between the groups with and without intervention (5 year overall survival: 52% vs 70%, disease specific survival: 73% vs 79%, recurrence free survival: 53% vs 63%). In functional terms, we report an overall functional larynx rate of 60%.
CONCLUSIONS: Airway intervention was not found to be a risk factor for poor oncological or functional outcome in this patient group.

PMID: 26715377 [PubMed - in process]

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Automated tracking of quantitative parameters from single line scanning of vocal folds: a case study of the 'messa di voce' exercise.

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Automated tracking of quantitative parameters from single line scanning of vocal folds: a case study of the 'messa di voce' exercise.

Logoped Phoniatr Vocol. 2015 Apr;40(1):44-54

Authors: Dejonckere PH, Lebacq J, Bocchi L, Orlandi S, Manfredi C

Abstract
This article presents a novel application of the 'single line scanning' of the vocal fold vibrations (kymography) in singing pedagogy, particularly in a specific technical voice exercise: the 'messa di voce'. It aims at giving the singer relevant and valid short-term feedback. A user-friendly automatic analysis program makes possible a precise, immediate quantification of the essential physiological parameters characterizing the changes in glottal impedance, concomitant with the progressive increase and decrease of the lung pressure. The data provided by the program show a strong correlation with the hand-made measurements. Additional measurements such as subglottic pressure and flow glottography by inverse filtering can be meaningfully correlated with the data obtained from the kymographic images.

PMID: 24456119 [PubMed - indexed for MEDLINE]

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Human vocal tract resonances and the corresponding mode shapes investigated by three-dimensional finite-element modelling based on CT measurement.

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Human vocal tract resonances and the corresponding mode shapes investigated by three-dimensional finite-element modelling based on CT measurement.

Logoped Phoniatr Vocol. 2015 Apr;40(1):14-23

Authors: Vampola T, Horáček J, Laukkanen AM, Švec JG

Abstract
Resonance frequencies of the vocal tract have traditionally been modelled using one-dimensional models. These cannot accurately represent the events in the frequency region of the formant cluster around 2.5-4.5 kHz, however. Here, the vocal tract resonance frequencies and their mode shapes are studied using a three-dimensional finite element model obtained from computed tomography measurements of a subject phonating on vowel [a:]. Instead of the traditional five, up to eight resonance frequencies of the vocal tract were found below the prominent antiresonance around 4.7 kHz. The three extra resonances were found to correspond to modes which were axially asymmetric and involved the piriform sinuses, valleculae, and transverse vibrations in the oral cavity. The results therefore suggest that the phenomenon of speaker's and singer's formant clustering may be more complex than originally thought.

PMID: 23517635 [PubMed - indexed for MEDLINE]

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