Presentations and Challenges in Tuberculosis of Head and Neck Region.

Presentations and Challenges in Tuberculosis of Head and Neck Region.

Indian J Otolaryngol Head Neck Surg. 2016 Sep;68(3):270-4

Authors: Yashveer JK, Kirti YK

Abstract
(1) To study the different patterns of presentations of tuberculosis in Head and Neck region. (2) To know the importance and reliability of ESR and Mantoux test as an aid in diagnosis of tuberculosis. This study was conducted at Department of ENT and Head and Neck Surgery, Gandhi Medical College, Bhopal, Madhya Pradesh from January 2014 to June 2015. Patients presenting with lesions in the Head and Neck region suspected of tuberculosis were subjected for cytological and histological investigations. Those cases confirmed to be tuberculosis on the basis of either of these tests were included in the study. Study comprised of 113 proven cases of tuberculosis of Head and Neck region. A female preponderance of 1:1.97 (M:F) ratio was noted. Most commonly involved structure was cervical lymph node (92.92 %) followed by larynx, skin and oral mucosa (1.76 %). It was also noted that Mantoux test was positive in 93.8 % of patients and ESR was >30 mm (first hour) in 95.5 % of patients with tuberculosis. Most common presentation of Tuberculosis in Head and Neck area was cervical lymphadenopathy. In a developing country like India the population is mostly in the lower socioeconomic strata. Access to various modern investigations is limited and diagnosis is challenging. Here ESR and Mantoux test are helpful in purusing the case for further evaluation. Based on these pointers cytologically negative cases can be taken up for biopsy.

PMID: 27508125 [PubMed]

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Small cell neuroendocrine carcinoma of tracheostomy site in a patient with a history of juvenile laryngeal papillomatosis.

Small cell neuroendocrine carcinoma of tracheostomy site in a patient with a history of juvenile laryngeal papillomatosis.

BMJ Case Rep. 2016;2016

Authors: Violet Wilmot V, Nixon IJ, Nixon IF

Abstract
Juvenile laryngeal papillomatosis is the commonest cause of benign epithelial tumours of the larynx. Following diagnostic biopsy, surgical debulking is the mainstay of therapy. The condition is often recurrent with further papillomas forming after debridement, requiring serial procedures and occasionally demanding tracheostomy. Rarely, the disease can undergo malignant transformation; most commonly to squamous cell carcinoma. We describe the first reported case of small cell neuroendocrine carcinoma occurring in the previous tracheostomy site of a 29-year-old male with a history of juvenile laryngeal papillomatosis. The patient, with a background of multiple treatments for juvenile papillomas, presented with voice change, breathing difficultly and erythema at the site of previous tracheostomy. Induction chemotherapy followed by chemoradiation was used to treat the lesion with a good response to initial therapy.

PMID: 27507691 [PubMed - in process]

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Entamoeba histolytica Cysteine Proteinase 5 Evokes Mucin Exocytosis from Colonic Goblet Cells via αvβ3 Integrin.

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Entamoeba histolytica Cysteine Proteinase 5 Evokes Mucin Exocytosis from Colonic Goblet Cells via αvβ3 Integrin.

PLoS Pathog. 2016 Apr;12(4):e1005579

Authors: Cornick S, Moreau F, Chadee K

Abstract
Critical to the pathogenesis of intestinal amebiasis, Entamoeba histolytica (Eh) induces mucus hypersecretion and degrades the colonic mucus layer at the site of invasion. The parasite component(s) responsible for hypersecretion are poorly defined, as are regulators of mucin secretion within the host. In this study, we have identified the key virulence factor in live Eh that elicits the fast release of mucin by goblets cells as cysteine protease 5 (EhCP5) whereas, modest mucus secretion occurred with secreted soluble EhCP5 and recombinant CP5. Coupling of EhCP5-αvβ3 integrin on goblet cells facilitated outside-in signaling by activating SRC family kinases (SFK) and focal adhesion kinase that resulted in the activation/phosphorlyation of PI3K at the site of Eh contact and production of PIP3. PKCδ was activated at the EhCP5-αvβ3 integrin contact site that specifically regulated mucin secretion though the trafficking vesicle marker myristoylated alanine-rich C-kinase substrate (MARCKS). This study has identified that EhCP5 coupling with goblet cell αvβ3 receptors can initiate a signal cascade involving PI3K, PKCδ and MARCKS to drive mucin secretion from goblet cells critical in disease pathogenesis.

PMID: 27073869 [PubMed - indexed for MEDLINE]

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Aggravation of Allergic Airway Inflammation by Cigarette Smoke in Mice Is CD44-Dependent.

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Aggravation of Allergic Airway Inflammation by Cigarette Smoke in Mice Is CD44-Dependent.

PLoS One. 2016;11(3):e0151113

Authors: Kumar S, Lanckacker E, Dentener M, Bracke K, Provoost S, De Grove K, Brusselle G, Wouters E, Maes T, Joos G

Abstract
BACKGROUND: Although epidemiological studies reveal that cigarette smoke (CS) facilitates the development and exacerbation of allergic asthma, these studies offer limited information on the mechanisms involved. The transmembrane glycoprotein CD44 is involved in cell adhesion and acts as a receptor for hyaluronic acid and osteopontin. We aimed to investigate the role of CD44 in a murine model of CS-facilitated allergic airway inflammation.
METHODS: Wild type (WT) and CD44 knock-out (KO) mice were exposed simultaneously to house dust mite (HDM) extract and CS. Inflammatory cells, hyaluronic acid (HA) and osteopontin (OPN) levels were measured in bronchoalveolar lavage fluid (BALF). Proinflammatory mediators, goblet cell metaplasia and peribronchial eosinophilia were assessed in lung tissue. T-helper (Th) 1, Th2 and Th17 cytokine production was evaluated in mediastinal lymph node cultures.
RESULTS: In WT mice, combined HDM/CS exposure increased the number of inflammatory cells and the levels of HA and OPN in BALF and Th2 cytokine production in mediastinal lymph nodes compared to control groups exposed to phosphate buffered saline (PBS)/CS, HDM/Air or PBS/Air. Furthermore, HDM/CS exposure significantly increased goblet cell metaplasia, peribronchial eosinophilia and inflammatory mediators in the lung. CD44 KO mice exposed to HDM/CS had significantly fewer inflammatory cells in BALF, an attenuated Th2 cytokine production, as well as decreased goblet cells and peribronchial eosinophils compared to WT mice. In contrast, the levels of inflammatory mediators were similar or higher than in WT mice.
CONCLUSION: We demonstrate for the first time that the aggravation of pulmonary inflammation upon combined exposure to allergen and an environmental pollutant is CD44-dependent. Data from this murine model of concomitant exposure to CS and HDM might be of importance for smoking allergic asthmatics.

PMID: 26999446 [PubMed - indexed for MEDLINE]

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Potential Sources of High Frequency and Biphonic Vocalization in the Dhole (Cuon alpinus).

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Potential Sources of High Frequency and Biphonic Vocalization in the Dhole (Cuon alpinus).

PLoS One. 2016;11(1):e0146330

Authors: Frey R, Volodin IA, Fritsch G, Volodina EV

Abstract
Biphonation, i.e. two independent fundamental frequencies in a call spectrum, is a prominent feature of vocal activity in dog-like canids. Dog-like canids can produce a low (f0) and a high (g0) fundamental frequency simultaneously. In contrast, fox-like canids are only capable of producing the low fundamental frequency (f0). Using a comparative anatomical approach for revealing macroscopic structures potentially responsible for canid biphonation, we investigated the vocal anatomy for 4 (1 male, 3 female) captive dholes (Cuon alpinus) and for 2 (1 male, 1 female) wild red fox (Vulpes vulpes). In addition, we analyzed the acoustic structure of vocalizations in the same dholes that served postmortem as specimens for the anatomical investigation. All study dholes produced both high-frequency and biphonic calls. The anatomical reconstructions revealed that the vocal morphologies of the dhole are very similar to those of the red fox. These results suggest that the high-frequency and biphonic calls in dog-like canids can be produced without specific anatomical adaptations of the sound-producing structures. We discuss possible production modes for the high-frequency and biphonic calls involving laryngeal and nasal structures.

PMID: 26730952 [PubMed - indexed for MEDLINE]

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Regeneration of Vocal Fold Mucosa Using Tissue-Engineered Structures with Oral Mucosal Cells.

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Regeneration of Vocal Fold Mucosa Using Tissue-Engineered Structures with Oral Mucosal Cells.

PLoS One. 2016;11(1):e0146151

Authors: Fukahori M, Chitose S, Sato K, Sueyoshi S, Kurita T, Umeno H, Monden Y, Yamakawa R

Abstract
OBJECTIVES: Scarred vocal folds result in irregular vibrations during phonation due to stiffness of the vocal fold mucosa. To date, a completely satisfactory corrective procedure has yet to be achieved. We hypothesize that a potential treatment option for this disease is to replace scarred vocal folds with organotypic mucosa. The purpose of this study is to regenerate vocal fold mucosa using a tissue-engineered structure with autologous oral mucosal cells.
STUDY DESIGN: Animal experiment using eight beagles (including three controls).
METHODS: A 3 mm by 3 mm specimen of canine oral mucosa was surgically excised and divided into epithelial and subepithelial tissues. Epithelial cells and fibroblasts were isolated and cultured separately. The proliferated epithelial cells were co-cultured on oriented collagen gels containing the proliferated fibroblasts for an additional two weeks. The organotypic cultured tissues were transplanted to the mucosa-deficient vocal folds. Two months after transplantation, vocal fold vibrations and morphological characteristics were observed.
RESULTS: A tissue-engineered vocal fold mucosa, consisting of stratified epithelium and lamina propria, was successfully fabricated to closely resemble the normal layered vocal fold mucosa. Laryngeal stroboscopy revealed regular but slightly small mucosal waves at the transplanted site. Immunohistochemically, stratified epithelium expressed cytokeratin, and the distributed cells in the lamina propria expressed vimentin. Elastic Van Gieson staining revealed a decreased number of elastic fibers in the lamina propria of the transplanted site.
CONCLUSION: The fabricated mucosa with autologous oral mucosal cells successfully restored the vocal fold mucosa. This reconstruction technique could offer substantial clinical advantages for treating intractable diseases such as scarring of the vocal folds.

PMID: 26730600 [PubMed - indexed for MEDLINE]

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Novel application of the Sonopet for endoscopic posterior split and cartilage graft laryngoplasty.

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Novel application of the Sonopet for endoscopic posterior split and cartilage graft laryngoplasty.

Laryngoscope. 2016 Apr;126(4):941-4

Authors: Yawn RJ, Daniero JJ, Gelbard A, Wootten CT

PMID: 26541889 [PubMed - indexed for MEDLINE]

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Serial full-thickness excision of dysplastic vocal fold leukoplakia: Diagnostic or therapeutic?

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Serial full-thickness excision of dysplastic vocal fold leukoplakia: Diagnostic or therapeutic?

Laryngoscope. 2016 Apr;126(4):923-7

Authors: Ahn A, Wang L, Slaughter JC, Nguyen AM, Ossoff RH, Francis DO

Abstract
OBJECTIVES/HYPOTHESIS: A previous study proposed that serial full-thickness excisional biopsies of vocal fold leukoplakia therapeutically decreased dysplasia grade. The current investigation aimed to 1) analyze the pathological evolution and natural history of these lesions and 2) re-examine the role of serial excisions in dysplasia grade regression in long-term follow-up.
STUDY DESIGN: Retrospective case series.
METHODS: Patients treated for vocal fold dysplasia (1994-2013) with serial full-thickness microflap-type excisions were identified and followed longitudinally. Excluded were those with one excision, invasive cancer at initial excision, or history of laryngeal cancer or radiation. Data from surgical procedures, associated pathology, and patient characteristics were recorded. Weighted repeated measures ordinal logistic regression measured associations with pathology findings.
RESULTS: Of 55 patients (median age = 65 years, interquartile range = 54-73 years, 89% male, 63% ever smokers, 27% alcohol users), 31 met inclusion criteria. During the study period, patients had two to 44 excisions, with a median time between excisions of 4.0 months. Each additional excision increased odds of higher-grade pathology by 4% (odds ratio = 1.04, 95% confidence interval = 1.01-1.06; P = .007). A transition model demonstrated that patients with moderate dysplasia, severe dysplasia, or carcinoma in situ on a prior biopsy had 2.64-, 5.64-, and 8.73-times increased odds of the same or higher pathology grade at the next excision, respectively.
CONCLUSIONS: Data do not support the hypothesis that serial full-thickness excisions decrease dysplasia grade. Progression of dysplasia appears to be nonlinear, but higher-grade dysplasia is more likely to progress to malignancy.
LEVEL OF EVIDENCE: 4.

PMID: 26527122 [PubMed - indexed for MEDLINE]

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Derivation and characterization of porcine vocal fold extracellular matrix scaffold.

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Derivation and characterization of porcine vocal fold extracellular matrix scaffold.

Laryngoscope. 2016 Apr;126(4):928-35

Authors: Wrona EA, Peng R, Born H, Amin MR, Branski RC, Freytes DO

Abstract
OBJECTIVES/HYPOTHESIS: To optimize decellularization of porcine vocal folds (VF) and quantify human bone marrow-derived mesenchymal stem cell (BM-MSC) interactions with this matrix to provide a foundation for regenerative approaches to VF repair.
STUDY DESIGN AND METHODS: Vocal folds were dissected from porcine larynges and three decellularization protocols were compared, each consisting of washes and mechanical agitations with different combinations of reagents. DNA content was analyzed via Quant-iT Picogreen assay and hematoxylin and eosin staining. Bone marrow-derived MSCs were then seeded onto the decellularized VF matrices. Morphology, metabolic activity, DNA content, and gene expression were assessed using LIVE/DEAD Cell Viability, alamarBlue Cell Viability Assay, Quant-iT Picogreen assay, and quantitative polymerase chain reaction, respectively.
RESULTS: The most successful decellularization protocol removed 95% DNA content within 1 day, compared to several days required for previously described protocols. Histology confirmed the retention of extracellular matrix (ECM) and its components, including glycosaminoglycans, collagen, and fibrin, while void of nuclear/cellular content. Decellularized scaffolds were then seeded with BM-MSCs. Similar DNA quantities were observed after 24 hours of seeding within the VF-ECM scaffold when compared to cells on tissue culture plastic (TCP). LIVE/DEAD staining of the seeded VF-ECM confirmed excellent cell viability, and the metabolic activity of BM-MSCs increased significantly on VF-ECM compared to TCP. Endoglin gene expression decreased, suggestive of differentiation.
CONCLUSION: Porcine VFs can be efficiently decellularized within 5 hours using a combination of sodium deoxycholate and peracetic acid. Decellularized VF-ECM supported attachment and growth of human BM-MSCs, with evidence of differentiation.
LEVEL OF EVIDENCE: N/A.

PMID: 26371887 [PubMed - indexed for MEDLINE]

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The progression of thyroid cartilage calcification as it relates to the utilization of laryngeal ultrasound.

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The progression of thyroid cartilage calcification as it relates to the utilization of laryngeal ultrasound.

Laryngoscope. 2016 Apr;126(4):913-7

Authors: Wenaas AE, Tran B, Ongkasuwan J

Abstract
OBJECTIVES/HYPOTHESIS: The purpose of this study is to review the computed tomography (CT) scans of infants, children, and adults to assess the degree of calcification of the thyroid cartilage at various ages in order to understand in which age group laryngeal ultrasound can be utilized.
STUDY DESIGN: Retrospective.
METHODS: Two hundred patients from newborn to 50 years who received a CT scan of the neck were identified. The Hounsfield units (HU) of the thyroid cartilage were calculated at one o'clock, four o'clock, eight o'clock, and eleven o'clock at the level of the true and false vocal fold. The Spearman correlation coefficient was calculated to evaluate the correlation between each measure and age, then a linear regression with a logarithmic transformation was applied to further study how the measures were related to age.
RESULTS: The Spearman correlation coefficients ranged from 0.58 to 0.75. The P values of these coefficients were all < 0.0001, showing a significant relationship to age. The age increase by 1 year resulted in increased calcification by 1.5% to 4%. The Wilcoxon signed rank test compared the rate of calcification at each site measured. This showed that the two posterolateral sites calcify faster than the two anteromedial sites.
CONCLUSION: The thyroid cartilage calcifies at a rate that is significantly related to increasing age and calcifies in a posterolateral to anteromedial direction. Based on the HU, the thyroid cartilage is not consistently denser than soft tissue until greater than 40 years of age, which would make laryngeal ultrasound feasible for this population.
LEVEL OF EVIDENCE: 4.

PMID: 26371447 [PubMed - indexed for MEDLINE]

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A low-cost transcervical laryngeal injection trainer.

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A low-cost transcervical laryngeal injection trainer.

Laryngoscope. 2016 Apr;126(4):901-5

Authors: Cabrera-Muffly C, Clary MS, Abaza M

Abstract
OBJECTIVES/HYPOTHESIS: To develop a low-cost, easy-to-construct model for education in transcervical laryngeal injection techniques. To validate the simulator among both fellowship-trained laryngologists and otolaryngology resident learners.
STUDY DESIGN: Survey.
METHODS: A transcervical laryngeal injection model was constructed. Fourteen otolaryngology residents used the model to practice vocal fold injection techniques. Survey feedback was obtained from all residents.
RESULTS: Most learners agreed or strongly agreed that the simulator was easy to use (93%), was a good method to learn transcervical laryngeal injection technique (79%), improved their confidence with the procedure (78%), and could be applied to patients (72%). One hundred percent of the learners agreed or strongly agreed that they would recommend the simulator to other learners.
CONCLUSION: Residents can be taught transcervical laryngeal injection techniques with a low-cost, easily constructed simulator prior to treating patients. This allows for a low-stress environment in which the learner can practice injection techniques. Resident feedback about the transcervical laryngeal injection simulator was very positive, including unanimous recommendation for use in other learners.
LEVEL OF EVIDENCE: N/A.

PMID: 26266892 [PubMed - indexed for MEDLINE]

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Repair of short type IV laryngotracheoesophageal cleft using long, tapered, engaging graft without need for tracheotomy.

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Repair of short type IV laryngotracheoesophageal cleft using long, tapered, engaging graft without need for tracheotomy.

Laryngoscope. 2016 Apr;126(4):1006-8

Authors: Propst EJ

Abstract
UNLABELLED: An infant with a type IV laryngotracheoesophageal cleft underwent transcervical repair using a long tapered cartilage graft. A laryngofissure was carried down to the innominate artery to expose the cleft that extended 5 mm inferior to the vessel. The edges of the cleft were excised, the trachealis was separated from the esophagus that was reapproximated, and clavicular periosteum was placed. A long posterior costal cartilage graft that tapered inferiorly in anteroposterior dimension and engaged behind the cricoid plate was inserted. This added rigidity to the repair and obviated the need for a tracheotomy while providing a four-layer closure.
LEVEL OF EVIDENCE: NA.

PMID: 26153063 [PubMed - indexed for MEDLINE]

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Voice Outcomes following a Single Office-Based Steroid Injection for Vocal Fold Scar.

Voice Outcomes following a Single Office-Based Steroid Injection for Vocal Fold Scar.

Otolaryngol Head Neck Surg. 2016 Aug 9;

Authors: Young WG, Hoffman MR, Koszewski IJ, Whited CW, Ruel BN, Dailey SH

Abstract
OBJECTIVE: Persistent dysphonia from vocal fold scar remains a clinical challenge, with current therapies providing inconsistent outcomes. We evaluated voice outcomes after a single office-based steroid injection.
STUDY DESIGN: Case series with chart review.
SETTING: Academic medical center.
SUBJECTS AND METHODS: This study was based on pre- and postoperative analysis of patient-reported, perceptual, acoustic, aerodynamic, and videostroboscopic parameters. The sample comprised 25 patients undergoing office-based dexamethasone injection into the superficial lamina propria for mild/moderate vocal fold scar. Average follow-up was 13.7 ± 4.4 weeks; patients completed 3.5 ± 2.3 sessions of voice therapy between assessments. Complete data sets were not available for each parameter; sample size is noted with results.
RESULTS: Voice handicap index (n = 24; P < .001) and glottal function index (n = 22; P < .001) decreased after injection. Total GRBAS score (grade, roughness, breathiness, asthenia, strain) decreased (n = 25; P < .001). Fundamental frequency range increased (n = 24; P = .024). Phonation threshold pressure decreased (n = 14; P = .017). Videostroboscopic parameters of vocal fold edge (P = .004), glottic closure (P = .003), and right mucosal wave (P = .016) improved after injection.
CONCLUSIONS: Office-based steroid injection combined with voice therapy for mild/moderate vocal fold scar is associated with improved patient-reported and functional voice measures. These findings provide preliminary support for this approach. Importantly, the procedure is low risk and can be performed in the office, thus offering a simple treatment alternative to patients with a disorder that has traditionally been difficult to manage. Prospective studies evaluating the effects of multiple injections are warranted.

PMID: 27507145 [PubMed - as supplied by publisher]

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Voice Outcomes following a Single Office-Based Steroid Injection for Vocal Fold Scar.

Voice Outcomes following a Single Office-Based Steroid Injection for Vocal Fold Scar.

Otolaryngol Head Neck Surg. 2016 Aug 9;

Authors: Young WG, Hoffman MR, Koszewski IJ, Whited CW, Ruel BN, Dailey SH

Abstract
OBJECTIVE: Persistent dysphonia from vocal fold scar remains a clinical challenge, with current therapies providing inconsistent outcomes. We evaluated voice outcomes after a single office-based steroid injection.
STUDY DESIGN: Case series with chart review.
SETTING: Academic medical center.
SUBJECTS AND METHODS: This study was based on pre- and postoperative analysis of patient-reported, perceptual, acoustic, aerodynamic, and videostroboscopic parameters. The sample comprised 25 patients undergoing office-based dexamethasone injection into the superficial lamina propria for mild/moderate vocal fold scar. Average follow-up was 13.7 ± 4.4 weeks; patients completed 3.5 ± 2.3 sessions of voice therapy between assessments. Complete data sets were not available for each parameter; sample size is noted with results.
RESULTS: Voice handicap index (n = 24; P < .001) and glottal function index (n = 22; P < .001) decreased after injection. Total GRBAS score (grade, roughness, breathiness, asthenia, strain) decreased (n = 25; P < .001). Fundamental frequency range increased (n = 24; P = .024). Phonation threshold pressure decreased (n = 14; P = .017). Videostroboscopic parameters of vocal fold edge (P = .004), glottic closure (P = .003), and right mucosal wave (P = .016) improved after injection.
CONCLUSIONS: Office-based steroid injection combined with voice therapy for mild/moderate vocal fold scar is associated with improved patient-reported and functional voice measures. These findings provide preliminary support for this approach. Importantly, the procedure is low risk and can be performed in the office, thus offering a simple treatment alternative to patients with a disorder that has traditionally been difficult to manage. Prospective studies evaluating the effects of multiple injections are warranted.

PMID: 27507145 [PubMed - as supplied by publisher]

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Survival outcomes in elderly patients with untreated upper aerodigestive tract cancer.

Survival outcomes in elderly patients with untreated upper aerodigestive tract cancer.

Head Neck. 2016 Aug 10;

Authors: Hughley BB, Sperry SM, Thomsen TA, Charlton ME, Pagedar NA

Abstract
BACKGROUND: This study is an evaluation of survival in patients with upper aerodigestive tract (UADT) cancer who did not receive guideline-directed therapy.
METHODS: The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database was examined to identify patients with invasive cancer of the UADT. Patients were classified as "untreated" if they received neither surgery nor radiotherapy. Kaplan-Meier observed survival estimates were computed and stage-specific actuarial estimates of relative survival were computed.
RESULTS: Of 3589 untreated patients, 13.7% were black, compared to 9.5% white, and 9.2% all other races (p <.0001). Patients with stage IV disease were more likely to be untreated than those with stage I disease (11.9% vs 3.8%; p <.0001). Median survival was 39 months for treated patients and 4 months for untreated patients.
CONCLUSION: The median survival for untreated patients was 4 months. Stage, race, and primary site were independently associated with untreated status. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27507712 [PubMed - as supplied by publisher]

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DNA-PkCS expression in oropharyngeal squamous cell carcinoma: Correlations with human papillomavirus status and recurrence after transoral robotic surgery.

DNA-PkCS expression in oropharyngeal squamous cell carcinoma: Correlations with human papillomavirus status and recurrence after transoral robotic surgery.

Head Neck. 2016 Aug 10;

Authors: Weaver AN, Cooper TS, Wei S, Carroll WR, Rosenthal EL, Yang ES

Abstract
BACKGROUND: Human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (SCC) has improved clinical outcomes compared to HPV-negative disease. However, the biology underlying differences in prognosis remains unclear.
METHODS: We characterized the expression of DNA-protein kinase catalytic subunit (DNA-PkCS ), a key DNA repair protein also associated with tumor progression, in 29 cases of oropharyngeal SCCs and correlated our findings with HPV status and disease recurrence. In addition, we assessed therapeutic response, migration, and invasion in head and neck cancer cell lines upon DNA-PkCS knockdown.
RESULTS: DNA-PkCS expression was significantly decreased in HPV-positive compared to HPV-negative oropharyngeal SCC samples. Within the HPV-positive subgroup, DNA-PkCS expression was inversely related to HPV E6 and E7 expression and trended toward significance as a predictor of recurrence. DNA-PkCS knockdown in cell lines resulted in increased sensitivity to cisplatin and radiotherapy and reduced cell migration and invasion.
CONCLUSION: These results suggest DNA-PkCS should be further studied as a potential marker of tumor progression in HPV-positive oropharyngeal SCCs. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27507640 [PubMed - as supplied by publisher]

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Combination of phosphotidylinositol-3-kinase targeting with cetuximab and irradiation: A preclinical study on an orthotopic xenograft model of head and neck cancer.

Combination of phosphotidylinositol-3-kinase targeting with cetuximab and irradiation: A preclinical study on an orthotopic xenograft model of head and neck cancer.

Head Neck. 2016 Aug 10;

Authors: Bozec A, Ebran N, Radosevic-Robin N, Chamorey E, Yahia HB, Marcie S, Gautier M, Penault-Llorca F, Milano G

Abstract
BACKGROUND: The purpose of this study was to investigate the effects of combining the phosphotidylinositol-3-kinase (PI3K) inhibitor buparlisib (BKM)120 with the anti-epidermal growth factor receptor (EGFR) agent cetuximab and radiotherapy (RT) on an orthotopic model of head and neck squamous cell carcinoma (HNSCC).
METHODS: We evaluated the antitumor efficacy of BKM120, cetuximab, and RT, administered alone or in combination, using the human PIK3CA-mutated HNSCC cell line, CAL33, injected into the floor of the mouth of nude mice.
RESULTS: Compared with control, the BKM120-cetuximab and the BKM120-cetuximab-RT combinations led to the highest tumor inhibition (p < .001). The highest inhibitory effect of treatments on cell proliferation, mitogen-activated protein kinase (MAPK) and PI3K/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) signaling pathways were found with the BKM120-cetuximab association. The association of BKM120 and cetuximab with RT inhibited RT-induced activation of the MAPK pathway.
CONCLUSION: These results can serve as a preclinical rationale for innovative treatments combining PI3K inhibition with anti-EGFR therapies and irradiation in patients with HNSCC. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27507562 [PubMed - as supplied by publisher]

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Impact of chemotherapy on the outcome of osteosarcoma of the head and neck in adults.

Impact of chemotherapy on the outcome of osteosarcoma of the head and neck in adults.

Head Neck. 2016 Aug 10;

Authors: Boon E, van der Graaf WT, Gelderblom H, Tesselaar ME, van Es RJ, Oosting SF, de Bree R, van Meerten E, Hoeben A, Smeele LE, Willems SM, Witjes MJ, Buter J, Baatenburg de Jong RJ, Flucke UE, Peer PG, Bovée JV, Van Herpen CM

Abstract
BACKGROUND: There is an ongoing debate about the value of (neo-)adjuvant chemotherapy in high- and intermediate-grade osteosarcoma of the head and neck.
METHODS: All records of patients older than 16 years diagnosed with osteosarcoma of the head and neck in the Netherlands between 1993 and 2013 were reviewed.
RESULTS: We identified a total of 77 patients with an osteosarcoma of the head and neck; the 5-year overall survival (OS) was 55%. In 50 patients with surgically resected high- or intermediate-grade osteosarcoma of the head and neck younger than 75 years, univariate and multivariable analysis, adjusting for age and resection margins, showed that patients who had not received chemotherapy had a significantly higher risk of local recurrence (hazard ratio [HR] = 3.78 and 3.66, respectively).
CONCLUSION: In patients younger than 75 years of age with surgically resected high- and intermediate-grade osteosarcoma of the head and neck, treatment with (neo-)adjuvant chemotherapy resulted in a significantly smaller risk of local recurrence. Therefore, we suggest (neo-)adjuvant chemotherapy in patients amenable to chemotherapy. © 2016 The Authors Head & Neck Published by Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27507299 [PubMed - as supplied by publisher]

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Radiotherapy in early-stage tongue squamous cell carcinoma with minor adverse features.

Radiotherapy in early-stage tongue squamous cell carcinoma with minor adverse features.

Head Neck. 2016 Aug 10;

Authors: Katz O, Nachalon Y, Hilly O, Shpitzer T, Bachar G, Limon D, Popovtzer A

Abstract
BACKGROUND: Treatment for early-stage tongue squamous cell carcinoma (SCC) is usually surgery alone. There is ambiguity regarding the impact of minor adverse features (MAFs) on outcome and the role of postoperative radiotherapy (PORT) in tongue SCC.
METHODS: A retrospective analysis was performed on 48 patients diagnosed with tongue SCC treated in our center. Patients with MAFs received adjuvant PORT. Disease outcome in patients with MAFs, and the effect of PORT were analyzed using the Kaplan-Meier method and log-rank test.
RESULTS: Thirty-one patients had T1 and 17 had T2 disease. PORT was given to 7 patients with MAFs. Mean follow-up time was 70 months. The 2-year overall survival (OS) rate was 86%. Perineural invasion had a significant impact on disease-free survival (DFS; p =.05). There was an improved DFS in patients with MAFs treated with PORT (p =.01).
CONCLUSION: MAFs may have an impact on outcome in tongue SCC, and PORT can improve disease outcome in these patients. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27507221 [PubMed - as supplied by publisher]

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Predisposing factors for poor prognosis of angiosarcoma of the scalp and face: Systematic review and meta-analysis.

Predisposing factors for poor prognosis of angiosarcoma of the scalp and face: Systematic review and meta-analysis.

Head Neck. 2016 Aug 10;

Authors: Shin JY, Roh SG, Lee NH, Yang KM

Abstract
BACKGROUND: Angiosarcoma of the scalp and face is an aggressive tumor with a high rate of local recurrence. Although many previous studies have demonstrated risk factors for poor prognosis, debate remains. We identified the predisposing factors for poor prognosis through comprehensive review of selected studies with meta-analysis.
METHODS: A systematic literature review and meta-analysis were performed using MEDLINE, EMBASE, and Cochrane databases. Nine variables were extracted from the included studies and evaluated based on a 5-year survival rate. The Newcastle-Ottawa scale was used to assess the quality of the studies.
RESULTS: The search strategy identified 89 publications. After screening, 11 articles were selected for review. Age, size, site of tumor, margin status, and surgery associated with poor angiosarcoma prognosis were identified.
CONCLUSION: Although further investigation of long-term and prospective studies is needed, we identified 5 variables as predisposing factors for poor prognosis of angiosarcoma through meta-analysis. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27507124 [PubMed - as supplied by publisher]

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A Trainable Hearing Aid Algorithm Reflecting Individual Preferences for Degree of Noise-Suppression, Input Sound Level, and Listening Situation.

A Trainable Hearing Aid Algorithm Reflecting Individual Preferences for Degree of Noise-Suppression, Input Sound Level, and Listening Situation.

Clin Exp Otorhinolaryngol. 2016 Aug 10;

Authors: Yoon SH, Nam KW, Yook S, Cho BH, Jang DP, Hong SH, Kim IY

Abstract
Objectives: In an effort to improve hearing aid users' satisfaction, recent studies on trainable hearing aids have attempted to implement one or two environmental factors into training. However, it would be more beneficial to train the device based on the owner's personal preferences in a more expanded environmental acoustic conditions. Our study aimed at developing a trainable hearing aid algorithm that can reflect the user's individual preferences in a more extensive environmental acoustic conditions (ambient sound level, listening situation, and degree of noise suppression) and evaluated the perceptual benefit of the proposed algorithm.
Methods: Ten normal hearing subjects participated in this study. Each subjects trained the algorithm to their personal preference and the trained data was used to record test sounds in three different settings to be utilized to evaluate the perceptual benefit of the proposed algorithm by performing the Comparison Mean Opinion Score test.
Results: Statistical analysis revealed that of the 10 subjects, four showed significant differences in amplification constant settings between the noise-only and speech-in-noise situation (P<0.05) and one subject also showed significant difference between the speech-only and speech-in-noise situation (P<0.05). Additionally, every subject preferred different β settings for beamforming in all different input sound levels.
Conclusion: The positive findings from this study suggested that the proposed algorithm has potential to improve hearing aid users' personal satisfaction under various ambient situations.

PMID: 27507270 [PubMed - as supplied by publisher]

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Effect of Hippophae rhamnoides Extract on Oxidative Oropharyngeal Mucosal Damage Induced in Rats Using Methotrexate.

Effect of Hippophae rhamnoides Extract on Oxidative Oropharyngeal Mucosal Damage Induced in Rats Using Methotrexate.

Clin Exp Otorhinolaryngol. 2016 Aug 10;

Authors: Erhan E, Terzi S, Celiker M, Yarali O, Cankaya M, Cimen FK, Malkoc I, Suleyman B

Abstract
Objectives: The objective of this study is to investigate and evaluate the effect of Hippophae rhamnoides extract (HRE) on oropharyngeal mucositis induced in rats with methotrexate (MTX) through biochemical, gene expression, and histopathological examinations.
Methods: Experimental animals were divided into a healthy group (HG), a HRE+MTX (HREM) group, HRE group (HREG), and a control group that received MTX (MTXG). The HREM and HREG groups of rats was administered 50 mg/kg HRE, while the MTXG and HG groups were given an equal volume distilled water with gavage. Then, the HREM and MTXG rat groups were given oral MTX at a dose of 5 mg/kg 1 hour after HRE and distilled water was administered. This procedure was repeated for 1 month. At the end of this period, all of the animals were sacrificed with a high dose of anesthesia. Then, the amounts of malondialdehyde (MDA) and total glutathione (tGSH) were determined in the removed oropharyngeal tissues. Interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) gene expressions were measured, and all the tissues were studied histopathologically.
Results: The amount of MDA was significantly increased in the MTXG group compared to the HREM, HREG, and HG groups (P<0.001). MTX significantly decreased the amount of tGSH in the MTXG group compared to the HREM, HREG, and HG groups (P<0.001). In this study, there were no visible ulcers in the animal group in which the levels of MDA, IL-1β, and TNF-α were high and the level of tGSH was low. However, histopathologic examination revealed mucin pools in wide areas due to ruptured oropharynx glands, and proliferated, dilated, and congested blood vessels and dilated ductal structures in some areas.
Conclusion: HRE protected oropharyngeal oxidative damage induced by MTX. As an inexpensive and natural product, HRE has important advantages in the prevention of oropharyngeal damage induced by MTX.

PMID: 27507269 [PubMed - as supplied by publisher]

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Cutaneous and Labyrinthine Tolerance of Bioactive Glass S53P4 in Mastoid and Epitympanic Obliteration Surgery: Prospective Clinical Study.

Related Articles

Cutaneous and Labyrinthine Tolerance of Bioactive Glass S53P4 in Mastoid and Epitympanic Obliteration Surgery: Prospective Clinical Study.

Biomed Res Int. 2015;2015:242319

Authors: Bernardeschi D, Nguyen Y, Russo FY, Mosnier I, Ferrary E, Sterkers O

Abstract
OBJECTIVE: To evaluate the cutaneous and the inner ear tolerance of bioactive glass S53P4 when used in the mastoid and epitympanic obliteration for chronic otitis surgery.
MATERIAL AND METHODS: Forty-one cases have been included in this prospective study. Cutaneous tolerance was clinically evaluated 1 week, 1 month, and 3 months after surgery with a physical examination of the retroauricular and external auditory canal (EAC) skin and the presence of otalgia; the inner ear tolerance was assessed by bone-conduction hearing threshold 1 day after surgery and by the presence of vertigo or imbalance.
RESULTS: All surgeries but 1 were uneventful: all patients maintained the preoperative bone-conduction hearing threshold except for one case in which the round window membrane was opened during the dissection of the cholesteatoma in the hypotympanum and this led to a dead ear. No dizziness or vertigo was reported. Three months after surgery, healing was achieved in all cases with a healthy painless skin. No cases of revision surgery for removal of the granules occurred in this study.
CONCLUSION: The bioactive glass S53P4 is a well-tolerated biomaterial for primary or revision chronic otitis surgery, as shown by the local skin reaction which lasted less than 3 months and by the absence of labyrinthine complications.

PMID: 26504792 [PubMed - indexed for MEDLINE]

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Ménière's Disease: Molecular Analysis of Aquaporins 2, 3 and Potassium Channel KCNE1 Genes in Brazilian Patients.

Ménière's Disease: Molecular Analysis of Aquaporins 2, 3 and Potassium Channel KCNE1 Genes in Brazilian Patients.

Otol Neurotol. 2016 Aug 9;

Authors: Lopes KC, Sartorato EL, da Silva-Costa SM, de Macedo Adamov NS, Ganança FF

Abstract
OBJECTIVES: Ménière's disease (MD) is a complex disease of unknown etiology characterized by a symptomatic tetrad of vertigo, hearing loss, tinnitus, and aural fullness. In addition to factors related to homeostasis of the inner ear, genetic factors have been implicated in its pathophysiology, including genes related to the transport of water and ionic composition maintenance of the endolymph, such as the aquaporin genes AQP2 and AQP3, and the potassium channel gene KCNE1. The aim of this study was to identify polymorphisms of these genes and determine their association with clinical characteristics of patients with MD.
DESIGN: A case-control genetic association study was carried out, including 30 patients with definite Ménière's disease and 30 healthy controls. The coding regions of the target genes were amplified from blood samples by polymerase chain reaction (PCR), followed by direct sequencing. The associations of polymorphisms with clinical characteristics were analyzed with logistic regression.
RESULTS: Five polymorphisms were identified: rs426496 in AQP2; rs591810 in AQP3; and rs1805127, rs1805128, and rs17173510 in KCNE1. After adjustment, rs426496 was significantly associated with tinnitus during the initial crisis and with altered electronystagmography, and rs1805127 was significantly associated with nephropathy.
CONCLUSIONS: The genetic variant rs426496 in AQP2; rs591810 in AQP3 and rs1805127, rs1805128, and rs17173510, in KCNE1 were found in patients with Ménière's disease. The polymorphism rs426496, in AQP2, is associated with tinnitus at the onset of Ménière's disease and altered electronystagmography. In addition, rs1805127, in KCNE1, is associated with the presence of nephropathy.

PMID: 27509294 [PubMed - as supplied by publisher]

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