[Congenital neck mass. Diagnosis and treatment].

Related Articles

[Congenital neck mass. Diagnosis and treatment].

Semergen. 2015 Nov 7;

Authors: Muñoz-Proto F, Sarría-Echegaray P, Epprecht-González MP, Alba-Mesquida J

Abstract
Congenital neck masses are a challenge for general practitioners and specialists. Although some of them are diagnosed in utero, most of them remain silent until complications appear in the adult age. The anatomical location, consistency and age are determinants in guiding the possible diagnosis. A midline infrahyoid mass may be a thyroglossal cyst, however a lateral neck mass is more possible to result in a brachial cyst. Complementary imaging studies are essential such as pathological tests like needle aspiration fine needle aspiration (FNA).

PMID: 26558520 [PubMed - as supplied by publisher]

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Optimizing frequency-to-electrode allocation for individual cochlear implant users.

Related Articles

Optimizing frequency-to-electrode allocation for individual cochlear implant users.

J Acoust Soc Am. 2014 Dec;136(6):3313

Authors: Grasmeder ML, Verschuur CA, Batty VB

Abstract
Individual adjustment of frequency-to-electrode assignment in cochlear implants (CIs) may potentially improve speech perception outcomes. Twelve adult CI users were recruited for an experiment, in which frequency maps were adjusted using insertion angles estimated from post-operative x rays; results were analyzed for ten participants with good quality x rays. The allocations were a mapping to the Greenwood function, a compressed map limited to the area containing spiral ganglion (SG) cells, a reduced frequency range map (RFR), and participants' clinical maps. A trial period of at least six weeks was given for the clinical, Greenwood, and SG maps although participants could return to their clinical map if they wished. Performance with the Greenwood map was poor for both sentence and vowel perception and correlated with insertion angle; performance with the SG map was poorer than for the clinical map. The RFR map was significantly better than the clinical map for three participants, for sentence perception, but worse for three others. Those with improved performance had relatively deep insertions and poor electrode discrimination ability for apical electrodes. The results suggest that CI performance could be improved by adjustment of the frequency allocation, based on a measure of insertion angle and/or electrode discrimination ability.

PMID: 25480076 [PubMed - indexed for MEDLINE]

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Perceptual learning of temporally interrupted spectrally degraded speech.

Related Articles

Perceptual learning of temporally interrupted spectrally degraded speech.

J Acoust Soc Am. 2014 Sep;136(3):1344

Authors: Benard MR, Başkent D

Abstract
Normal-hearing (NH) listeners make use of context, speech redundancy and top-down linguistic processes to perceptually restore inaudible or masked portions of speech. Previous research has shown poorer perception and restoration of interrupted speech in CI users and NH listeners tested with acoustic simulations of CIs. Three hypotheses were investigated: (1) training with CI simulations of interrupted sentences can teach listeners to use the high-level restoration mechanisms more effectively, (2) phonemic restoration benefit, an increase in intelligibility of interrupted sentences once its silent gaps are filled with noise, can be induced with training, and (3) perceptual learning of interrupted sentences can be reflected in clinical speech audiometry. To test these hypotheses, NH listeners were trained using periodically interrupted sentences, also spectrally degraded with a noiseband vocoder as CI simulation. Feedback was presented by displaying the sentence text and playing back both the intact and the interrupted CI simulation of the sentence. Training induced no phonemic restoration benefit, and learning was not transferred to speech audiometry measured with words. However, a significant improvement was observed in overall intelligibility of interrupted spectrally degraded sentences, with or without filler noise, suggesting possibly better use of restoration mechanisms as a result of training.

PMID: 25190407 [PubMed - indexed for MEDLINE]

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The role of creaky voice in Cantonese tonal perception.

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The role of creaky voice in Cantonese tonal perception.

J Acoust Soc Am. 2014 Sep;136(3):1320

Authors: Yu KM, Lam HW

Abstract
There are few studies on the role of phonation cues in the perception of lexical tones in tonal languages where pitch is the primary dimension of contrast. This study shows that listeners are sensitive to creaky phonation in native tonal perception in Cantonese, a language in which the low falling tone, Tone 4, has anecdotally been reported to be sometimes creaky. First, in a multi-speaker corpus of lab speech, it is documented that creak occurs systematically more often on Tone 4 than other tones. Second, for stimuli drawn from this corpus, listeners identified Tone 4 with 20% higher accuracy when it was realized with creak than when it was not. Third, in a two-alternative forced choice task of identifying stimuli as Tone 4 or Tone 6 (the low level tone) isolating creak from any concomitant pitch cues, listeners had a higher proportion of Tone 4 responses for creaky stimuli. Finally, listeners had more Tone 4 responses for creaky stimuli with longer durations of nonmodal phonation. These results underscore that differences in voice quality contribute to human perception of tone alongside f0. Automatic tonal recognition and clinical applications for tone would benefit from attention to voice quality beyond f0 and pitch.

PMID: 25190405 [PubMed - indexed for MEDLINE]

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Microvascular head and neck reconstruction in the elderly: The University of Brescia experience.

Microvascular head and neck reconstruction in the elderly: The University of Brescia experience.

Head Neck. 2015 Nov 11;

Authors: Piazza C, Grammatica A, Paderno A, Taglietti V, Del Bon F, Marengoni A, Nicolai P

Abstract
BACKGROUND: Microvascular reconstruction in head and neck surgery is increasing in the elderly because of prolonged life expectancy. The purpose of this study was to evaluate the impact of age on outcomes after microvascular reconstruction.
METHODS: We retrospectively reviewed 453 microvascular reconstructions and stratified patients according to age (40.8% >65 years old). Medical and surgical complications and flap success rates were evaluated according to the American Society of Anesthesiologists (ASA) score for physical status and age.
RESULTS: Overall flap success and perioperative mortality were 96.1% and 0.7%, respectively. Minor medical complications were higher in the elderly (28.1% vs 15.3%; p = .001). High ASA scores affected rates of major surgical (20% vs 9.2%; p = .001) and minor medical complications (27.2% vs 13.3%; p < .001).
CONCLUSION: Microvascular reconstruction is reliable in the elderly. Age should not be considered a contraindication by itself; comorbidities play a stronger role in predicting adverse events. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26561407 [PubMed - as supplied by publisher]

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Prospective randomized controlled trial to compare 3-dimensional conformal radiotherapy to intensity-modulated radiotherapy in head and neck squamous cell carcinoma: Long-term results.

Prospective randomized controlled trial to compare 3-dimensional conformal radiotherapy to intensity-modulated radiotherapy in head and neck squamous cell carcinoma: Long-term results.

Head Neck. 2015 Nov 11;

Authors: Ghosh-Laskar S, Yathiraj PH, Dutta D, Rangarajan V, Purandare N, Gupta T, Budrukkar A, Murthy V, Kannan S, Agarwal JP

Abstract
BACKGROUND: Grade ≥2 acute xerostomia between 3D conformal radiotherapy (RT) and intensity-modulated radiotherapy (IMRT) was evaluated in patients with head and neck squamous cell carcinomas (HNSCCs) treated radically.
METHODS: Between 2005 and 2007, 59 patients with HNSCC (T1-3, N0-2b) were randomized to IMRT or 3D-RT. On RT, weekly xerostomia, dysphagia, dermatitis, and mucositis were graded by Radiation Therapy Oncology Group (RTOG) acute toxicity criteria. Patients underwent examination under anesthesia, positron emission tomography (PET)-CT, and toxicity assessments per protocol (NCT00652613) thereafter.
RESULTS: Incidence of grade ≥2 xerostomia at 8 weeks posttreatment was significantly lower with IMRT compared with 3D conformal RT (24% vs 53%; p = .024). At subsequent follow-up, significantly fewer patients receiving IMRT had grade ≥2 xerostomia. Long-term weight loss was higher in patients in the 3D conformal RT arm compared to IMRT (50% vs 21%; p = .038). Disease-related outcomes between arms (median follow-up, 70 months) were similar.
CONCLUSION: IMRT significantly reduces incidence of acute and late grade ≥2 xerostomia in patients with HNSCC. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26561342 [PubMed - as supplied by publisher]

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Prognostic value of p16 expression in Epstein-Barr virus-positive nasopharyngeal carcinomas.

Prognostic value of p16 expression in Epstein-Barr virus-positive nasopharyngeal carcinomas.

Head Neck. 2015 Nov 11;

Authors: Jiang W, Chamberlain PD, Garden AS, Kim BY, Ma D, Lo EJ, Bell D, Gunn GB, Fuller CD, Rosenthal DI, Beadle BM, Frank SJ, Morrison WH, El-Naggar AK, Glisson BS, Sturgis EM, Phan J

Abstract
BACKGROUND: Overexpression of p16 is associated with improved outcomes among patients with oropharyngeal carcinoma. However, its role in the outcomes of patients with nasopharyngeal cancer (NPC) remains unclear.
METHODS: Eighty-six patients with NPC treated at MD Anderson Cancer Center from 2000 to 2014 were identified. Epstein-Barr virus (EBV) and human papillomavirus (HPV) status were determined by in situ hybridization (ISH) and p16 by immunohistochemical staining.
RESULTS: EBV positivity was associated with extended overall survival (OS; median, 95.0 vs 44.9 months; p < .004), progression-free survival (PFS; median, 80.4 vs 28.1 months; p < .013), and locoregional control (median, 104.4 vs 65.5 months; p < .043). In patients with EBV-positive tumors, p16 overexpression correlated with improved PFS (median, 106.3 vs 27.1 months; p < .02) and locoregional control (median, 93.6 vs 64.5 months; p < .02).
CONCLUSION: P16 overexpression is associated with improved PFS and locoregional control in patients with EBV-positive NPC. P16 expression may complement EBV status in predicting treatment outcomes for patients with NPC. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26560893 [PubMed - as supplied by publisher]

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Raster-scanned intensity-controlled carbon ion therapy for mucosal melanoma of the paranasal sinus.

Raster-scanned intensity-controlled carbon ion therapy for mucosal melanoma of the paranasal sinus.

Head Neck. 2015 Nov 11;

Authors: Mohr A, Chaudhri N, Hassel JC, Federspil PA, Vanoni V, Debus J, Jensen AD

Abstract
BACKGROUND: The purpose of this study was to evaluate the use of raster-scanned intensity-controlled carbon ion therapy (ICCT) in the treatment of mucosal melanoma of the paranasal sinus.
METHODS: Patients received combined intensity-modulated radiotherapy (IMRT) plus carbon ion (C12). Records of 18 consecutive patients treated between 2009 and 2013 were analyzed retrospectively regarding toxicity (Common Terminology Criteria for Adverse Events, version 4), treatment response (Response Evaluation Criteria in Solid Tumors [RECIST]), and control/survival rates.
RESULTS: Most patients had advanced disease (T4, 94%; gross residual disease, 78%). Median dose was 74 GyE (median boost volume = 157 mL). C12 treatments were planned as ICCT, no concurrent chemotherapy was administered. Grade III or higher late toxicity was not observed. Overall survival (OS), progression-free survival (PFS), and locoregional control at 3 years were 16.2%, 0%, and 58.3%, respectively (median follow-up, 18 months). Resection status did not impact locoregional control or survival rates.
CONCLUSION: ICCT results in promising locoregional control at mild toxicity. OS is poor because of the occurrence of distant metastases; therefore, addition of systemic components to primary treatment should be investigated. © 2015 Wiley Periodicals, Head Neck, 2015.

PMID: 26560744 [PubMed - as supplied by publisher]

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Long-term functional results after open partial horizontal laryngectomy type IIa and type IIIa: A comparison study.

Long-term functional results after open partial horizontal laryngectomy type IIa and type IIIa: A comparison study.

Head Neck. 2015 Nov 11;

Authors: Schindler A, Pizzorni N, Fantini M, Crosetti E, Bertolin A, Rizzotto G, Succo G

Abstract
BACKGROUND: The purpose of this study was to compare long-term swallowing, voice results, and quality of life (QOL) after open partial horizontal laryngectomy (OPHL) type IIa and type IIIa.
METHODS: Twenty-three patients after OPHL type IIa and 18 patients after OPHL type IIIa were involved. Swallowing skills and neoglottis' motility and vibrations were videoendoscopically assessed. Aerodynamic measures, spectrogram analysis, aspiration pneumonia, body weight variations, and voice perceptual assessment were performed. Generic voice-related and swallowing-related QOL were assessed. Data were statistically compared using Mann-Whitney U test or Fisher exact tests, as appropriate.
RESULTS: Significant differences were found only for the residue with solids and for the intelligibility (I) parameter of the overall quality impression and intelligibility, additive and unnecessary noise, speech fluency, and presence of voiced segments scale with patients of the OPHL type IIIa group showing worse performances than the OPHL type IIa group.
CONCLUSION: Patients who underwent OPHL type IIa and type IIIa show comparable long-term functional outcomes. OPHL type IIIa represents a valid surgical alternative to OPHL type IIa. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26560504 [PubMed - as supplied by publisher]

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Automated analysis of confocal laser endomicroscopy images to detect head and neck cancer.

Automated analysis of confocal laser endomicroscopy images to detect head and neck cancer.

Head Neck. 2015 Nov 11;

Authors: Dittberner A, Rodner E, Ortmann W, Stadler J, Schmidt C, Petersen I, Stallmach A, Denzler J, Guntinas-Lichius O

Abstract
BACKGROUND: The purpose of this study was to develop an automated image analysis algorithm to discriminate between head and neck cancer and nonneoplastic epithelium in confocal laser endomicroscopy (CLE) images.
METHODS: CLE was applied to image head and neck cancer epithelium in vivo. Histopathologic diagnosis from biopsies was used to classify the CLE images offline as cancer or noncancer tissue. The classified images were used to train automated software based on distance map histograms. The performance of the final algorithm was confirmed by "leave 2 patients out" cross-validation and area under the curve (AUC)/receiver operating characteristic (ROC) analysis.
RESULTS: Ninety-two CLE videos and 92 biopsies were analyzed from 12 patients. One hundred two frames of classified neoplastic tissue and 52 frames of nonneoplastic tissue were used for cross-validation of the developed algorithm. AUC varied from 0.52 to 0.92.
CONCLUSION: The proposed software allows an objective classification of CLE images of head and neck cancer and adjacent nonneoplastic epithelium. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26560348 [PubMed - as supplied by publisher]

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Endoscope-guided coblator tongue base resection using an endoscope-holding system for obstructive sleep apnea.

Endoscope-guided coblator tongue base resection using an endoscope-holding system for obstructive sleep apnea.

Head Neck. 2015 Nov 11;

Authors: Cho HJ, Park DY, Min HJ, Chung HJ, Lee JG, Kim CH

Abstract
BACKGROUND: Multilevel obstruction in obstructive sleep apnea commonly includes retroglossal obstruction. To improve surgical success rates, tongue volume reduction with posterior midline glossectomy and/or lingual tonsillectomy is widely performed.
METHODS: Nasotracheal intubation was utilized, and the combined tongue procedure was performed as a final step after palatal surgery. The tongue was pulled maximally by a retraction suture and a McIVOR (Karl Storz, Tuttlingen, Germany) or Davis mouth gag (Karl Storz,Tuttlingen, Germany), and a medium-length tongue blade was applied to expose the tongue base. A 70-degree rigid endoscope was fixed by the holding system and introduced into the oral cavity. Endoscope-guided coblator tongue base resection was then performed.
RESULTS: The surgeon could use both hands for the surgery, enabling a more delicate resection of tongue base tissue.
CONCLUSION: This technique was acceptable and can be successfully used in patients with a large tongue, in whom exposing the tongue base for surgery is difficult. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26560073 [PubMed - as supplied by publisher]

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Valid and reliable techniques for measuring fibrosis in patients with head and neck cancer postradiotherapy: A systematic review.

Valid and reliable techniques for measuring fibrosis in patients with head and neck cancer postradiotherapy: A systematic review.

Head Neck. 2015 Nov 11;

Authors: Shaw SM, Skoretz SA, O'Sullivan B, Hope A, Liu LW, Martino R

Abstract
BACKGROUND: Fibrosis is a common side effect of radiotherapy for head and neck cancer. Although treatments for fibrosis have been developed, valid and reliable measurement tools are needed to verify their efficacy. The purpose of this review was to identify and appraise tools used to measure head and neck fibrosis.
METHODS: Electronic databases were searched for primary research published through April 2014. Main search terms included head and neck cancer, radiotherapy, fibrosis, validity, and reliability. Methodological quality was assessed using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Two blinded raters conducted all assessments. Discrepancies were resolved by consensus.
RESULTS: The search retrieved 534 unique citations. Nine studies met our inclusion criteria, representing 9 different tools. Only 1 tool was assessed for reliability and validity. QUADAS-2 revealed that all studies were at risk for bias.
CONCLUSION: To date, there are no valid and reliable techniques for measuring fibrosis postradiotherapy for head and neck cancer, especially within the suprahyoid and pharyngeal regions. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26559913 [PubMed - as supplied by publisher]

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Efficacy of pectoralis major muscle flap for pharyngocutaneous fistula prevention in salvage total laryngectomy: A systematic review.

Efficacy of pectoralis major muscle flap for pharyngocutaneous fistula prevention in salvage total laryngectomy: A systematic review.

Head Neck. 2015 Nov 11;

Authors: Guimarães AV, Aires FT, Dedivitis RA, Kulcsar MA, Ramos DM, Cernea CR, Brandão LG

Abstract
BACKGROUND: The role of pectoralis major muscle flap (PMMF) in reducing the rate of pharyngocutaneous fistula after salvage total laryngectomy has not been clearly established. The purpose of this study was to evaluate the impact of PMMF in reducing pharyngocutaneous fistula rates after total laryngectomy.
METHODS: The analyzed intervention was the use of a PMMF after total laryngectomy.
RESULTS: Pharyngocutaneous fistula occurred in 230 cases (global incidence, 30.9%). In the group of patients who underwent PMMFs, there were 49 cases of pharyngocutaneous fistula, compared with 181 cases in the control group. There was a 22% decreased risk of pharyngocutaneous fistula incidence in the PMMF group (p < .001). Patients who underwent a PMMF had lower risk of pharyngocutaneous fistula compared with the control group (p = .008). There were no changes when only patients who underwent total laryngectomy (p < .001) and those who underwent total pharyngolaryngectomy (p = .007) were separately assessed.
CONCLUSION: Prophylactic use of PMMF decreases the incidence of pharyngocutaneous fistula after salvage total laryngectomy. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26559777 [PubMed - as supplied by publisher]

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Feasibility of surgeon-performed ultrasound-guided core needle biopsy in the thyroid and lymph nodes.

Feasibility of surgeon-performed ultrasound-guided core needle biopsy in the thyroid and lymph nodes.

Head Neck. 2015 Nov 11;

Authors: Ahn D, Sohn JH, Yeo CK, Jeon JH

Abstract
BACKGROUND: The purpose of this study was to evaluate the feasibility of ultrasound-guided core needle biopsy (CNB) performed by a surgeon for mass lesions in the thyroid and lymph nodes.
METHODS: A single surgeon performed 30 office-based ultrasound-guided CNB procedures for mass lesions in the thyroid and lymph nodes that were previously biopsied by ultrasound-guided fine-needle aspiration cytology (FNAC). The procedure time, targeting success, pathological diagnosis, and complications were evaluated.
RESULTS: The mean procedure time for ultrasound-guided CNB was 6.7 minutes, and it reached a plateau of 4 to 7 minutes after the first 5 procedures. The overall unsatisfactory sampling rate was 3.3% (1 of 30). Specific pathological diagnoses that permitted the surgeon to establish an appropriate treatment plan were provided in 93.3% of the patients (28 of 30). There were no major complications.
CONCLUSION: Ultrasound-guided CNB is technically feasible for a head and neck surgeon and a useful adjunct technique when ultrasound-guided FNAC is inadequate for mass lesions in the thyroid and lymph nodes. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26559644 [PubMed - as supplied by publisher]

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In vitro model for gastroduodenal reflux-induced nuclear factor-kappaB activation and its role in hypopharyngeal carcinogenesis.

In vitro model for gastroduodenal reflux-induced nuclear factor-kappaB activation and its role in hypopharyngeal carcinogenesis.

Head Neck. 2015 Nov 11;

Authors: Sasaki CT, Issaeva N, Vageli DP

Abstract
BACKGROUND: The purpose of this study was to investigate whether gastroduodenal reflux can play a role in the pathogenesis of hypopharyngeal cancer; therefore, we assessed its effect on the nuclear factor-kappa B (NF-κB) pathway, as similarly noted in the esophagus.
METHODS: We exposed human cells derived from the hypopharyngeal epithelium to bile acids or deoxycholic acid. We centered our study on the transcriptional activation of NF-κB pathway, previously linked to head and neck squamous cell carcinoma (HNSCC).
RESULTS: We show that acidic-bile salts induce: (1) NF-κB activation with high cytoplasmic Bcl-2 expression; (2) significant increase in expression v-rel avian reticuloendotheliosis viral oncogene homolog A (RELA(p65)), v-rel avian reticuloendotheliosis viral oncogene homolog (c-REL) signal transducer and activator of transcription 3 (STAT3), isoform of transformation related protein p63 (ΔNp63), B-cell lymphoma 2 (Bcl-2), tumor necrosis factor alpha (TNF-α), epidermal growth factor receptor (EGFR), and wingless type MMTV integration site family member 5A (WNT5A) and a decrease in tumor protein p53 (Tp53); and (3) phenotypic changes that are similar to the phenotype of the untreated hypopharyngeal cancer cell line, University of Michigan squamous cell carcinoma (UMSCC)-11B. These changes are not seen when cells were exposed to neutral control or acid alone.
CONCLUSION: Our findings in vitro are consistent with the hypothesis that gastroduodenal reflux plays a role in hypopharyngeal carcinogenesis and its effect is mediated through activation of NF-κB pathway. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26559497 [PubMed - as supplied by publisher]

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Transoral robotic surgery for early T classification hypopharyngeal cancer.

Transoral robotic surgery for early T classification hypopharyngeal cancer.

Head Neck. 2015 Nov 11;

Authors: Wang CC, Liu SA, Wu SH, Wang CP, Liang KL, Jiang RS, Lin JC

Abstract
BACKGROUND: For hypopharyngeal cancer, transoral robotic surgery (TORS) has been reported as a new organ preserving treatment but outcomes are rarely reported.
METHODS: From 2010 to 2013, 10 patients with early T classification pyriform sinus cancer were selected to receive TORS and conventional neck dissection. The clinical parameters, including rates of adjuvant radiotherapy, survivals, as well as organ and function preservation, were retrospectively analyzed.
RESULTS: TORS was successful in all 10 patients, and 5 patients received adjuvant radiotherapy. After mean follow-up of 26 months, 1 patient died of distant metastasis and 1 patient died of other malignancy. There was no local recurrence and larynxes were all preserved. Eight surviving patients who were followed up continuously could receive oral intake and had a serviceable voice without tracheostomy or feeding tubes.
CONCLUSION: TORS is a feasible transoral approach for selected patients with early T classification hypopharyngeal cancer. The reported oncologic/functional outcomes are satisfactory. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26559383 [PubMed - as supplied by publisher]

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The efficacy and safety of systemic injection of Ginkgo biloba extract, EGb761, in idiopathic sudden sensorineural hearing loss: a randomized placebo-controlled clinical trial.

The efficacy and safety of systemic injection of Ginkgo biloba extract, EGb761, in idiopathic sudden sensorineural hearing loss: a randomized placebo-controlled clinical trial.

Eur Arch Otorhinolaryngol. 2015 Nov 11;

Authors: Koo JW, Chang MY, Yun SC, Kim TS, Kong SK, Chung JW, Goh EK

Abstract
Steroids are currently the most frequently accepted agents for idiopathic sudden sensorineural hearing loss (ISSNHL). However, the therapeutic effect of steroids is not always satisfactory. In this pilot study, we evaluated whether systemic treatment with Ginkgo biloba extract (EGb761) has an additive therapeutic effect in patients receiving a systemic steroid due to ISSNHL. A multicenter, randomized, double-blind clinical trial was performed. Fifty-six patients with ISSNHL were allocated to either EGb761 or placebo. In both groups, methylprednisolone was administered for 14 days. EGb761 was infused intravenously for 5 days in the EGb761 group, while the same amount of normal saline was infused in the placebo group. For the efficacy evaluation, pure-tone audiometry, speech audiometry, tinnitus handicap inventory (THI) and short form-36 health (SF-36) survey outcomes were obtained before administration and on days 3, 5, 14 and 28 of administration. Twenty-four patients in each group completed the study protocol. There was no difference in hearing loss between the two groups before treatment. At day 28, air conduction threshold values in the placebo and EGb761 groups were 34.63 ± 28.90 and 23.84 ± 25.42 dB, respectively (p = 0.082). Speech discrimination scores in the placebo and EGb761 groups were 69.17 ± 40.89 and 87.48 ± 28.65 %, respectively (p = 0.050). THI and SF-36 scores in the placebo and EGb761 groups were similar. Although a combination of steroid and EGb761 for initial treatment did not show better pure tone threshold, compared with steroid alone, speech discrimination was significantly improved in combination therapy. Further studies will be needed to know if addition of EGb761 actually improves the outcome of ISSNHL treatment.

PMID: 26559533 [PubMed - as supplied by publisher]

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Incidence of Suicide in Patients With Head and Neck Cancer.

Incidence of Suicide in Patients With Head and Neck Cancer.

JAMA Otolaryngol Head Neck Surg. 2015 Nov 12;:1-8

Authors: Kam D, Salib A, Gorgy G, Patel TD, Carniol ET, Eloy JA, Baredes S, Park RC

Abstract
Importance: Suicide rates among patients with cancer in the US are significantly higher than those of the general population. To our knowledge, large cohort studies examining suicide rates among patients with head and neck cancer have not been performed.
Objective: To identify incidence rate, trends, and risk factors of suicide in patients with cancer of the head and neck.
Design, Setting, and Participants: This was a retrospective cohort study of geographic areas served by the Surveillance, Epidemiology, and End Results (SEER) program. In total, 350 413 cases of patients with head and neck cancer were recorded within the SEER registry between 1973 and 2011. Data analyses were performed in 2014. Incidence data were calculated from the subset of that population that had the cause of death category coded as "suicide and self-inflicted injury."
Exposures: Patients diagnosed as having a primary cancer of the head and neck region.
Main Outcomes and Measures: Influence of demographic factors, anatomic site of tumor, disease stage, and time since diagnosis on risk for suicide.
Results: Among 350 413 SEER registry patients with head and neck cancer, observed for 2 263 376 person-years, 857 suicides were identified with an age-, sex-, and race-adjusted suicide rate of 37.9/100 000 person-years. In contrast, the US general population suicide rate was 11.8 per 100 000 person-years. Suicide rates were higher in those treated with radiation alone (standardized mortality ratio [SMR], 5.12; 95% CI, 3.83-6.41) compared with those treated with surgery alone (SMR, 2.57; 95% CI, 1.66-3.49). The highest suicide risk was seen in patients with cancers of the hypopharynx (SMR, 13.91; 95% CI, 11.78-16.03) and larynx (SMR, 5.48; 95% CI, 4.14-6.81).
Conclusions and Relevance: Patients with head and neck cancer have more than 3 times the incidence of suicide compared with the general US population. Furthermore, suicide rates were highest among those with cancers of the larynx and hypopharynx.

PMID: 26562764 [PubMed - as supplied by publisher]

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Definitive proton radiation therapy and concurrent cisplatin for unresectable head and neck adenoid cystic carcinoma: A series of 9 cases and a critical review of the literature.

Definitive proton radiation therapy and concurrent cisplatin for unresectable head and neck adenoid cystic carcinoma: A series of 9 cases and a critical review of the literature.

Head Neck. 2015 Nov 11;

Authors: Bhattasali O, Holliday E, Kies MS, Hanna E, Garden AS, Rosenthal DI, Morrison WH, Gunn GB, Fuller CD, Zhu XR, Frank SJ

Abstract
BACKGROUND: The primary treatment for head and neck adenoid cystic carcinoma (ACC) is surgery. Infrequently, however, ACC's propensity for perineural and base of skull invasion can preclude definitive surgical management. We present our experience with proton radiation therapy (RT) and concurrent platinum-based chemotherapy.
METHODS: Nine patients with unresectable node-negative, nonmetastatic head and neck ACC received definitive proton RT and concurrent cisplatin. Outcomes and toxicities were recorded. A systematic review of the literature was performed.
RESULTS: Median follow-up was 27 months (range, 9.2-48.3 months). Four patients achieved complete response at the primary site, and an additional 4 patients achieved stabilization of local disease. Only 1 patient developed local disease progression. Four patients had 5 acute grade 3 (G3) toxicities, and 1 patient developed a chronic G4 optic nerve disorder.
CONCLUSION: Our preliminary results suggest proton RT and concurrent chemotherapy is a definitive treatment option for select patients with head and neck ACC. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26561041 [PubMed - as supplied by publisher]

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Full-thickness skin burn caused by radiofrequency ablation of a benign thyroid nodule.

Full-thickness skin burn caused by radiofrequency ablation of a benign thyroid nodule.

Thyroid. 2015 Nov 11;

Authors: Bernardi S, Lanzilotti V, Papa G, Panizzo N, Dobrinja C, Fabris B, Stacul F

PMID: 26561213 [PubMed - as supplied by publisher]

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