Medicine and Health Sciences Commons^™

Preoperative Immunotherapy In The Multidisciplinary Management Of Oral Cavity Cancer., Ramez Philips, Md, Chihun Han, Brian Swendseid, Md, Joseph Curry, Athanassios Argiris, Adam Luginbuhl, Jennifer Johnson, Md

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Despite advances in multimodal treatment for oral cavity squamous cell carcinoma, recurrence rates remain high, providing an opportunity for new therapeutic modalities that may improve oncologic outcomes. Much recent attention has been paid to the molecular interactions between the tumor cells with the adjacent peritumoral microenvironment, in which immunosuppressive molecular changes create a landscape that promotes tumor progression. The rationale for the introduction of immunotherapy is to reverse the balance of these immune interactions in a way that utilizes the host immune system to attack tumor cells. In the preoperative setting, immunotherapy has the advantage of priming the unresected tumor …

A Novel In Vivo Model For Evaluating Functional Restoration Of A Tissue-Engineered Salivary Gland., Swati Pradhan-Bhatt, Daniel A Harrington, Randall L Duncan, Mary C Farach-Carson, Xinqiao Jia, Robert L Witt

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVES/HYPOTHESIS: To create a novel model for development of a tissue-engineered salivary gland from human salivary gland cells that retains progenitor cell markers useful for treatment of radiation-induced xerostomia.

STUDY DESIGN: A three-dimensional (3D) hyaluronic acid (HA)-based hydrogel scaffold was used to encapsulate primary human salivary gland cells and to obtain organized acini-like spheroids. Hydrogels were implanted into rat models, and cell viability and receptor expression were evaluated.

METHODS: A parotid gland surgical resection model for xenografting was developed. Salivary cells loaded in HA hydrogels formed spheroids and in vitro were implanted in the three-fourths resected parotid bed of athymic …

A Preliminary Report Of Percutaneous Craniofacial Osteoplasty In A Rat Calvarium., William Parkes, Jewel Greywoode, Brian J O'Hara, Ryan N. Heffelfinger, Howard Krein

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: To evaluate the potential for injectable, permanent bone augmentation by assessing the biocompatability and bioactivity of subperiosteal hydroxylapatite (Radiesse) deposition in a rat model.

STUDY DESIGN: Randomized controlled animal model METHODS: Fourteen adult Sprague Dawley rats were injected in the parietal skull with 0.2 ml of hydroxylapatite (10 animals) or a carrier gel control (4 animals), using a subperiosteal injection technique on the right and a subcutaneous injection technique on the left. At 1, 3, and 6 months, 3 rats (1 negative control, 2 variables) were sacrificed and calvaria were harvested. At 12 months, the remaining 5 rats were …

Incidence And Management Of Rhinosinusitis After Complex Orbitofacial Reconstruction., William Parkes, Gurston G. Nyquist, Christopher Rizzi, Sarah Zhang, James J. Evans, Ryan N. Heffelfinger, Marc Rosen, Joseph Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: To examine the sinus-related sequelae of free flap reconstruction for complex orbitofacial defects.

STUDY DESIGN: Retrospective chart review METHODS: Demographic, clinical, and radiographic data on a series of 55 patients who had undergone free tissue transfer for orbitofacial reconstruction was retrospectively reviewed. Follow-up of ≥ 3 months was available for 49 patients. Outcome measures studied included clinical or radiographic evidence of sinusitis and the need for sinus surgery.

RESULTS: The most commonly involved sinuses were the ethmoid (n=40) and maxillary (n=38) sinuses, and the anterolateral thigh was the most common flap used (n=41). Clinical and/or radiographic sinusitis was evident …

Value-Based Analysis Of Routine Pathologic Septal And Inferior Turbinate Specimens., James J Daniero, Jaemi S Chu, Brian J O'Hara, Edmund A. Pribitkin

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

This article was presented at the 2012 AAO-HNSF Annual Meeting & OTO EXPO; September 9-12, 2012; Washington, DC.

Objective To determine the frequency and clinical relevance of unanticipated histopathologic results in routine sinonasal surgery and evaluate the necessity for histologic processing of nasal septal cartilage, bone, and inferior turbinate specimens. Study Design Case series with chart review. Setting Tertiary care academic medical center. Subjects and Methods A retrospective review of surgical pathology reports on adult patients undergoing sinonasal surgery during a 5-year period from 2005 to 2010 was performed. All cases with the preoperative diagnosis of sinonasal neoplasia, autoimmune disease, …

A Thermoplastic Vest To Prevent Self Mutilation In Experimental Flap Surgery In Rats, Eli A. Gordin, Md, Sarah M. Drejet, Md, Ryan N. Heffelfinger, Md

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Poster presented at: 8th International Conference on Head and Neck Cancer in Toronto, Canada.

Introduction:

Rats are frequently utilized for both research and training related to reconstructive head and neck surgery. The femoral neurovascular complex represents a useful mode for microvascular anastomosis, both for the purposes of testing adjuncts designed to improve anastomotic patency rates, as well as for residents and students to gain experience in microvascular surgery outside the operating room. Additionally, the rat proves useful in investigations examining the survivability of both random and axial pattern skin flaps.

Monocarboxylate Transporter 4 And Caveolin-1 Expression In Squamous Cell Carcinoma Of The Oral Cavity, Julie A. Ames, Md, Aileen Butera, Md, Joseph Curry, Md, Madalina Tuluc, Md, Ubaldo E. Martinez-Outshoorn, Md, Diana Whitaker-Menezes, Phd, Federica Sotgia, Phd, Michael P. Lisanti, Md, Phd

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Poster presented at: 8th International Conference on Head and Neck Cancer in Toronto Canada, July 21-25, 2012.

Objective: To determine the significance of caveolin-1 (cav-1) and monocarboxylate transporter 4 (MCT4) in squamous cell carcinoma of the oral cavity. We hypothesized that high stromal MCT4 would predict a worse prognosis and correlate with low stromal Cav-1.

Frontal Sinus Osteoma Removal With The Ultrasonic Bone Aspirator., Eric Ehieli, Jaemi Chu, Eli Gordin, Edmund A Pribitkin

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Osteomas, the most common skull tumors, are typically excised through either an open or endoscopic ostectomy using a high-speed drill, a technically challenging procedure that can result in injury to adjacent soft tissue structures. Osteoma removal through ultrasonic bone emulsification and aspiration (UBA) offers the advantages of decreased blood loss, preservation of adjacent soft tissue structures, and precise bone removal. UBA was used to successfully remove a forehead osteoma without injury to adjacent nerves and with a satisfactory cosmetic outcome. We describe skull osteoma removal with an ultrasonic bone aspirator, which offers potential advantages over conventional bone removal techniques.

Novel Irradiated Axial Rotational Flap Model In The Rodent, Adam J. Luginbuhl, Mara Modest, Bs, Kaiguo Yan, Joseph Curry, Ryan N. Heffelfinger

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Abstract

Objectives: To design an easily reproducible rodent rotational skin flap and to evaluate the effects of radiation on flap viability.

Methods: Ten rats received 40 Gy irradiation to the abdominal wall. Following a recovery period of one month, a 3 X 8 cm fasciocutaneous flap based axially on the inferior epigastric vessel, was raised and rotated 60 degrees into a contralateral deficit. Five non-irradiated rats underwent the identical procedure as a control. Animals were sacrificed seven days postoperatively, areas of flap necrosis were documented, and histological specimens were taken to compare flap viability and vessel density.

Results: 60% of …

Sour Ageusia In Two Individuals Implicates Ion Channels Of The Asic And Pkd Families In Human Sour Taste Perception At The Anterior Tongue., Taufiqul Huque, Beverly J Cowart, Luba Dankulich-Nagrudny, Edmund A Pribitkin, Douglas L Bayley, Andrew I Spielman, Roy S Feldman, Scott A Mackler, Joseph G Brand

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

BACKGROUND: The perception of sour taste in humans is incompletely understood at the receptor cell level. We report here on two patients with an acquired sour ageusia. Each patient was unresponsive to sour stimuli, but both showed normal responses to bitter, sweet, and salty stimuli.

METHODS AND FINDINGS: Lingual fungiform papillae, containing taste cells, were obtained by biopsy from the two patients, and from three sour-normal individuals, and analyzed by RT-PCR. The following transcripts were undetectable in the patients, even after 50 cycles of amplification, but readily detectable in the sour-normal subjects: acid sensing ion channels (ASICs) 1a, 1beta, 2a, …

Assessment Of Smoking Status Based On Cotinine Levels In Nasal Lavage Fluid., Mehmet Hakan Ozdener, Karen K Yee, Ryan Mcdermott, Beverly J Cowart, Aldona A Vainius, Pamela Dalton, Nancy E Rawson

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

ABSTRACT: Cotinine is a principal metabolite of nicotine with a substantially longer half-life, and cotinine levels in saliva, urine or serum are widely used to validate self-reported smoking status. The nasal cavity and olfactory system are directly exposed to tobacco smoke in smokers and in non-smokers who live with or work around smokers. However, despite the potential for a direct impact of tobacco smoke on the nasal epithelium and olfactory neurons, no prior studies have assessed cotinine levels in nasal mucus. We sought to determine whether cotinine levels in nasal lavage fluid (NLF) would provide a reasonable estimate of smoke …

Malignant Melanoma Metastatic To The Thyroid Gland: A Case Report And Review Of The Literature., Brian Kung, Md, Saba Aftab, Bs, Moira D. Wood, Md, David Rosen, Md

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

The thyroid gland is a relatively uncommon site for a secondary malignancy; even less common is a case of malignant melanoma metastatic to the thyroid. We describe the case of a 68-year-old man who presented with a neck mass in the posterior triangle. Fine-needle aspiration biopsy (FNAB) identified the mass as a malignant melanoma. The patient had had no known primary skin melanoma. He underwent a left modified radical neck dissection, and the mass was discovered to be a positive lymph node. Postoperatively, he declined to undergo radio- and chemotherapy. Eighteen months later, he returned with a diffusely enlarged thyroid. …

Nasal Airflow And Odorant Transport Modeling In Patients With Chronic Rhinosimusitis, Kai Zhao, Beverly J. Cowart, N. E. Rawson, Peter W. Scherer, K. T. Clock, A. A. Vainius, Pamela Dalton, Edward Pribitkin, David Rosen

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Poster presentation at Association for Chemoreception Sciences (ACHEMS) in Sarasota Florida April 25-29, 2007.

Introduction:

Our on-going clinical project aims to quantify the conductive mechanism contributing toolfactory loss in chronic rhinosinusitis (CRS) patients, in addition to other inflammatory causes(see Yee, et al, 200 and Feng, et al, 203). CRS, a common disease affecting 32 millionAmericans annually, is reportedly associated with at least 15% of all olfactory losses. Airwayconstriction as a result of inflammation or the presence of polyps may limit odor access to thereceptor sites and lead to olfactory dysfunction. As yet, the functional impact of various nasalobstructions as sequelae …

Malignant Melanoma Metastacizing To The Thyroid Gland: A Case Report And Review Of The Literature, Brian Kung, Saba Aftab, Moira Wood, David Rosen

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Oral presentation 2006 AAO-H&NS Annual Meeting

Toronto, Canada September 17-20, 2006.

Objectives: The thyroid gland is a relatively uncommon site for secondary malignancy. Even lesscommon is metastasis of malignant melanoma to the thyroid gland. We present a case of malignantmelanoma metastatic to the thyroid gland presenting as thyroid enlargement.

Study Design: This is a case report which utilizes chart review, intraoperative photographs,radiographic images, and pathology slides.

Methods: A 68 year old patient with no prior evidence of primary skin melanoma presented witha neck mass which tested positive for melanoma. A year and a half following modified radical neckdissection, the patient …

Methemoglobinemia Induced By Topical Anesthesia During Fiberoptic Endotracheal Intubation, Matthew C. Miller, Michael T. Gaslin, Kathleen Herb, David Rosen

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Poster presentation at 2005 American Academy Of Otolaryngology Head and Neck Surgery Annual Meeting, Los Angeles, CA September 25-28, 2005.

Introduction: Although local anesthetics are usually well tolerated, otolaryngologists need to be aware of the sometimes serious adverse events they can cause. The benzocaine containing sprays Hurricaine and Cetacaine are occasionally associated with the onset of life-threatening methemoglobinemia. The specific treatment for this condition is methylene blue.

Methods and Measures: We describe a case report of a 48 year old female who developed a methemoglobin level of 41% after receiving topical benzocaine to her oropharynx. We discuss the case in …

Unilateral Olfactory Thresholds In A Chemosensory Clinic Population, Beverly Cowart, Edmund Pribitkin, David Rosen, Christopher Klock, Timothy Laflam

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Poster presentation at 26th Annual Meeting of the Association of Chemoreception Sciences in Sarasota Florida, April 21-25, 2004.

INTRODUCTION

Because there is the possibility of unilateral loss of olfactory function or differential degrees of olfactory dysfunction in the two nostrils, unilateral tests of olfactory threshold sensitivity are routinely included in many chemosensory clinical test batteries to supplement bilateral tests (e.g., Cain et al., 1988; Hummel et al., 1997). Surprisingly, however, the results of unilateral testing in patients with chemosensory complaints have not been extensively reported. Thus, it is unclear how useful these additional measures are in characterizing individual patients.

A …