Effects of zinc sulfate supplementation on cell-mediated immune response in head and neck cancer patients treated with radiation therapy.

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Effects of zinc sulfate supplementation on cell-mediated immune response in head and neck cancer patients treated with radiation therapy.

Nutr Cancer. 2015;67(3):449-56

Authors: Sangthawan D, Phungrassami T, Sinkitjarurnchai W

Abstract
Zinc deficiency is an important factor that impairs cellular immunity and contributes to low T lymphocyte counts in head and neck cancers. Persistent T lymphopenia is clinically relevant in terms of tumor persistence and/or recurrence. The primary objective was to evaluate the impact of zinc sulfate supplementation on the absolute numbers of circulating T lymphocytes and T lymphocyte subpopulations. The secondary objectives were to evaluate overall survival, progression-free survival, and the adverse events of zinc sulfate. Seventy-two head and neck cancer patients were enrolled in a randomized, double-blind, placebo-controlled trial. Zinc sulfate 50 mg in 10 cc and an identically appearing placebo were self-administered 3 times daily at meal times. Blood samples were obtained for complete blood count, total T lymphocytes and T lymphocyte subpopulations before radiation therapy as baselines, at the fifth week during radiation therapy, and at the first month after completion of radiation therapy. The baseline characteristics of patients, tumors, and treatments and the baseline lymphocyte parameters were not significantly different between the 2 groups. Zinc sulfate supplementation during head and neck radiation therapy showed no increase in absolute numbers of circulating T lymphocytes, T lymphocyte subpopulations, or survival with acceptable side effects.

PMID: 25803777 [PubMed - indexed for MEDLINE]

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upper respiratory tract infection; +24 new citations

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PubMed comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

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Primary inverted papilloma of the middle ear with intracranial invasion.

Primary inverted papilloma of the middle ear with intracranial invasion.

Head Neck. 2015 Dec 24;

Authors: Coca-Pelaz A, Gómez-Martínez J, Vivanco-Allende B, Hermsen M, Llorente JL

Abstract
BACKGROUND: Primary inverted papillomas of the middle ear are extremely rare tumors, with only few cases published in the literature. They have a characteristic epithelium surface inversion to the inside of the stroma. Inverted papillomas are benign lesions but have a high propensity of recurrence, local aggressiveness, and association with malignancy.
METHODS: We present a patient with an inverted papilloma originating in the middle ear producing chronic otorrhea and facial nerve palsy treated with a subtotal petrosectomy.
RESULTS: During the follow-up, the patient developed an intracranial invasion of the tumor causing his death.
CONCLUSION: Primary inverted papillomas of the middle ear can have an extremely aggressive behavior despite their benign characteristics; therefore, an aggressive treatment must be performed in order to minimize the possibility of recurrence. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26698908 [PubMed - as supplied by publisher]

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Three-dimensional endoscopy in transnasal transsphenoidal approach to clival chordomas.

Three-dimensional endoscopy in transnasal transsphenoidal approach to clival chordomas.

Head Neck. 2015 Dec 24;

Authors: Garzaro M, Zenga F, Raimondo L, Pacca P, Pennacchietti V, Riva G, Ducati A, Pecorari G

Abstract
BACKGROUND: The purpose of this prospective, observational study was to evaluate the management of skull base chordomas surgically resected via a 3D-endoscopic transnasal approach.
METHODS: Thirteen consecutive patients were observed and only 9 were surgically treated using a 3D-endoscopic transnasal approach assisted by a novel 3D visualization system.
RESULTS: Nine consecutive male patients (mean age, 57.4 years) underwent exclusive 3D-endoscopic transnasal transsphenoidal resection of clival chordomas; gross total resection was achieved in 66.6% of cases (6 of 9 patients), near-total resection in 11.2% (1 of 9 patients), and partial resection in 22.2% (2 of 9 patients). The complications observed were 2 cases of postoperative cerebrospinal fluid (CSF) leaks and 1 case of temporary VI cranial nerve palsy.
CONCLUSION: No discomfort was recorded; when a dura opening was required, 3D vision allowed an accurate intradural sharp dissection and a precise repair of the skull base. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26698603 [PubMed - as supplied by publisher]

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Clinicopathologic factors associated with recurrence in low- and high-grade parotid cancers.

Clinicopathologic factors associated with recurrence in low- and high-grade parotid cancers.

Head Neck. 2015 Dec 24;

Authors: Lee DY, Park MW, Oh KH, Cho JG, Kwon SY, Woo JS, Jung KY, Baek SK

Abstract
BACKGROUND: The purpose of this study was to determine clinicopathological correlates of outcome among patients with parotid gland cancer.
METHODS: The medical records of 126 patients treated by surgery for localized parotid cancer were retrospectively reviewed to identify the clinicopathologic correlates of recurrence-free survival (RFS) according to histologic grade.
RESULTS: Multivariate analysis revealed that age and lymphovascular invasion were significant factors for recurrence in patients with low-grade cancer (p = .049 and p = .019, respectively), whereas perineural invasion was the only significant factor in patients with high-grade cancer (p = .001). The most frequent recurrence site tends to be different according to histologic grade: local recurrence at low-grade cancer (8.3%) and distant at high-grade cancer (13.6%). The duration of RFS was significantly longer in low-grade cancer than high-grade cancer in regional and distant recurrence (p = .044 and p = .016, respectively).
CONCLUSION: Consideration of different factors may be required for individual low-grade and high-grade parotid cancers when predicting the risk of recurrence. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26698329 [PubMed - as supplied by publisher]

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Laryngeal Adenoid Cystic Carcinoma: A Systematic Review.

Laryngeal Adenoid Cystic Carcinoma: A Systematic Review.

Otolaryngol Head Neck Surg. 2015 Dec 23;

Authors: Marchiano E, Chin OY, Fang CH, Park RC, Baredes S, Eloy JA

Abstract
OBJECTIVE: Adenoid cystic carcinoma is a malignant minor salivary gland tumor that represents <1% of all laryngeal tumors. The submucosal location of laryngeal adenoid cystic carcinoma (LACC) results in delayed presentation. Here, we present the first systematic review of reported cases of LACC to determine trends in presentation, diagnostic and treatment modalities, and patient outcome.
DATA SOURCES: PubMed, Web of Science, MEDLINE, and EMBASE databases.
METHODS: A search of the above databases was done to identify articles reporting cases of LACC. The variables included in the analysis were patient demographics, presenting symptoms, tumor location, imaging, treatment, follow-up time, recurrence, and outcome.
RESULTS: A total of 50 articles and 120 cases were included in the review. The most common presenting symptom was dyspnea (48.8%), followed by hoarseness (43.9%). LACC arose most frequently from the subglottis (56.7%). At presentation, 14.6% (13 of 89) of patients had regional disease. The average follow-up time was 54.0 months. At follow-up, distant metastasis was reported in 30 cases (33.3%). Surgery alone (43.3%) and surgery with radiotherapy (43.3%) were used most frequently and resulted in 57.1% and 55.3% of patients alive with no evidence disease at follow-up, respectively.
CONCLUSION: LACC was most often located in the subglottis. Patients commonly presented with dyspnea and hoarseness. In this systematic review, surgery with radiotherapy and surgery alone were the most commonly employed treatment modalities, and both resulted in slightly more than 50% of patients alive with no evidence of disease at follow-up.

PMID: 26701176 [PubMed - as supplied by publisher]

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Diffuse, encasing lymphangioma of the supraglottis.

Diffuse, encasing lymphangioma of the supraglottis.

Am J Otolaryngol. 2016 Jan-Feb;37(1):41-3

Authors: Thompson TL, Gungor A

Abstract
BACKGROUND: Lymphangioma of the head and neck is considered a rare congenital tumor with the vast majority presenting before two years of age. Surgical excision and sclerosing therapy using OK-432 are recognized as effective treatment options for the majority of these lesions; however, treatment options of laryngeal lesions are less straightforward due to the risk of airway compromise and the desire to maintain the integrity of a functional larynx. We present the case of a four month old male who presented with chief complaint of inspiratory stridor after a single episode of pneumonia. His clinical presentation, flexible fiberoptic laryngoscopic examination, and operative evaluation were consistent with a lymphangioma completely encasing the epiglottis and arytenoids and isolated to the supraglottis. This report outlines our approach to workup and treatment of this rare lesion.
METHOD: Case report of presentation, diagnosis and treatment is presented.
RESULTS: A four-month old male presented to ENT clinic with inspiratory stridor, worsened with crying, without frank respiratory distress. History and initial examination was consistent with airway obstruction. Flexible fiberoptic laryngoscopy showed laryngomalacia as well as diffuse and symmetric supraglottic edema. Surgical evaluation identified edema limited to the supraglottis, notably along the ventral surface of the epiglottis and dorsal surface of bilateral arytenoids. Biopsies were taken and immunohistochemical staining was performed with strong positivity for D2-40 and CD31, supporting the diagnosis of isolated lymphangioma of the supraglottis. Treatment was performed through multiple point spot welding with a fiber equipped CO2 LASER (OmniGuide TM) at 5 watt continuous power.
CONCLUSION: Isolated supraglottic lymphangioma was diagnosed via direct laryngoscopy, with pathologic and immunohistochemical confirmation. Carbon dioxide laser spot welding technique was used with excellent clinical improvement in stridor. Clinical improvement is sustained after 6months follow-up.

PMID: 26700259 [PubMed - in process]

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