The Laryngoscope
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Comparative Study
Diagnostic evaluation of squamous cell carcinoma metastatic to cervical lymph nodes from an unknown head and neck primary site.
To discuss our experience with the diagnostic evaluation in patients with squamous cell carcinomas (SCCAs) of the head and neck metastatic to the cervical lymph nodes from an unknown primary site. ⋯ Diagnostic evaluation should include a thorough physical examination, CT and/or MRI of the head and neck, and panendoscopy with directed biopsies. Unilateral or bilateral tonsillectomy should be performed on patients with adequate lymphoid tonsillar tissue. FDG-PET or FDG-PET/CT should be considered for those with indeterminate findings on physical examination and/or head and neck CT and/or MRI if those sites are located outside of the oropharynx.
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To investigate the feasibility of transoral robotic surgery as a method of surgical treatment of oropharyngeal squamous cell carcinoma. ⋯ Transoral robotic surgery is a safe and efficacious method of surgical treatment of oropharyngeal neoplasms. Advantages of the technique include adequate ability to visualize and manipulate with two hands lesions in the base of tongue. Patients were able to retain or rapidly regain oropharyngeal function in the majority of cases.
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In suspected cases of Sjogren syndrome (SS), patients are often referred for a labial minor salivary gland biopsy. However, studies have shown this test to be unreliable. Pathologic misinterpretation and immunosuppressive medications may affect the results of the biopsy. As a result, it is best to perform this procedure only when necessary. The purpose of the current study was to review clinical signs and symptoms of patients who underwent a lip biopsy to determine which patients benefited most from this procedure. ⋯ In this study, clinical presentation of sicca symptoms and positive serology reliably predicted the results of a lip biopsy. The results of this study suggest that patients with clear criterion for SS may not require a lip biopsy, especially those patients on immunosuppression. When physicians suspect SS, a thorough clinical and laboratory examination is necessary to determine if a patient will benefit from a minor salivary gland biopsy.
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To investigate changes in parotid and submandibular gland volumes of patients with head and neck cancer treated with postoperative intensity-modulated radiotherapy (IMRT) or conventional radiotherapy (CRT), and to relate the volume changes to different mean radiation therapy (RT) doses to the parotid and submandibular glands. ⋯ The parotid and submandibular glands shrunk during RT, but the parotid glands shrunk more than the submandibular glands. These gland volume reductions correlated significantly with the mean dose to the irradiated glands; the spared glands showed few changes.