Married Head/Neck Cancer Patients Less Likely To Smoke, More Likely To Live Longer

MedicalResearch.com Interview with:

Nosayaba Osazuwa-Peters, BDS, MPH, CHES Instructor, Department of Otolaryngology-Head and Neck Surgery Saint Louis University School of Medicine Member, Saint Louis University Cancer Center St Louis, Missouri

Nosayaba Osazuwa-Peters

Nosayaba Osazuwa-Peters, BDS, MPH, CHES
Instructor, Department of Otolaryngology-Head and Neck Surgery
Saint Louis University School of Medicine
Member, Saint Louis University Cancer Center
St Louis, Missouri 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Several studies have shown that there is an adverse effect of smoking on head and neck cancer survival; however, there are studies that show no effect between smoking and head and neck cancer. We wanted to investigate this problem using a single institution’s cancer dataset. Additionally, we wanted to understand the role of marital status in the smoking behavior of head and neck cancer patients, and to understand if smoking played any role in head and neck cancer survival.

Our study confirmed that head and neck cancer patients who were smokers at the time of diagnosis had lower survival rates than nonsmokers. We also found that married head and neck cancer patients were less likely to be smokers and more likely to survive longer than those unmarried.

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Modifiable Surgical Outcomes in ENT Cancer Surgery That May Improve Survival

MedicalResearch.com Interview with:
David Schoppy, MD PhD
Resident, Division of Head and Neck Surgery
Department of Otolaryngology
Stanford University School of Medicine
Stanford, Palo Alto, California

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There is a growing focus in healthcare on quality, and one component of this focus is the development of robust measures of quality. Currently, there are relatively few validated metrics of performance in oncologic surgery, and several of these indicators are relatively static metrics (such as hospital case volume and institution type).

This study examined the relationship between overall survival (one surrogate of quality cancer surgery) and two modifiable variables in Head and Neck surgery – achieving negative surgical margins around a primary tumor and 18 or more lymph nodes from a concurrent neck dissection. After controlling for multiple other patient variables, data collected from the National Cancer Database (NCDB) showed that treatment at hospitals where a high percentage of patients had a surgery with negative margins and 18 or more lymph nodes removed from their neck was associated with improved survival. Importantly, this survival benefit was independent of the individual, patient-level survival benefit conferred by having either of these surgical process measures reached.

This study therefore highlights two modifiable measures of institutional performance in Head and Neck surgery that may serve as targets for quality improvement programs.

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Mild Hypothermia During Prolonged Surgery May Reduce Complications

MedicalResearch.com Interview with:

Brett A. Miles, DDS MD FACS Associate Professor of Otolaryngology Head and Neck Surgery Co-Chief Division Head and Neck Oncology Fellowship Director Head and Neck Oncologic and Microvascular Reconstructive Surgery Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York, NY 10029

Dr. Miles

Brett A. Miles, DDS MD FACS
Associate Professor of Otolaryngology Head and Neck Surgery
Co-Chief Division Head and Neck Oncology
Fellowship Director
Head and Neck Oncologic and Microvascular Reconstructive Surgery
Department of Otolaryngology Head and Neck Surgery
Icahn School of Medicine at Mount Sinai
New York, NY 10029 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The ideal core temperature for patients undergoing prolonged major head and neck surgery remains unknown. Previous data indicates the low temperatures may increase the risk of developing postoperative complications such as tissue loss, hematomas, or surgical infections.(1) Other studies have indicated that high temperatures may also influence outcomes and lead to increased complications such as bleeding.(2)

This study was a study of 519 patients who underwent major head and neck surgery at the Mount Sinai Hospital, New York, New York. The study looked at the core temperature of the patients during prolonged surgery for head and neck cancer in order to identify the optimal temperature range for these patients to prevent complications.

The study found that higher intraoperative temperatures were associated with worse outcomes in terms of tissue loss, wound complications, and infection. Our study suggests an optimal temperature range of 35.3C-37.6C. If patients were above or below that range for a significant period of time, their complications increased. Therefore maintaining this temperature range (mild hypothermia) may improve flap outcomes in this population.

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Risk Factors For Reoperation and Readmission After Parathyroidectomy Identified

MedicalResearch.com Interview with:

Raymond L. Chai, MD Assistant Professor of Otolaryngology Icahn School of Medicine at Mount Sinai.

Dr. Rai

Raymond L. Chai, MD
Assistant Professor of Otolaryngology
Icahn School of Medicine at Mount Sinai. 

MedicalResearch.com: What is the background for this study?

Response: Primary hyperparathyroidism is a common endocrine disorder affecting up to 1% of the general population. Surgical intervention is the only known durable cure for the disease. Untreated primary hyperparathyroidism can lead to number of health problems, including progressive osteoporosis and kidney stones. Although parathyroidectomy is a commonly performed surgical procedure by otolaryngologists, limited data exists regarding risk factors and rates of reoperation and readmission following surgery.

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Volunteers Plus Free Hearing Aids Can Supply Adequate Auditory Care

MedicalResearch.com Interview with:
Aileen Wertz, MD

Otolaryngology – Head and Neck Surgery
University of Michigan 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The key finding of this study is: free, comprehensive audiologic care, including hearing aids and fitting, is feasible within a well-established free clinic model.

We found that donated hearing aids and volunteer health care providers were able to run the clinic and that 20 patients have thus far been fit with hearing aids.

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Laypeople Perceive Facelift To Give More Youthful, Healthier Appearance

MedicalResearch.com Interview with:
Lisa E. Ishii, MD, MHS
Associate Professor of Otolaryngology – Head and Neck Surgery
John Hopkins Medicine

Lisa Earnest Ishii, M.D. Associate Professor of Otolaryngology - Head and Neck Surgery Johns Hopkins Medicine

Dr. Ishii

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There was a gap in our knowledge about what the average lay person thought about the impact of a facelift.  We had information about what experts thought, and some about what patients themselves thought, but nothing about lay people.
Patients who choose to have a facelift are typically concerned about the opinions of:

1) Themselves when they look in the mirror, and

2) Laypeople they encounter socially in society.

Our study showed for the first time that laypeople find people who have had a facelift to appear more attractive, more youthful, healthier and more successful than they were before their facelift.

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Obstructive Sleep Apnea More Common In Obese Adolescents With Enlarged Tonsils

MedicalResearch.com Interview with:

Ron B. Mitchell, MD Professor and Vice Chairman, Department of Otolaryngology, Head and Neck Surgery William Beckner Distinguished Chair in Otolaryngology Chief of Pediatric Otolaryngology UT Southwestern and Children's Medical Center Dallas Dallas, TX 75207

Dr. Ron Mitchell

Ron B. Mitchell, MD
Professor and Vice Chairman,
Department of Otolaryngology, Head and Neck Surgery
William Beckner Distinguished Chair in Otolaryngology
Chief of Pediatric Otolaryngology
UT Southwestern and Children’s Medical Center Dallas
Dallas, TX 75207

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Obstructive Sleep Apnea (OSA) has not been widely studies in adolescents. This is one of a few studies that was targeted at 12-17 year olds who were referred for a sleep study for possible OSA. The study included 224 adolescents (53% male). aged 12 to 17 years. The mean BMI was 33.4 and most were either Hispanic or African American (85.3%). A total of 148 (66.1%) were obese. Most adolescents referred for a sleep study (68%), had  Obstructive Sleep Apnea. Normal-weight adolescents were least likely to have OSA at 48%, while obese children were most likely at 77%. Severe OSA was most likely in obese males with tonsillar hypertrophy.

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DNA Methylation Allows Head and Neck Tumors To Be SubClassified

MedicalResearch.com Interview with:

Jacek Majewski PhD Associate Professor Department of Human Genetics McGill University and Genome Quebec Innovation Centre Montreal, Canada

Dr. Jacek Majewski

Jacek Majewski PhD
Associate Professor
Department of Human Genetics
McGill University and Genome Quebec Innovation Centre
Montreal, Canada 

MedicalResearch.com: What is the background for this study?

Response: Our lab, in collaboration with Dr. Nada Jabado, has been investigating the molecular genetics of pediatric glioblastoma – a deadly brain cancer. Several years ago, in the majority of our patients’ tumors we discovered mutations in genes that encode histone proteins. Those mutations disrupt the epigenome – that is the way the DNA is modified, silenced, or activated in the cancer cells. It appears that epigenome-modifying mutations are particularly important in pediatric cancers, and our hypothesis is that they act by diverting the normal developmental pathways into unrestrained proliferation. Many other studies have highlighted the significance of epigenome disruption in a number of cancers.

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Iron Deficiency Anemia Linked to Hearing Loss

MedicalResearch.com Interview with:
Kathleen Schieffer, BS, PhD Candidate
Biomedical Sciences and Clinical and Translational Science
Clinical and Translational Science Fellow
Hershey, PA 17033

MedicalResearch.com: What is the background for this study?

Response: Hearing loss is common in the United States, with its prevalence increasing with each decade of life. Iron deficiency anemia is a common, reversible condition, associated with negative health outcomes. The inner ear is highly sensitive to ischemic damage and previous animal studies have shown that iron deficiency anemia alters the inner ear physiology. Understanding the association between iron deficiency anemia and hearing loss may open new possibilities for treatment.

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Vestibular or Inner Ear System Weakens After Age 40

MedicalResearch.com Interview with:

Daniel M. Merfeld, Ph.D. Professor of Otolaryngology Harvard Medical School Massachusetts Eye and Ear Director, Jenks Vestibular Physiology Laboratory Senior Scientist

Dr. Daniel M. Merfeld

Daniel M. Merfeld, Ph.D.
Professor of Otolaryngology
Harvard Medical School
Massachusetts Eye and Ear
Director, Jenks Vestibular Physiology Laboratory
Senior Scientist

MedicalResearch.com: What is the background for this study?

Response: Nearly half of the population will see a clinician at some point in their lives with symptoms related to the vestibular system (e.g., dizziness, vertigo, imbalance and blurred vision). The vestibular system, made up of tiny fluid-filled membranes in the inner ear, is responsible for receiving information about motion, balance and spatial orientation. With the goal of determining whether age affected the function of the vestibular system, our research team administered balance and motion tests to 105 healthy people ranging from 18 to 80 years old and measured their vestibular thresholds (“threshold” refers to the smallest possible motion administered that the subject is able to perceive correctly).

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Post-Op Radiotherapy Improved Survival In Oral Cavity and Oropharyngeal Squamous Cell Carcinoma

MedicalResearch.com Interview with:

Michelle M. Chen, MD/MHS Department of Otolaryngology- Head and Neck Surgery Stanford University

Dr. Michelle Chen

Michelle M. Chen, MD/MHS
Department of Otolaryngology- Head and Neck Surgery
Stanford University 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The benefit of post-operative radiotherapy (PORT) for patients with T1-T2 N1 oral cavity and oropharyngeal cancer without adverse pathologic features is unclear. Starting in 2014, the national guidelines no longer recommended consideration of post-operative radiotherapy for N1 oropharyngeal cancer patients, but left it as a consideration for N1 oral cavity cancer patients. We found that post-operative radiotherapy was associated with improved survival in both oral cavity and oropharyngeal cancers, particularly in patients younger than 70 years of age and those with T2 disease.

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Epidemic of HPV Associated Throat Cancer in Men

MedicalResearch.com Interview with:

Eric M Genden, MD, FACS Isidore Friesner Professor and Chairman Department of Otolaryngology-Head and Neck Surgery The Icahn School of Medicine at Mount Sinai

Dr. Eric Genden

Eric M Genden, MD, FACS
Isidore Friesner Professor and Chairman
Department of Otolaryngology-Head and Neck Surgery
The Icahn School of Medicine at Mount Sinai

MedicalResearch.com: What is the background for this report? How has the clinical picture of HPV infections of oral and throat cancers changed over the past two decades?

Response: There has been no change however there has been a epidemic of viral induced throat cancer in men. The HPV virus has been established a the causative agent in cervical cancer in women. It has now been identified as a major causative agent in tonsillar and base of tongue cancer.

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Cell Biomarkers To Distinguish Deadly From Less Aggressive HPV Oral Cancers

MedicalResearch.com Interview with:

Elizabeth Franzmann, M.D. Scientific Founder and Chief Scientific Officer Vigilant Biosciences

Dr. Elizabeth Franzmann

Elizabeth Franzmann, M.D.
Scientific Founder and Chief Scientific Officer
Vigilant Biosciences

MedicalResearch.com: What is the background for this study?

Response: Head and neck cancer involves cancers of the oral cavity, oropharynx and larynx. It is difficult to treat. Part of the challenge is that it is distinguishing the patients with tumors that are going to behave aggressively from those with less aggressive disease. As a result, many patients undergo treatment that may be more intensive and morbid than they need while others need more aggressive treatment. Tissue markers associated with prognosis may be able to help clinicians differentiate patients who need more aggressive treatment from those whose treatment can be less intensive. CD44 is a cell surface glycoprotein and tumor-initiating marker. CD44 and another surface protein, EGFR, are involved in tumor extension and are associated with poor prognosis. Certain forms of Human Papillomavirus (HPV) are known to cause oropharyngeal cancer and are associated with a good prognosis. P16 is a surrogate marker for the kind of HPV that causes cancer. Understanding the relationships between how these markers are expressed in cancer tissue may direct patient treatment in the future.

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Decision-Making in Laryngology: Both Sides of the Story

MedicalResearch.com Interview with:

Senior Faculty,Otolaryngology The Mount Sinai Hospital New York Eye and Ear Infirmary of Mount Sinai

Dr. Mark Courey

Dr. Mark Courey, MD
Senior Faculty,Otolaryngology
The Mount Sinai Hospital
New York Eye and Ear Infirmary of Mount Sinai

MedicalResearch.com: Would you tell us a little about yourself? How did you become interested in voice disorders?

Response: I became interested in voice disorders because during my residency in the late 1980’s there was little known about how to help patients with disorders of voice. The main instrument we use to evaluate vocal folds (the stroboscope) was just becoming clinically available. Only a handful of physicians had one available. We could not see vocal fold function and could only see the lesions on the vocal folds. We did not know how the lesions affected function. So many surgeons only treated patients with laryngeal cancer and told the others to be happy that they did not have cancer.

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ENT Surgeon Manages Middle Ear Cholesteatoma Removal In One Surgical Procedure

MedicalResearch.com Interview with:

Eric E Smouha, MD Professor, Otolaryngology The Mount Sinai Hospital New York Eye and Ear Infirmary of Mount Sinai

Dr. Eric E Smouha

Eric E Smouha, MD
Professor, Otolaryngology
The Mount Sinai Hospital
New York Eye and Ear Infirmary of Mount Sinai

MedicalResearch.com: Would you tell us a little about yourself? How did you become interested in ENT and specifically middle ear problems?

Response: I am a neurotologist, i.e. , ENT physician specialized in disorders of the ear and skull base. Neurotologists treat problems of the middle ear and inner ear. Middle ear problems are interesting because they are prevalent, and surgery frequently results in restoration of function.

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3D Models and Immersive Virtual Reality Simulation for Complex Skull Base Surgery

MedicalResearch.com Interview with:

Alfred Marc Calo Iloreta

Dr. Alfred Marc Calo Iloreta

Alfred Marc Calo Iloreta, MD
Assistant Professor
Skull Base Surgery and Rhinology
Department of Otolaryngology –
Head and Neck Surgery
Icahn School of Medicine at Mount Sinai
New York, New York

MedicalResearch.com: Would you tell us a little about yourself? How did you become interested in ENT and your subspecialty in particular?

Response: I am a ENT/Head and Neck Surgeon practicing in Manhattan at the Mount Sinai Hospital. I trained here in New York City for residency and also completed a fellowship in Rhinology and Skull Base Surgery.

I chose this field and sub-specialty because of the intricate and complex anatomy of the head and neck. In addition rhinology and skull base surgery utilizes multiple advanced technologies from high definition optics, to neuronavigation to allow us to work with this complex anatomy.

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An answer for eschar buildup: anti-stick solution for electrosurgery

MedicalResearch.com Interview with
electrolube-surgicalTim Reese, president of Eagle Surgical Products, LLC,
Sales and distribution company for Electro Lube®


MedicalResearch.com: What is the background of Electro Lube®?

Response: Developed in 2004, Electro Lube® is an anti-stick solution for electrosurgery designed to keep instruments clean. The product is a mixture of natural, non-synthetic, non-flammable, non-allergenic biocompatible phospholipids without any known side effects associated with patient use.
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