Assessment of risk factors in laryngeal cancer in India: a case-control study.

Cancer of the larynx is fourteenth most common cancer in the world. Limited data are available from India on associations with risk factors and hence the present hospital based matched case-control study was conducted. Three hundred and five laryngeal cancer patients and an equal number of healthy controls matched for their age within 2 years, sex and place of residence constituted the study population. A pre-tested, semi-structured questionnaire was administered to each individual to elicit information on their socio-demographic profile, food habits and risk factors and dietary consumption patterns. Univariate logistic regression analysis and multivariate forward stepwise conditional logistic analysis were performed. In the univariate analysis a lower consumption of roots and tubers green leaf vegetable other vegetables and fruits, and higher consumption of milk, eggs, meat, tea, alcohol , smoking, consumption of betel leaf with tobacco as well as a preference for spicy and fried foods emerged as significant positive variables. After adjusting for education, years of use of alcohol, smoking, chewing of betel leaf with tobacco in the model, low green leafy vegetables and preference for spicy foods were found to be positively related to the risk of laryngeal cancer. There was a significant difference in the dietary consumption patterns of laryngeal cancer patients and controls, indicating a role for nutritional factors in the etiology of laryngeal cancer in the Indian population.

Partial maxillectomy for malignant neoplasms of para nasal sinuses and hard palate.

BACKGROUND: The universal application of sectional imaging to the evaluation of para nasal sinus neoplasms has indicated that many of the regions encompassed in a total maxillectomy are often uninvolved and are perhaps unnecessarily resected. METHODS: A set of guidelines was formulated regarding the indications and techniques of partial maxillectomies. These guidelines were then tested on a prospective cohort of 20 cases. The adequacy was judged by histological evaluation of all resection margins. Morbidity was assessed in terms of functional parameters (trismus, swallowing disturbances, speech disturbances) and cosmetic parameters (cheek retraction). RESULTS: As per the pre-formulated guidelines a partial maxillectomy (PM) was suitable in ten and was undertaken. The same was unsuitable in the other ten and these therefore had a total maxillectomy (TM). Four of ten cases in each group had an involved resection margin. All such cases had additional treatment for the microscopic residual disease. In the four cases in the PM group with involved resection margins in none was this at the area with the limited resection. The status of the resection margins in these cases would not have been different even if they had had a total maxillectomy. Morbidity in the PM group was significantly less than in the TM group. CONCLUSION: By careful case- selection based on imaging, partial maxillectomy can provide for equivalent oncologic clearance as with a Total Maxillectomy, and significantly reduced morbidity.