Squamous cell carcinoma of tongue and buccal mucosa: clinico-pathologically different entities.

The objective of this study was to examine the clinical and pathological features of squamous cell carcinoma of the Tongue and Buccal Mucosa and understand their differences. This is a retrospective analysis of prospectively collected data of 735 patients with squamous cell carcinoma of the tongue and 665 cases of carcinoma of the buccal mucosa treated by surgery at our hospital. Statistical analysis was done to examine clinical and pathological differences between carcinoma of the tongue and the buccal mucosa with regards to age, gender, clinical T stage/N stage, pathological T stage/N stage, overall stage, grade, thickness, perinodal extension (PNE), lymphovascular emboli (LVE) and perineural invasion (PNI). Statistically significant differences were found for factors like age (p < 0.001), gender (p < 0.001), clinical T staging (p < 0.001) and pathological stage (p < 0.001), grade of tumor (p < 0.001) and perineural invasion (p < 0.001) between carcinoma of the tongue and the buccal mucosa. Forty-eight percent patients in either subsite had pathologically proven node negative necks (pN0, p = 0.88). Multivariate analysis for occult nodal metastases revealed that predictive factors were different for the two subsites. There are significant differences between cancers of the tongue and buccal mucosa for various clinical and pathological factors. This may be a reflection of the underlying differences in their causation and pathophysiology. Squamous cell carcinoma in these two subsites should therefore be regarded as clinico-pathologically distinct entities.

A clinical survey of laryngectomy patients to detect presence of the false perception of an intact larynx or the "phantom larynx" phenomenon.

HYPOTHESIS: The Phantom larynx phenomenon (the false perception on an intact larynx in a laryngectomee) exists and is an important issue in the post-laryngectomy rehabilitation of such patients. OBJECTIVES: The phantom limb phenomenon has been described after amputation of a limb or other parts of the body. Amputation or removal of any part is usually associated with a global feeling that the missing part is still present. We undertook this study to identify whether a phantom larynx phenomenon actually exists in laryngectomees. We also aimed to elicit its association with the duration following surgery. PATIENTS AND METHODS: We did a clinical survey of 66 post-laryngectomy patients (30-80 years of age). Twenty-two of these patients were assessed within 6 months following surgery, whereas 44 patients were assessed at least 6 months later. A questionnaire containing 11 questions was served to these laryngectomees pertaining to false perception of persistent laryngeal functions and adaptation to the post-laryngectomy status. RESULTS: All patients showed an evidence of a phantom larynx phenomenon. In the majority of these patients, it persisted even after 6 months following surgery. There was no significant difference in the two groups (less than or more than 6 months) except for one question pertaining to occlusion of stoma for speech (77% vs. 29%). False perception of nasal breathing (59% and 43%) and olfactory sensation (63% in both groups) were the most common. CONCLUSION: Phantom larynx phenomenon following laryngectomy exists and may cause anxiety and poor rehabilitation among patients. Education and rehabilitation with regards to such a phenomenon is therefore needed in all patients.

Current status and future prospects in prosthetic voice rehabilitation following laryngectomy.

Total laryngectomy or laryngopharyngectomy remains the procedure of choice for advanced-stage (UICC T3 and T4) laryngeal carcinoma around the world despite advances in conservative laryngeal surgery and radiotherapy. However, it has profound effects on respiration and deglutition, in addition to the most disabling effect-the loss of verbal communication. Successful voice restoration can be attained with any of three speech options, namely esophageal speech, electrolarynx, and tracheoesophageal (TO) speech using an artificial valve. Although, no single method is considered the best for every patient, the tracheoesophageal puncture has become the preferred method in the past decade. Several types of voice prostheses have been produced since the first prosthesis was introduced in 1980 by Blom and Singer. However, eventually all prostheses are confronted by the same problem, i.e., the development of a biofilm, leading to deterioration and ultimately to dysfunction of the prostheses, necessitating replacement. This article attempts to sum up the historical background as well as the current state of surgical voice rehabilitation following laryngectomy; we review the recent major advances as well as the future prospects. Data was collected by conducting a computer-aided search of the MEDLINE and PubMed databases, supplemented by hand searches of key journals. Over 50 articles published in the last three decades on the topic have been reviewed, out of which about 20 were found to be of relevance for this article.

A rare myoepithelioma of the sinonasal cavity: case report.

Myoepithelioma is a rare benign neoplasm. Pure accounting for less than 1% of all salivary gland tumors. Only three cases of sinonasal myoepithelioma have been reported in the literature. Diagnosis of myoepithelioma through light microscopy is possible and immunohistochemistry is done to facilitate the diagnosis. The lesion is so rare that there are no specific indications/guidelines for its treatment. We report to you a rare case of sinonasal myoepithelioma in a 57 year old Asian female.Myoepitheliomas are rare tumours that account for only about 1% of all salivary gland tumors. Most are benign, but some can be malignant. Only three cases of sinonasal myoepithelioma have been reported in the literature so far.