A Pilot Study of the Waterless Empirical Taste Test.

OBJECTIVES: This study was performed to test the clinical applicability of a new taste test-the waterless empirical taste test (WETT). METHODS: Sixty healthy volunteers and 20 patients with oral cancer were enrolled. They all received the conventional solution-based whole-mouth suprathreshold taste test (WMTT), which contained sucrose, citric acid, sodium chloride, and caffeine solutions for tastants, along with the WETT. The WETT used plastic strips to deliver tastants. The strip was embedded with sucrose, citric acid, sodium chloride, caffeine, or monosodium glutamate taste enhancer in 4 different concentrations. Each strip was tested twice. Thirty of the healthy volunteers received the WETT again to measure a retest reliability. Case-control matching by age and gender was used to compare the scores of WMTT and WETT between 13 healthy volunteers and 13 patients with oral cancer. RESULTS: The correlation was not high between the WMTT and WETT (r < 0.7) whether in the healthy volunteers or in patients with oral cancer. In terms of retest reliability of the WETT, the mean total score was 24.9 ± 7.3 for the first test and 25.8 ± 8.4 for the second test. The intraclass correlation coefficient was 0.85 (P < .001). When case-control matching was performed, the WMTT scores were not significantly different between 13 healthy volunteers and 13 patients with oral cancer (P = .266), but the WETT scores were significantly lower in patients with oral cancer (P = .017). CONCLUSION: This study showed that the results of the WETT were not highly correlated with those of the WMTT. However, its retest reliability was high, and its results were significantly different between the healthy volunteers and the patients with oral cancer.

Complex Microbiome in Brain Abscess Revealed by Whole-Genome Culture-Independent and Culture-Based Sequencing.

Brain abscess is a severe infectious disease with high mortality and mobility. Although culture-based techniques have been widely used for the investigation of microbial composition of brain abscess, these approaches are inherent biased. Recent studies using 16S ribosomal sequencing approaches revealed high complexity of the bacterial community involved in brain abscess but fail to detect fungal and viral composition. In the study, both culture-independent nanopore metagenomic sequencing and culture-based whole-genome sequencing using both the Illumina and the Nanopore platforms were conducted to investigate the microbial composition and genomic characterization in brain abscess. Culture-independent metagenomic sequencing revealed not only a larger taxonomic diversity of bacteria but also the presence of fungi and virus communities. The culture-based whole-genome sequencing identified a novel species in Prevotella and reconstructs a Streptococcus constellatus with a high GC-skew genome. Antibiotic-resistance genes CfxA and ErmF associated with resistance to penicillin and clindamycin were also identified in culture-based and culture-free sequencing. This study implies current understanding of brain abscess need to consider the broader diversity of microorganisms.

Saliva Pepsin Detection and Proton Pump Inhibitor Response in Suspected Laryngopharyngeal Reflux.

OBJECTIVES/HYPOTHESIS: To evaluate the prediction value of saliva pepsin detection for an 8-week proton pump inhibitor (PPI) response in patients with a Reflux Symptoms Index (RSI) score ≥13, which indicates possible laryngopharyngeal reflux. STUDY DESIGN: Prospective individual single-cohort study. METHODS: Patients were recruited who had experienced chronic laryngopharyngeal symptoms (RSI score ≥13) for more than 3 months after excluding other etiologies. The patients received PPI (40 mg of esomeprazole once daily) treatment for 8 weeks. Prior to treatment, the patients submitted saliva/sputum samples that were collected during the time symptoms were observed. The samples were taken for pepsin detection, and performed using the commercially available Peptest lateral flow device. The association of the Peptest results and PPI response were statistically analyzed with the χ2 test. RESULTS: Seventy-four patients completed the study, and upon completion of PPI treatment, the mean RSI score was significantly reduced from 19.22 ± 5.18 to 8.99 ± 5.69. Forty-four (59.5%) patients exhibited a good response as defined by an RSI score reduction ≥50%. The results of the Peptest were semiquantitatively graded as 0, 1, 2, 3 (negative, weak positive, moderate positive and strong positive, respectively) based upon the visual intensity of the test sample line as compared to the control line. Twenty-four patients (32.4%) exhibited grade 3 strong positive results. The Peptest strong positive results (P < .05) were significantly associated with a good PPI response, with the positive predictive value being 79.2%. CONCLUSIONS: Analysis of strong positive results for pepsin detection in saliva/sputum samples may be a useful, noninvasive method for predicting better PPI response in patients with suspected reflux induced chronic laryngopharyngeal symptoms. LEVEL OF EVIDENCE: 2 Laryngoscope, 129:709-714, 2019.

Treatment outcomes of unknown primary squamous cell carcinoma of the head and neck.

BACKGROUND: Treatment modality of unknown primary squamous cell carcinoma of the head and neck (SCCHN) remains controversial. OBJECTIVES: To evaluate the treatment outcomes and prognostic factors of unknown primary SCCHN. MATERIALS AND METHODS: Patients with unknown primary SCCHN from April 1995 to March 2013 were recruited retrospectively. RESULTS: Sixty-nine patients were enrolled. The median time of follow-up was 55.5 months. The 2-year loco-regional control rate of all the patients was 60.4%. Multivariate Cox regression analysis revealed that N3 stage, extracapsular spread, distant metastasis, and treatment modality were significantly associated with neck recurrence. The actuarial 5-year disease-specific survival rates of neck dissection, neck dissection plus adjuvant therapy, radiotherapy alone, and combined therapy were 80.0%, 61.7%, 33.3%, and 68.8%, respectively (p = 0.046). The 5-year disease-specific survival rates of N1/N2a, N2b/N2c, and N3 stage were 83.9%, 64.3%, and 36.7%, respectively (p = 0.013). Univariate regression analysis revealed that neck recurrence, supraclavicular node involvement, distant metastasis, N3 stage, and unhealthy lifestyle habits were correlated with disease-specific mortality, especially the first three parameters. Patient's occupation and comorbidity were not significantly correlated with survival. CONCLUSIONS: Composite therapy is mandatory for advanced unknown primary SCCHN. Supraclavicular node involvement and unhealthy lifestyle habits, such as betel nut chewing, indicate a poor prognosis.

Transoral robotic surgery for early T classification hypopharyngeal cancer.

BACKGROUND: For hypopharyngeal cancer, transoral robotic surgery (TORS) has been reported as a new organ preserving treatment but outcomes are rarely reported. METHODS: From 2010 to 2013, 10 patients with early T classification pyriform sinus cancer were selected to receive TORS and conventional neck dissection. The clinical parameters, including rates of adjuvant radiotherapy, survivals, as well as organ and function preservation, were retrospectively analyzed. RESULTS: TORS was successful in all 10 patients, and 5 patients received adjuvant radiotherapy. After mean follow-up of 26 months, 1 patient died of distant metastasis and 1 patient died of other malignancy. There was no local recurrence and larynxes were all preserved. Eight surviving patients who were followed up continuously could receive oral intake and had a serviceable voice without tracheostomy or feeding tubes. CONCLUSION: TORS is a feasible transoral approach for selected patients with early T classification hypopharyngeal cancer. The reported oncologic/functional outcomes are satisfactory. © 2015 Wiley Periodicals, Inc. Head Neck 38: 857-862, 2016.

Osteoradionecrosis of mandible bone in patients with oral cancer--associated factors and treatment outcomes.

BACKGROUND: The purpose of this study was to investigate factors associated with osteoradionecrosis (ORN) of the mandible bone in a large cohort of patients with oral cancer. METHODS: We reviewed the medical records of patients with oral cancer and identified those with ORN of the mandible bone. Variables of patients with and without ORN were compared and associated factors were investigated by logistic regression model. RESULTS: A total of 1692 patients were included in the final analysis and 105 patients (6.2%) developed ORN in the mandible bone. Primary site, including mouth floor, buccal mucosa, retromolar trigone, or gum, segmental mandibulectomy, and total radiation dose to the primary site ≥75 Gy were independent factors associated with ORN. After aggressive treatment using surgical intervention with/without hyperbaric oxygen, 93.3% of the patients healed completely. CONCLUSION: Among patients with oral cancer after radiation, ORN is an uncommon and dreaded complication. Recognition of associated factors can help physicians to identify those at risk.

Fetal Rhabdomyoma of the Right Tonsil with Polyp-Like Appearance.

Skeletal muscle neoplasms, in contrast to other groups of tumors, are almost malignant. The benign variant, rhabdomyoma, is distinctly rare. Rhabdomyomas can be classified generally into two types: cardiac and extracardiac. Extracardiac rhabdomyoma can be further divided into three subtypes: adult, fetal, and genital type. Adult rhabdomyoma is the most common subtype of rhabdomyoma even though it remains relatively rare. Fetal rhabdomyomas are less common than the adult type. In this paper we report a rare case of a fetal rhabdomyoma with polyp-like appearance originating from right tonsil. Punch biopsy and then right tonsillectomy were performed for complete excision. There was no obvious recurrence.

Laryngeal electromyography-guided hyaluronic acid vocal fold injection for unilateral vocal fold paralysis: a prospective long-term follow-up outcome report.

IMPORTANCE: Unilateral vocal fold paralysis (UVFP) is a common voice disorder that may cause glottal closure insufficiency with hoarseness of voice. Laryngeal electromyography (LEMG)-guided hyaluronic acid vocal fold (VF) injection has been proposed as a treatment option to improve glottal closure with a satisfactory short-term effect. To our knowledge, this study reports the first long-term follow-up result of this treatment modality. OBJECTIVE: To present the long-term treatment results of LEMG-guided hyaluronic acid VF injection for UVFP. DESIGN, SETTING, AND PARTICIPANTS: Prospective study of the treatment results of 74 patients who received LEMG-guided hyaluronic acid VF injection for UVFP at a tertiary referral medical center from March 2010 to February 2013. INTERVENTIONS: In the office-based procedure, 1.0 mL of hyaluronic acid was injected via a 26-gauge monopolar injectable needle electrode into paralyzed thyroarytenoid muscles by LEMG guidance. MAIN OUTCOMES AND MEASURES: Various glottal closure evaluations such as normalized glottal gap area, maximal phonation time, phonation quotient, mean airflow rate, perceptual GRBAS (grade, roughness, breathiness, asthenia, strain) scale, and Voice Handicap Index were compared before and after injection using the nonparametric Wilcoxon signed rank test within 1 month, at 6 months, and at the last follow-up examination. RESULTS: Sixty patients had been followed up for at least 6 months. Forty-four patients received only 1 injection, and 16 patients received repeated injections (2 injections for 13 patients and 3 for 3 patients). All the glottal closure parameters improved significantly (P < .001) within 1 month, at 6 months, and at the last follow-up examination, with a mean (SD) of 17.4 (8.9) months. At the last follow-up examination, the mean (SD) normalized glottal gap area was significantly reduced from 7.9 (5.7) to 0.6 (1.6). Mean (SD) maximal phonation time was significantly prolonged from 4.6 (3.8) seconds to 12.1 (7.4) seconds. Mean (SD) phonation quotient was significantly reduced from 647 (508) mL/s to 277 (212) mL/s. Mean (SD) airflow rate was significantly reduced from 445 (338) mL/s to 175 (145) mL/s. When all the GRBAS scale parameters improved, the mean (SD) Voice Handicap Index score was significantly reduced from 76 (22) to 38 (30) (all P < .001). CONCLUSIONS AND RELEVANCE: Of the 74 patients in this study, 44 (60%) who received a single injection and 16 (22%) who received repeated injections did not require another treatment after long-term follow-up. Laryngeal electromyography-guided hyaluronic acid VF injection is an option for treating UVFP with satisfactory results.

Laryngeal electromyography and prognosis of unilateral vocal fold paralysis--a long-term prospective study.

OBJECTIVES/HYPOTHESIS: To confirm the value of using laryngeal electromyography (LEMG) to predict the long-term prognosis of unilateral vocal fold paralysis (UVFP), and elucidate the adequate timing of LEMG. STUDY DESIGN: Prospective cohort prognosis study. METHODS: The LEMG data of 84 patients with UVFP were prospectively collected, and 81 patients received follow-up at least 6 months after symptom onset. If the paralyzed vocal fold had <20% recruitment reduction during phonation compared to the normal vocal fold signals, and absence of fibrillation when the patient was silent, the prognosis was considered to be good (negative finding). Otherwise, the prognosis was considered to be poor (positive finding). The association between UVFP outcome and LEMG prognostic rules and the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of LEMG were calculated. RESULTS: The mean duration of LEMG after symptom onset was 3.7 months, and follow-up after symptoms onset was 18.4 months. Sixty-six of 71 patients with a positive finding had persistent UVFP; four of 10 patients with a negative finding recovered vocal fold motion. LEMG results were significantly associated with the outcome of UVFP (P = .007). The overall accuracy, sensitivity, specificity, PPV, and NPV of LEMG were 86.4%, 91.7%, 44.4%, 93.0%, and 40.0%, respectively. When LEMG was done more than 2 months after symptom onset, the PPV was 97.9%. CONCLUSIONS: LEMG has a high PPV in predicting the long-term outcome of UVFP patients with poor prognosis. Permanent laryngeal framework surgery is feasible if patients have positive findings at least 2 months after symptom onset.

Risk factors of recipient site infection in head and neck cancer patients undergoing pectoralis major myocutaneous flap reconstruction.

The aim of this study was to investigate the factors associated with infection at the recipient site of pectoralis major myocutaneous flap (PMMF) of head and neck cancer patients. We retrospectively reviewed head and neck cancer patients who underwent PMMF reconstruction and identified those with recipient site infection. Variables of patients with and without infection were compared and associated factors were investigated by logistic regression model. A total of 478 patients were included in the final analysis and 183 patients (38.3%) developed recipient site infection. Lower margin of skin island, concurrent tracheotomy, diabetes mellitus, mandibular plate reconstruction, prior radiation, and peri-operative blood transfusion were independent factors associated with recipient site infection of PMMF. Skin island of PMMF beyond the eighth intercostal space markedly increased the risk of recipient site infection after major head and neck cancer surgery. Recognition of relevant factors associated with infection may help surgeons to identify those at risk.

Carotid blowout in patients with head and neck cancer: associated factors and treatment outcomes.

BACKGROUND: The purpose of this study was to investigate factors associated with carotid blowout in the cervical portion of patients with head and neck cancer in a large cohort. METHODS: We reviewed patients with head and neck cancer and identified those with carotid blowout. Variables of patients with and without carotid blowout were compared and associated factors were investigated by logistic regression model. RESULTS: A total of 2590 patients were included in the final analysis and 102 patients (3.9%) developed carotid blowout in the cervical region. Body mass index (BMI) <22.5 kg/M(2) , primary site in the hypopharynx or oropharynx, open wound in the neck requiring wet dressing, radical neck dissection, and total radiation dose to the neck ≥70 Gy were independent factors associated with carotid blowout. CONCLUSION: After completion of treatment in patients with head and neck cancer, carotid blowout was an uncommon complication with catastrophic results. Recognition of associated factors helps physicians to identify those at risk.

Influence of superior laryngeal nerve injury on glottal configuration/function of thyroidectomy-induced unilateral vocal fold paralysis.

OBJECTIVE: Recurrent laryngeal nerve (RLN) injury may induce unilateral vocal fold paralysis (UVFP). During thyroidectomy, the most common cause of UVFP, the superior laryngeal nerve (SLN), is also at risk of injury. In the literature, the influence of SLN injury on glottal configuration and function in patients with UVFP remains controversial. The present study investigates SLN injury influence on glottal configuration and function in patients with UVFP after thyroidectomy. STUDY DESIGN: Prospective controlled study. SETTING: Tertiary medical center. SUBJECTS AND METHODS: The SLN and RLN function of 34 patients with UVFP after thyroidectomy was determined by laryngeal electromyography. The subjects were dichotomized into the isolated RLN injury group (n = 26) or the concurrent SLN/RLN injury group (n = 8). We evaluated glottal angle and paralyzed vocal fold shape during inspiration, normalized glottal gap area, and glottal shape during phonation. The glottal function measurements included voice acoustic and aerodynamic analyses and the Voice Handicap Index. The aforementioned parameters of the RLN and concurrent SLN/RLN injury groups were compared. RESULTS: There were no statistical differences in glottal configuration such as glottal angle, paralyzed vocal fold shape, normalized glottal gap area, and glottal shape between the RLN and concurrent SLN/RLN injury groups. There were also no significant differences in other glottal function analyses including fundamental frequency, mean airflow rate, phonation quotient, maximal phonation time, and Voice Handicap Index. CONCLUSION: In the present study, we did not find any evidence that SLN injury could significantly influence the glottal configuration and function in patients with UVFP.

Survival analysis of patients with oral squamous cell carcinoma with simultaneous second primary tumors.

BACKGROUND: The purpose of this study was to investigate the rate of simultaneous second primary tumor (SPT) in patients with oral squamous cell carcinoma. The survival of patients with simultaneous SPT was also compared with patients without. METHODS: The presence of SPT was documented along with the patients' demographic data, tumor-related features, and survival status. Kaplan-Meier method was used for survival analysis. Relevant factors influencing the survival were examined by the Cox proportional hazard model. RESULTS: A total of 897 patients' medical records were obtained. Among them, 43 patients (4.8%) had simultaneous SPT and their prognosis was poorer than that of patients without. The Cox proportional hazard model revealed that patients with simultaneous SPT tended to have a higher probability of death (relative risk [RR], 1.694; p = .015). CONCLUSIONS: Simultaneous SPT is an independent prognostic factor for patients with oral squamous cell carcinoma. Those with simultaneous SPT have poorer survival when compared to those without.

Voice low tone to high tone ratio, nasalance, and nasality ratings in connected speech of native Mandarin speakers: a pilot study.

OBJECTIVE: Voice low tone to high tone ratio (VLHR) is defined as the power ratio of a voice spectrum with a specific cut-off frequency. Previous studies have shown that there are significant correlations between VLHR and nasalance and hypernasality ratings in vowels. The correlation was investigated in this study using connected speech material. DESIGN: The Zoo Passage, the Rainbow Passage, the English Nasal Sentences, the Mandarin Nonnasal Sentences, and the Mandarin Nasal Sentences were used to acquire VLHRs, nasalance scores, and perceptual judgments of nasality. Each passage was recorded twice for averaging, and the cut-off frequencies from 200 Hz to 1200 Hz were used to survey for the presence of optimal correlations with VLHR. Participants : Ten native Mandarin speakers with an English learning history of over 8 years were enrolled. Main outcome measures : VLHRs, nasalance scores, and hypernasality ratings. RESULTS: The correlations of VLHR with nasalance (rho  =  .76, p < .001, Spearman rank correlation) and nasality ratings (rho  =  .81, p < .001) were significant using a cut-off frequency of 300 Hz for the English passages. For the Mandarin Sentences, the optimal correlations of VLHR with nasalance (rho  =  .83, p < .001) and nasality ratings (rho  =  .79, p < .001) were identified using a cut-off frequency of 500-Hz. CONCLUSION: The significant correlations of VLHR with nasalance and perceptual ratings of nasality using connected speech show that these approaches have a potential value in terms of basic and clinical application.

Laryngeal electromyography-guided hyaluronic acid vocal fold injection for unilateral vocal fold paralysis--preliminary results.

OBJECTIVES: The purpose of this study is to investigate the feasibility of using an injectable needle electrode to guide hyaluronic acid (HA) vocal fold injection (VFI) during laryngeal electromyography (LEMG) for unilateral vocal fold paralysis (UVFP). STUDY DESIGN: Prospective study. METHODS: From March to June 2010, 20 UVFP patients received LEMG examination at our clinic. Before completion of LEMG, 1.0 cc of HA (Restylane Perlane(®); Q-Med, Uppsala, Sweden) was injected via a 26-gauge monopolar injectable needle electrode into paralyzed thyroarytenoid muscle. After injection, 20 patients completed 3-months follow-up and 16 patients completed 6-months follow-up. The data before, 1 week, 3 months, and 6 months after injection, including the normalized glottal gap area (NGGA) from videostroboscopy, maximal phonation time (MPT), mean airflow rate (MAFR), phonation quotient (PQ), perceptual evaluation of voice (grade, roughness, breathiness, asthenia, strain [GRBAS] scale), Voice Handicap Index (VHI), and self-grading of choking (grade 1-7), were analyzed by the Wilcoxon signed rank test. RESULTS: All of the patients completed the procedure without complications. After injection, mean NGGA was significantly reduced from 8.28 units to 0.52 units (1 week), 1.79 units (3 months), and 1.36 units (6 months). The mean MPT was prolonged from 5.66 seconds to 11.73, 11.25, and 11.93 seconds, respectively. VHI was reduced from 76.05 to 38.10, 37.40 and 35.00, respectively. Other analyzed data (PQ, MAFR, GRBAS scale, and choking severity) also showed statistically significant improvement. CONCLUSION: LEMG-guided HA VFI provides UVFP patients with neuromuscular function evaluation and treatment in one step. This clinical technique is feasible, and the short-term results are satisfactory.

The association between surgical site infection and previous operation in oral cavity cancer patients.

We investigated the post-operative surgical site infection (SSI) rate in oral cavity cancer patients who had previous operation in the oral cavity region and compared it with that of patients without previous operation. We retrospectively reviewed over 1,000 chart records of oral cavity cancer patients from January 2004 to November 2010 and relevant data were collected. Statistical methods included descriptive statistics, bivariate analyses, and a multiple logistic regression model for investigating the relevant factors of post-operative SSI. A total of 894 patients were enrolled in the final analyses. The overall post-operative SSI rate was 20.8%. Previous history of operation was identified in 173 patients (19.4%). There was no significant difference in post-operative SSI rate between the patients with previous operation and those without (22.5 vs. 20.4%, P = 0.601). Previous operation in the oral cavity region was not associated with increased post-operative SSI rate in oral cavity cancer patients.

The basis of preoperative vocal fold paralysis in a series of patients undergoing thyroid surgery: the preponderance of benign thyroid disease.

BACKGROUND: Preoperative vocal fold paralysis (VFP) is thought to be rare in patients with benign thyroid disease (BTD). In contrast with cases of malignancy, in which the recurrent laryngeal nerve (RLN) should be severed, in patients with BTD and VFP the RLN can be preserved without threatening patients' lives. This study investigates the clinical features that enable identification of patients who have VFP associated with BTD. METHODS: Medical records of 187 consecutive patients who underwent thyroid surgery were retrospectively reviewed. The association between preoperative VFP and pathology (benign or malignant), clinical features, and treatment results of patients with BTD and VFP were analyzed. RESULTS: Of the 187 patients, 145 patients had BTD and 8 of these cases (5.52%) had preoperative unilateral VFP. The prevalence of BTD with VFP was 4.3% (8/187). The other 42 patients had malignant thyroid disease and 4 of these cases (9.52%) had preoperative unilateral VFP. None of the aforementioned VFP was caused by previous thyroidectomy or surgery to the neck. Although the relative risk of VFP in patients with thyroid malignancy was 1.726 (9.52%/5.52%), there was no significant association between VFP and malignancy. Of the eight patients with BTD, benign fine-needle aspiration cytology or frozen sections, goiter with a diameter larger than 5 cm, cystic changes, and significant radiologic tracheo-esophageal groove compression were the common findings. During thyroidectomy, the RLN was injured but repaired in three patients. Two events occurred in patients who had severe RLN adhesion to the tumor caused by thyroidectomy performed decades ago. Two of the five patients without nerve injury recovered vocal fold function. The overall VFP recovery rate for patients with BTD and VFP was 25% (2/8). CONCLUSIONS: Preoperative unilateral VFP is not uncommon in thyroid surgery. Obtaining information on laryngeal function is of extreme importance when planning surgery, especially contralateral surgery. Goiter with preoperative VFP is not necessarily an indicator of malignancy. Benign perioperative cytopathologic findings with typical radiographic compression strongly suggest that VFP is caused by BTD. If, during thyroidectomy, the RLN is carefully preserved, recovery of vocal fold function may still be possible.

Surgical site infection after preoperative neoadjuvant chemotherapy in patients with locally advanced oral squamous cell carcinoma.

BACKGROUND: We investigated whether preoperative neoadjuvant chemotherapy is associated with increased surgical site infection (SSI) rate in patients with locally advanced oral cancer. METHODS: In this hospital-based study, we retrospectively reviewed over 2000 chart records of patients with oral cavity cancer from March 1994 to December 2007. Those who received neoadjuvant chemotherapy were identified and matched for age, sex, tumor classification, primary site, and reconstruction methods to hospitalized patients who did not receive chemotherapy. Data were analyzed for the relationship between chemotherapy and SSI. RESULTS: A total of 306 patients were enrolled for final analyses. The overall postoperative SSI rate was 31.0%. The SSI rate in patients after neoadjuvant chemotherapy was similar to that in patients who did not receive the chemotherapy (33.3% vs 29.9%, p = .631). CONCLUSIONS: Preoperative neoadjuvant chemotherapy was not associated with increased SSI rate in patients with locally advanced oral cancer.

Comparison between free flap and pectoralis major pedicled flap for reconstruction in oral cavity cancer patients--a quality of life analysis.

We aimed to compare the differences between free flap and pectoralis major myocutaneous flap (PMMF) for reconstruction in oral cavity cancer patients. Patients who received free flap or PMMF reconstruction after ablation surgeries were eligible for the current study. The patients' demographic data, medical history, and quality of life scores were collected and analyzed. A total of 491 patients' records were obtained. Among them, 100 patients completed a quality of life questionnaire. No significant differences could be found in age, morbidity, stage, and hospitalization between the free flap and PMMF groups. However, there were significant differences between both groups in gender, primary site, peri-operative blood loss, and operation duration. Patients reconstructed with free flap had better speech and shoulder functions as well as better mood status. Data from this study provide useful information for physicians and patients during their discussion of treatment modalities for oral cancers.