Radiation-induced oscilllopsia in nasopharyngeal carcinoma patients

Purpose: This study applied a battery of audiovestibular function testings and MRI scan to investigate the causes of oscillopsia in NPC patients after irradiation. Methods and Materials: Twelve (4%) out of 300 NPC patients developed oscillopsia after irradiation. The mean accumulated radiation dosage for the nasopharynx was 112 + 30 Gy. Each patient underwent a battery of audiovestibular function testings, including audiometry, dynamic illegible E test, caloric test, and rotational test. Results: Excluding 3 patients with neck fibrosis who failed to perform head turning movement, the remaining 9 patients displayed 100% abnormal dynamic illegible E test and 100% abnormal refixation saccades. All 12 patients presented bilateral hearing loss, caloric reductions, and reduced gains of vestibulo-ocular reflex (VOR) on rotational test, indicating bilateral VOR loss. After excluding tumor relapse or radiation necrosis of the brain via MRI scan, oscillopsia in these 12 irradiated NPC patients were attributed to bilateral VOR loss. Conclusion: Radiation-induced oscillopsia in NPC patients is attributed to bilateral VOR loss, possibly due to higher radiation dosage. Hence, therapeutic benefits of a second course of irradiation are associated with a potential risk for the development of oscillopsia after irradiation

Association of Neutrophil-to-Lymphocyte Ratio and Bloodstream Infections with Survival after Curative-Intent Treatment in Elderly Patients with Oral Cavity Squamous Cell Carcinoma

Patients with oral cavity squamous cell carcinoma (OSCC) undergoing curative-intent treatment may become immunocompromised. This study aimed to investigate the association of pretreatment sarcopenia, nutritional status, comorbidities, and blood-based inflammation prognostic biomarkers in bloodstream infection (BSI) with survival status in elderly patients with OSCC. Retrospective data were collected from 235 patients who were newly diagnosed with OSCC, were aged ≥ 65 years, had undergone curative-intent treatment, and were classified into either the BSI group or the no-BSI group within 6 months after surgery and/or adjuvant therapy initiation. Of the 235 elderly patients, 27 presented with BSI episodes. A preoperative high neutrophil-to-lymphocyte ratio (NLR) was a significant independent risk factor for BSI. BSI was not significantly associated with survival status. Ever betel nut chewing, hypoalbuminemia, and advanced tumor stage were associated with shorter overall survival. Moreover, a high NLR was an independent risk factor associated with disease-free survival. A high NLR was associated with BSI and resistance to curative-intent treatment. Pretreatment of NLR could act as an independent prognostic indicator and help inform treatment strategies for older patients with OSCC

Association of Neutrophil-to-Lymphocyte Ratio and Bloodstream Infections with Survival after Curative-Intent Treatment in Elderly Patients with Oral Cavity Squamous Cell Carcinoma

Patients with oral cavity squamous cell carcinoma (OSCC) undergoing curative-intent treatment may become immunocompromised. This study aimed to investigate the association of pretreatment sarcopenia, nutritional status, comorbidities, and blood-based inflammation prognostic biomarkers in bloodstream infection (BSI) with survival status in elderly patients with OSCC. Retrospective data were collected from 235 patients who were newly diagnosed with OSCC, were aged ≥ 65 years, had undergone curative-intent treatment, and were classified into either the BSI group or the no-BSI group within 6 months after surgery and/or adjuvant therapy initiation. Of the 235 elderly patients, 27 presented with BSI episodes. A preoperative high neutrophil-to-lymphocyte ratio (NLR) was a significant independent risk factor for BSI. BSI was not significantly associated with survival status. Ever betel nut chewing, hypoalbuminemia, and advanced tumor stage were associated with shorter overall survival. Moreover, a high NLR was an independent risk factor associated with disease-free survival. A high NLR was associated with BSI and resistance to curative-intent treatment. Pretreatment of NLR could act as an independent prognostic indicator and help inform treatment strategies for older patients with OSCC

DEEP NECK INFECTION: ANALYSIS OF 185 CASES

Abstract: Purpose. This study reviews our experience with deep neck infections and tries to identify the predisposing factors of life-threatening complications. Methods. A retrospective review was conducted of patients who were diagnosed as having deep neck infections in the Department of Otolaryngology at National Taiwan University Hos-pital from 1997 to 2002. Their demographics, etiology, associated systemic diseases, bacteriology, radiology, treatment, duration of hospitalization, complications, and outcomes were reviewed. The attributing factors to deep neck infections, such as the age and systemic diseases of patients, were also analyzed. Results. One hundred eighty-five charts were recorded; 109 (58.9%) weremen, and 76 (41.1%) were women, with amean age of 49.5 F 20.5 years. Ninety-seven (52.4%) of the patients were older than 50 years old. There were 63 patients (34.1%) who ha