Case Report - Lingual schwannoma

Schwannomas or neurilemmomas are benign, slow growing, usually solitary and encapsulated tumor, originating from Schwann cells of the nerve sheath. Intraoral schwannoma accounts for 1% of head and neck region and are commonly seen at the base region of tongue. Most of the few such reports in the literature, have described schwannomas that occurred in the tongue. In this article, we report a rare case of lingual schwannoma involving the anterior of tongue, in a young individual, in whom the lesion was completely excised via an intra oral approach

COMPARISON OF LATERALIZATION THYROPLASTY AND LASER CORD WEDGE RESECTION IN TERMS OF VOICE QUALITY IN PATIENTS WITH BILATERAL ABDUCTOR VOCAL CORD PARALYSIS

AbstractBackground/Aims: It was aimed to compare lateralization thyroplasty with laser cord wedge resection in terms of postoperative voice analysis, duration of hospital stay, tracheotomy rate, and decannulation time in patients with bilateral abductor vocal cord paralysis. Methods: A total of 37 patients who presented to our department with bilateral abductor vocal cord paralysis between February 2005 and February 2009 were enrolled in this prospective study. External arytenoid lateralization (lateralization thyroplasty) was randomly performed in 22 patients and laser posterior cordotomy was performed in 15 patients. Fifteen healthy volunteers were assigned to the control group. Postoperative 6th month maximum phonation time (MPT), S/Z ratio, and the results of objective voice analysis [mean frequency perturbation (jitter), mean amplitude perturbation (shimmer), mean fundamental frequency (fo), and NHR (noise to harmonic ratio)] were compared between the two groups and the control group. Decannulation time, patient tracheotomy status, and duration of hospital stay were also recorded.Results: The mean postoperative MPT decreased but S/Z ratio increased in both patient groups compared to the control group. The mean MPT was shorter in the external arytenoid lateralization group versus the laser posterior cordotomy group (p= 0.011). There was no statistically significant difference between the external arytenoid lateralization and laser posterior cordotomy groups in terms of mean S/Z ratio (p= 0.306). It was observed that jitter, shimmer, and NHR values were increased, i.e. voice quality impaired, in both patient groups. Jitter (p= 0.004), shimmer (p<0.001), and NHR (p= 0.052) values were significantly increased in the laser posterior cordotomy group as compared with the external arytenoid lateralization group. No statistically significant difference was found between the external arytenoid lateralization group and the laser posterior cordotomy group in terms of the mean postoperative f(o) (p= 0.417), as well as for decannulation time (p= 0.076) and duration of hospital stay (p= 2.30).Conclusions: External arytenoid lateralization is a more preferable technique than laser posterior cordotomy because it preserves mucosal integrity and cord mass, which results in better voice quality

Case Report - Lingual schwannoma

Schwannomas or neurilemmomas are benign, slow growing, usually solitary and encapsulated tumor, originating from Schwann cells of the nerve sheath. Intraoral schwannoma accounts for 1% of head and neck region and are commonly seen at the base region of tongue. Most of the few such reports in the literature, have described schwannomas that occurred in the tongue. In this article, we report a rare case of lingual schwannoma involving the anterior of tongue, in a young individual, in whom the lesion was completely excised via an intra oral approach

Analysis of the hMSH2 Gene Variants in Head and Neck Cancer

The hMSH2 (human MutS homolog 2) gene plays a central role in DNA mismatch repair. Structural variations in the gene may lead to protein instability and deficient mismatch repair. However, the role of polymorphic variants of the hMSH2 gene have not been defined in head and neck cancer. In this study, the roles of three polymorphic variants in the functional domains of the gene were investigated in 166 patients with head and neck cancer by allele-specific PCR, electronical array addressing, and PCR/RFLP (restriction fragment length polymorphism). This is the first study to investigate the gIVS12-6T -> C polymorphism in head and neck cancer. A significant association between the CC genotype and reduced risk of disease suggests that the gIVS12-6T -> C substitution at the splice-acceptor site may affect the risk of head and neck cancer. We did not observe an association between the Asn127Ser and Gly322Asp polymorphisms and cancer risk. A possible role of the gIVS12-6T -> C substitution warrants further validation in larger cohorts because of low allele frequency

Analysis of Cyclin D1 G870A Polymorphism in Patients with Head and Neck Cancers

Objective: Head and neck cancer (HNC) is the sixth leading cancer among the most frequent cancers worldwide. Studies indicate that genetic predisposition plays an important role for HNC risk and a polymorphism in cyclin D1 (CCND1) gene taking part in regulation of cell cycle is considered to be the underlying cause of genetic predisposition. A few studies are available in literature on CCND1 gene polymorphism in HNC. No studies are available in literature investigating this polymorphism in Turkish HNC patients. In our study, G870A polymorphism in CCND1 gene was analysed and the relationship between allele and genotype distributions and clinical parameters was evaluated. Material and Methods: Peripheral blood samples of 95 HNC patients and 40 healthy controls were analysed as part of the study. CCND1 gene-specific polymorphic region was reproduced with polymerase chain reaction after DNA was obtained from the collected samples, afterwards it was cut using a proper restriction enzyme and results were assessed with video-gel documentation system. Polymorphic distributions were compared with allele frequencies of healthy individuals using Finetti case-control statistical program and relationships with clinical and pathologic findings of the patients were analysed using chi(2) (Chi-square) tests. Results: While a significant difference was not found between head and neck cancer patients and control group in terms of allele and genotype distributions, GA heterozygot genotype and combined GA + AA genotypes were found associated with low disease risk in patient with non-squamous cell cancer (NSCC). Additionally, A allele was detected significantly frequent in SCC group compared to NCCC patients. Conclusion: Different variants of CCND1 gene are considered to be effective in head and neck carcinogenesis according to tumor histology

Assessment of microsatellite instability in head and neck cancer using consensus markers

Head and neck cancer is the sixth most common cancer in the world and one of the most lethal cancers. Microsatellite instability is an important characteristic of tumor cells and is observed both in presence and absence of mismatch repair gene mutations. The importance of microsatellite instability in head and neck cancer is not well established due to the lack of a consensus panel and selection of different markers, criteria and methodological variances. The main objective of this study was to investigate the performance of a consensus panel of microsatellite repeats by automated fragment analysis. Matched tumor and normal tissue samples from 99 patients were analyzed using five mononucleotide markers. Following PCR the amplified fragments were analyzed by capillary electrophoresis on an ABI 310 genetic analyzer. Microsatellite instability was observed in 26 patients. In 17 patients instability was detected at multiple loci. NR21 and BAT25 were the most frequently altered targets. These two mononucleotide markers could detect all samples displaying high-instability. In this study we describe a standardized fluorescent multiplex PCR combined with computerized analysis, which allows rapid and accurate analysis of a high number of samples and obviates the need to compare tumors with matching normal tissue

Simultaneous Methylation Profiling of Tumor Suppressor Genes in Head and Neck Cancer

Head and neck cancer (HNC) is a common cancer, and its prognosis has not changed during the last decades. Detection of the disease at an early stage is crucial for successful treatment, as early diagnosis can significantly increase the survival rate. Methylation of tumor suppressor genes is an early event in cancer responsible for incorrect gene silencing. Since methylation changes are reversible, they also provide a promising target for therapy. So far, only individual genes have been analyzed for aberrant methylation in HNC. In this study, we analyzed the methylation status of 24 tumor suppressor genes simultaneously by methylation-specific multiplex ligation-dependent probe amplification in matched tumor and normal tissue samples from patients with HNC. CHFR, RAR beta, DAPK1, and RASFF1 genes were the most frequently methylated genes in tumor tissue. Eight genes were not methylated in any sample. The methylation frequencies for individual genes ranged from 0% to 19%. Our results indicate that methylation of tumor suppressor genes is not high as previously reported by methylation-specific polymerase chain reaction and is confined to a smaller but significant fraction of the tumors. Whether this group represents a unique entity in the disease spectrum warrants further studies