Lipids play an important role in cell division and growth and have long been associated with cancers. Smoking is also known to alter serum lipid level. In this study, serum lipid profile in chronic smokers with head and neck malignancy was compared with chronic smokers without head and neck malignancy.

In this study, 50 chronic smokers with histopathologically proven head and neck malignancy and 50 chronic smokers without malignancy were studied. Fasting blood samples were collected from the subjects and plasma lipid profile estimated.

There is no significant difference in total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, very low-density lipoprotein values between the groups.

There is no significant alteration of serum lipid profile in patients with head and neck malignancies and therefore it cannot be used as a serum marker as a diagnostic tool for early detection.

Ramachandran R, Manohar S, Somayaji G. Serum Lipid Profile in Chronic Smokers with Head and Neck Malignancy vs Chronic Smokers without Head and Neck Malignancy: A Comparative Study. Int J Head Neck Surg 2016;7(4):193-196.

Oral submucous fibrosis (OSMF) is a well-known premalignant condition. Use of areca nut is a known cause of OSMF. More and more adolescents are becoming habitual to the use of areca nut and thus become prone for oral cancer.

To assess the prevalence of areca nut eating habits and its association with OSMF in the preuniversity college-going adolescents of Raichur in Karnataka, India.

A prospective cross-sectional study was conducted among the preuniversity college-going adolescents. A questionnaire was asked to be filled by them with regard to areca nut eating habits. All of them were examined by a single examiner for the detection of OSMF.

Among the total of 1,208 adolescents included in the study, 527 were males and 681 were females. A total of 358 (29.64%) people accepted that they have the habit of eating areca nut. There was a significant association between areca nut eating habit and OSMF. There exists a significant relationship between the frequency and duration of areca nut eating habit with the presence of OSMF (p < 0.0001).

Areca nut eating habit is increasingly becoming prevalent among college-going adolescents. This needs to be addressed promptly by all concerned to prevent the occurrence of oral cancer.

Shrikrishna BH, Jyothi AC. Prevalence of Areca Nut Eating Habits and its Association with Oral Submucous Fibrosis in Preuniversity College-going Adolescents of Raichur in Karnataka, India: A Prospective Cross-sectional Survey. Int J Head Neck Surg 2016;7(4):197-203.

To report the feasibility of Medrobotics Flex® System for laryngeal surgery.

Cadaver study in research laboratory.

The Medrobotics Flex System was utilized with the Medrobotics Flex Retractor to evaluate robotic laryngeal surgery in a cadaver model. Two surgeons using two cadavers tested the robotic system to expose the larynx and facilitate robotic airway surgery using the Flex Instruments. In both cadavers, these procedures were performed transorally with excellent visualization: supraglottoplasty, arytenoidectomy, epiglottectomy, vocal cord lesion excision, posterior cordotomy, hemilaryngectomy, and endoscopic anterior/posterior cricoid split. Laryngeal cleft repair was limited by availability of suture to close the interarytenoid band. Laryngeal exposure was rated as “excellent” by both surgeons using the robotic platform.

Robotic surgery for the head and neck, while still in relative infancy, remains one of the newest platforms for the otolaryngologist. Currently available robotic platforms, while adapted to head and neck and airway surgery, were not designed for this purpose and pose challenges in size and accessibility to the larynx. The Flex System is specifically designed for head and neck and laryngeal surgery. This system provides outstanding visualization of hard to access areas in the larynx and hypopharynx. The flexible surgical instruments used with the Flex System allow for reasonable surgical exposure and technique. The Flex System may provide an improved robotic experience for transoral laryngeal and head and neck surgery.

Roy S, Naqvi SHS, Karni RJ. Medrobotics Flex System for Laryngeal Surgery: A Feasible Study in Two Cadavers. Int J Head Neck Surg 2016;7(4):204-206.

This study aimed at evaluating the pattern of head and neck sarcomas among patients treated at Muhimbili National Hospital, Tanzania.

Sarcomas of the head and neck are very rare, representing only 1% of all primary tumors arising within the head and neck region and accounting for 4 to 10% of all sarcomas, with more than 50 distinct existing histologic subtypes.

It was a retrospective study whereby histological results of the lesions arising from oral and maxillofacial region between 2008 and 2016 were analyzed. Patient's demographic data, histopathological diagnosis, and the type of sarcoma were recorded. The lesions were broadly grouped as soft and hard tissue sarcomas (HTSs). Data analysis was done using Statistical Package for the Social Sciences version 19 computer program.

Sarcomas accounted for 7% of all lesions occurring in orofacial region. Male to female ratio was 1:1.4. The age ranged from 3 to 81 years, mean age being 33 ± 16 years. The most affected age groups were of 30 to 39 followed by 20 to 29 years. Approximately half of the patients were aged below 30 years and three quarters below 40 years. Kaposi's sarcoma (KS) and rhabdomyosarcoma were the most common soft tissue sarcoma (STS), while osteosarcoma and chondrosarcoma were the commonest HTS.

The analysis demonstrated that the head and neck sarcomas are a very rare group of neoplasm, with approximately 20 cases per year. The STSs are more common than the HTSs, while KS is the most common, followed by osteosarcoma and rhabdomyosarcoma. Generally, patients less than 40 years of age are the mostly affected, with a slightly higher female predominance.

By contributing to the identification of the incidence of sarcomas at a tertiary hospital in Tanzania, this study promotes scientific understanding of pattern of occurrence and underscores the necessity of early detection of sarcomas, since the affected are young individuals.

Moshy JR, Owibingire SS, Sohal KS. An 8-year Pattern of Orofacial Sarcoma from the National Referral Hospital in United Republic of Tanzania. Int J Head Neck Surg 2016;7(4):207-212.

The most common differentiated malignant thyroid neoplasm is papillary carcinoma. Association of concurrent presence of chronic lymphocytic thyroiditis and its subtypes with differentiated epithelial thyroid carcinoma remains controversial.

To evaluate epidemiological factors of chronic lymphocytic thyroiditis and association between chronic lymphocytic thyroiditis and its subtypes with papillary thyroid carcinoma.

A total of 684 patients who underwent thyroidectomy at Teaching Hospital Kandy, Sri Lanka, for a period of two-and-half years from 2013 January were reviewed. The clinical and pathological characteristics were analyzed. Chronic lymphocytic thyroiditis was diagnosed by histology.

Thyroid malignancies were detected in 14.2% of thyroidectomy specimen, of which well-differentiated epithelial thyroid carcinoma was seen in 82%. Chronic lymphocytic thyroiditis was present in 31%, out of which 73.1% were nonspecific chronic lymphocytic thyroiditis and 26.9% were Hashimoto's thyroiditis. Gender, age, and presence of thyroiditis were significantly associated with papillary thyroid carcinoma. Males were more likely to have papillary carcinoma compared with females (p = 0.013). Those with nonspecific chronic lymphocytic thyroiditis were more likely to have papillary thyroid carcinoma (p = 0.002) compared with those without. With increasing age, proportion of lymphovascular invasion in patients with papillary thyroid carcinoma significantly (p = 0.010) decreases. None of the three factors mentioned were significant predictors of tumor focality, capsular or lymphovascular invasion.

Presence of nonspecific chronic lymphocytic thyroiditis is associated with papillary thyroid carcinoma at a given age and gender. Influence of nonspecific chronic lymphocytic thyroiditis on the prognosis of well-differentiated epithelial thyroid carcinoma needs to be investigated further with a larger sample size.

Nawarathna NJ, Hewage SN, Ratnayake P, Seneviratne RJK. Association of Papillary Carcinoma of Thyroid and Nonspecific Chronic Lymphocytic Thyroiditis and Its Clinicopathological Effects. Int J Head Neck Surg 2016;7(4):213-219.

Thyromegaly is a common cause of physician consultation. Solitary thyroid nodules are conventionally viewed with suspicion. Clinical examination cannot reliably distinguish between a solitary thyroid nodule and a dominant nodule in multinodular goiter. Ultrasonographical examination has its own pitfalls. Technetium 99 is a commonly used modality for the functional assessment of solitary thyroid nodule detection. It has the advantage of low cost with lower radiation dose to the exposed patients. On literature search, studies on Technetium 99 scintigraphy for thyroid in context to the Indian scenario does not yield much information, and very few studies are notable. This study was conducted to correlate and qualify thyroid cold nodule as detected by technetium 99 pertechnetate thyroid scan.

This study was conducted to correlate, qualify, and compare the predictive value of technetium 99 pertechnetate scintigraphy on solitary thyroid nodule vis-à-vis fine needle aspiration cytology (FNAC) and to countercheck with histopathological examination (HPE).

A prospective cohort study in a National Accreditation Board for Hospitals & Health care Providers, National Assessment and Accreditation Council, and Joint Commission International-accredited tertiary care teaching university hospital was conducted over a period of 36 months. All the subjects underwent clinical assessment of the neck that included standard examination techniques to segregate solitary thyroid nodules. They were then subjected to technetium 99 pertechnetate scintigraphy using the standard protocol. All the patients with solitary cold nodule underwent FNAC followed by nodule excision or hemi-thyroidectomy under general anesthesia. All the specimens underwent HPE by an experienced histopathologist. The results were statistically analyzed using Pearson's chi-square test.

(1) Cold nodules as detected by technetium 99 pertechnetate thyroid scan is a reasonable indicator of probable malignancy vis-à-vis FNAC. (2) Occurrence of cold nodules is highest in third to fifth decade of life (21- to 50-year age group). (3) Occurrence of cold nodules is higher in females (83%), whereas occurrence of malignancy in cold nodules is higher in males (85%). (4) Occurrence of malignancy in cold nodules is higher in subjects less than 21 and above 50 years. (5) Technetium 99m pertechnetate thyroid scintigraphy is an important preoperative tool in management of thyroid nodules, and its routine use in all such patients is recommended, especially to rule out cold nodules.

Mohanty S, Sreenivas C, Raj V, Efficacy of Technetium Scintigraphy as an investigative Tool in Papillary Carcinoma of Thyroid: A Prospective Study. Int J Head Neck Surg 2016;7(4):220-222.

Kumar S, Singh HP, Singh AK. Syringocystadenoma Papilliferum of External Auditory Canal: A Rare Entity. Int J Head Neck Surg 2016;7(4):223-224.

Singh K, Sharma A. Localized Amyloidosis of Tongue: A Rare Case from India. Int J Head Neck Surg 2016;7(4):225-227.

Reconstruction of major head and neck defects remains challenging for head and neck surgeons . As esthetic expectations are extremely demanding, in terms of colormatch, texture and functional dexterity. Reconstructive options range widely from skin grafts tolocoregional or even free flaps. The need of the hour would be a versatile flap that harbours only the desired characteristics of both local and free flaps.

Patients requiring local flap reconstruction after excision of the head and neck malignant lesion in our department, were included in the study after informed consent.

Two patients had reconstruction of the extended radical parotidectomy skin defect and one patient had intraoral defect post oncological resection, which were reconstructed with supraclavicular artery flap.

The early experience of using supraclavicular artery flap in three cases of head and neck reconstruction following oncological resection is highly gratifying.

Janardhan D, Thomas S, Krishnan SK, Kottaram PJ. Supraclavicular Artery Flap – A promising versatile Flap: An early Experience. Int J Head Neck Surg 2016;7(4):228-230.