Wepresent 2 cases of advanced juvenile nasopharyngeal angiofibroma UNA) to illustrate theadvantages of endoscopic Coblation-assisted resection ofintranasalextensions of these masses. Bothpatients-an l l-year-old boyand a i4-year-old boy-presented with a large, extensive mass (Radkowski stage IIIband Fisch stage Tvb in both cases). Afterembolization wasperformed oneach patient, hisINA was partially ablated viaanendoscopic approach withthe Coblator II Surgery System with an EVac Xtra Plasma Wand in conjunction with an image-guided navigation system. Bothpatients experienced resolution oftheirnasal obstruction with removal of the intranasal extension of the tumor. Coblation allowed for a controlled debulking ofthetumors withless blood loss and withouttheneedfor multiple instruments. To the best of our knowledge, our report is one of thefirst to describe image-guided endoscopic Coblation ofadvanced INA tumors. Future studies in adequately sizedpopulations areneeded to determine the safety and effectiveness of Coblation-assisted endoscopic removal of both advanced and lower-stage INAs.

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Objectives: Determine the human papillomavirus (HPV) infection and p53 protein expression in oral squamous cell carcinoma (OSCC) and their correlation with patient overall survival (OS) and disease-free survival (DFS).Methods: HPV general and type specific 16 and 18 were investigated by means of PCR. P53 protein overexpression was investigated by means of immunohistochemistry. Results of HPV association and p53 overexpression were evaluated in relation to different clinicopathological parameters and survival.Results: Out of 140 patient samples HPV was detected in 95 (68%) cases, out of which 85 (90%) were associated with HPV16, 2 (2%) were associated with HPV 18, 2 (2%) were co-infected (with HPV 16 and 18), and 6 (6%) were positive for HPV by the general primer and could not be type specified. HPV positive patients had comparatively prolonged OS when compared with HPV-negative patients, but this difference was not statistically significant (P = .97). Furthermore, overexpression of p53 protein was observed in 75 patients (54%) using a threshold of 10% stained tumor nuclei. Patients with p53 negative tumors had improved OS when compared with patients with p53 positive tumors. This difference was statistically significant (P = .036) in univariate Cox regression analysis; however, it lost its worth in the multivariate analysis.Conclusions: Our study found a high prevalence of HPV (type 16) in OSCC of Pakistani patients with male sex showing significant correlation with HPV. However, we did not find a statistically significant favorable association between p53 overexpression, HPV, survival, and histologic variables. Impact of Thyroid Molecular Testing with Surgeon Performed FnAC and Immediate On-Site Cytopathological InterpretationRay Sukumor, MD (presenter); Robert L. Witt, MD; Fady Gerges, MD Objectives: (1) Describe how thyroid molecular testing affects surgeon-performed ultrasound-guided fine-needle aspiration (FNA) with immediate on-site cytopathological interpretation.(2) Analyze percentage of inadequate FNA cytology (FNAC) and number of aspirations, comparing with and without surgeon-performed ultrasound guidance.Methods: Retrospective cohort comparison. A cytopathologist is present for on-site staining (Diff-Quik) adequacy evaluation and molecular testing triage. This is followed by pap stain, cell block, and liquid-based cytology. Cytological adequacy and number of aspirations for 200 consecutive patients undergoing surgeon-performed ultrasound-guided FNA are compared with a series from the same surgeon without ultrasound guidance. A questionnaire subjectively scoring anticipated and actual pain from 1 through 10 (10 severe) was recorded immediately before and after FNAC.Results: Patients with an inadequate FNAC, with and without ultrasound guidance, were 0% and 3% (P > .05). The mean number of aspirations with and without ultrasound guidance were 1.7 and 4.0 (P < .05). Using ultrasound guidance, benign, indeterminate, and malignant FNA results were 173 out of 200 (87%), 18 out of 200 (9%), and 9 out of 200 ...