In high-risk patients we found tongue scalloping to be predictive of sleep pathology. Tongue scalloping was also associated with pathologic polysomnography data and abnormal Mallampati grades. We feel the finding of tongue scalloping is a useful clinical indicator of sleep pathology and that its presence should prompt the physician to inquire about snoring history.

The aim of this study was to investigate whether a simplified diagnostic procedure based on ambulatory monitoring with MESAM IV altered subsequent compliance with continuous positive airway pressure (CPAP) in obstructive sleep apnoea (OSA) patients. During a period of 16 months, 60 patients with symptoms evocative of OSA and positive MESAM recording were prescribed CPAP after titration with standard polysomnography. Compliance was followed during 2 yrs based on built-in time counters and was compared with the compliance in two comparison groups: an equal number of equally severely affected patients diagnosed with standard polysomnography during the 18 months (8 months before and 8 months after) preceding and following the study period and a group of 48 patients with an estimated similar apnoea/hypopnoea index but less typical clinical and/or MESAM features, diagnosed as having OSA based on polysomnography during the study period. The three groups were not different by age, body mass index, or sleepiness score. Patients diagnosed with the ambulatory procedure had higher drop-out rates (21.7% versus 10% and 6.25%; p<0.05) and lower rates of use of their CPAP (43+/-0.3 h x night(-1)) than any of the control groups (53+/-0.2 and 5.6+/-0.2 h x night(-1), p<0.05). In conclusion, there is a risk that ambulatory diagnostic procedures alter the relationship of patients to their disease and/or the medical staff so that subsequent compliance with treatment may be decreased. The greatest care concerning compliance should be taken before an ambulatory-based diagnostic procedure is implemented.

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OBJECTIVES: To assess the correlation between cortaction overexpression, the clinicopathological characteristics, and tumor behavior in oral squamous cell carcinoma (OSCC). METHODS: Some 122 OSCC patients subjected to surgical resection of primary tumor and neck dissection between January 2001 to September 2004 were enrolled in the study. Cortactin expression of tumor tissue by immunohistochemical stain, tumor size, lymph node numbers, differentiation status, lymphvascular invasion, local-regional recurrence, and distant metastasis were evaluated. The outcome measurement was schematic with Kaplan-Meire survival method. The Fisher exact test and Chi-square test were used for statistical analysis. RESULTS: Statistical analysis indicates no correlation between cortactin overexpression with pathologic grade (P ϭ 0.960), or tumor site (P ϭ 0.377). Nevertheless, statistical differences were found with respect to pT stage of primary tumor (P ϭ 0.037), pN stage of lymph node metastasis (P ϭ 0.007), disease stage (P ϭ 0.01), disease status (P ϭ 0.00034), and tumor recurrence (P ϭ 0.00123). The cumulative survival after surgery is typically correlated with disease stage, regardless of cortactin expression (P ϭ 0.001). Also, there is a statistically significant difference in cortactin levels between stages I/II or III/IV OSCC patients (P ϭ 0.048, and P ϭ 0.006). CONCLUSIONS: EMS1 gene amplification and the concomitant overexpression of cortactin have been shown to correlate with poor prognosis and tumor metastasis in OSCC.

OBJECTIVES: 1. Report the first published case of neonatal airway obstruction due to a congenital cystic parotid oncocytoma. 2. Describe the histologic features of salivary oncocytic neoplasms and propose a new etiology for tumorigenesis. METHODS: A single case at a tertiary care hospital is reported. A 6-week-old male presented with progressive airway obstruction. Imaging demonstrated a large parapharyngeal cyst, extending to the skull base and crossing the midline. This was excised using a retromandibular transparotid approach. Histopathologic diagnosis confirmed a parotid oncocytic cyst. Clinical features of newborn parotid oncocytoma are described and compared to standard adult findings in the literature. RESULTS: The newborn recovered with normal upper airway function and swallowing, without facial nerve weakness. Oncocytic neoplasms are rare salivary gland tumors most commonly seen within the parotid gland and almost exclusively found in adults. The etiology of oncocytic neoplasia is obscure, although tumorigenesis may be secondary to both metaplasia and acquired mitochondrial dysfunction. CONCLUSIONS: This case demonstrates that salivary oncocytic neoplasia can be present and symptomatic at birth, suggesting that congenital molecular mechanisms rather than acquired mitochondriopathy may play a role in tumorigenesis. Surgical excision is curative.