Laryngeal Biopsies: Are We Doing More? A Decade of Results

Abstract

Objective: To investigate the presence of Helicobacter pylori (H pylori), a key pathogen in chronic gastritis and recognized as a major cause of gastric cancer, in cancer samples and adjacent normal tissues of the head and neck region.Method: Twenty-eight fresh-frozen HNSCC samples and 11 biopsies from normal tissue were obtained from fully informed and consented patients at GSHU. From 8 of these cancer samples adjacent normal tissue was available. FISH using a probe for H pylori was used to examine sections of these samples and enumerate the bacterium.Results: The average number of H pylori per biopsy section was significantly higher in the SCC group (P < .03) than controls for all sites examined. Most interestingly, in paired SCC and adjacent normal biopsies from the same patient the average number of H pylori per biopsy was significantly higher in the SCC tissue compared with the adjacent normal tissue (P < .006). These data indicate that H pylori shows a numerical and spatial association with squamous cell cancer lesions of the head and neck. Conclusion:The fact that H pylori is present in higher numbers in the tumor tissue compared with adjacent tissue and tissue obtained from healthy individuals suggests either a predisposition for the colonization of SCC with H pylori, or a causative role for the bacterium in cancer at these sites.Laryngology/Broncho-Esophagology injection laryngoplasty: impact on Swallowing and Aspiration Elena Willis, MD (presenter); Melin Tan, MD; Gina Palma; Miriam Herschman Objective: Vocal fold paralysis (VCP) and glottic insufficiency result in difficulties with dysphonia, dysphagia, and cough strength. This pilot study compares quality of life (QOL) and aspiration in patients with VCP before and after injection laryngoplasty (IL).Methods: A prospective case series at an academic tertiary care hospital on 7 pilot patients (age 64-85 years, mean 71 years) with VCP and symptoms of aspiration. All patients underwent modified barium swallow (MBS) or fiberoptic endoscopic evaluation of swallow (FEES). MBS and FEES studies were evaluated using Penetration-Aspiration scale (PENASP). Additionally, patients completed 2 QOL questionnaires, the EAT-10 and the Voice Handicap Index (VHI). All patients underwent IL with micronized dermis. Four underwent unilateral injection, 3 underwent bilateral injection. Repeat evaluation at 3 months with MBS or FEES was again scored with PENASP scale. Patients again completed the questionnaires.Results: All 7 reported improvement in QOL on VHI (P = .03). There was no difference in pre and post procedure EAT-10 scores. Two of 7 patients showed decreased aspiration on thin liquid PENASP scores and 5 of 7 patients showed no change (P = .19). There was no difference in pre and post PENASP scores with semi-solids. Conclusion:This study suggests that IL improves QOL for patients with VCP and that IL may improve aspiration with thin liquids. A prospective case series with a larger sample size is needed to further evaluate the effects of IL on aspiration and quality...