Nutrition and taste and smell dysfunction

Food selection plays a pivotal role in maintaining adequate nutrient intake, thus elucidating drivers of food choice is a meaningful strategy to maintain health and manage disease. Taste and smell are key determinants of food choice and warrant careful consideration. In this review, we first discuss how sensory stimulation influences food selection and metabolism. We then review the evidence regarding the relationship between taste and smell dysfunction and food preferences and selection, with attention given to contexts of certain chronic diseases. We conclude with brief recommendations for the management of chemosensory disorders. While sensory abilities influence food selection, the effect of taste and smell dysfunction on long-term consumption patterns and health status must be considered in light of environment, exposure, and culture.     

Aging and olfactory and taste function

This article focuses on the change in olfaction and taste with aging. It discusses histopathology with an emphasis on age-related changes, causes of chemosensory dysfunction in the elderly, how to evaluate a patient with dysfunction, useful tests and imaging, clinical consequences of chemosensory impairments, and available treatment options.     

HPV and head and neck cancer

Head and neck cancer is frequent worldwide and oropharyngeal locations are presently sharply on the increase, in relation with an increasing incidence of oropharyngeal infection by oncogenic type-16 human papillomavirus (HPV). The clinical and biologic profile of these patients is distinct from that of other oropharyngeal carcinoma patients, with earlier onset, cystic cervical nodes and basaloid carcinoma histopathology. Detection of intratumoral viral DNA is essential to confirm the role of HPV, and E6/E7 mRNA expression is the most relevant indicator for stratification. Several methods can reveal intratumoral oncogenic HPV DNA, but PCR with hybridization is the most sensitive and most widely used. According to several reports, prognosis in terms of survival and locoregional control is better in HPV-positive oropharyngeal carcinoma than in oropharyngeal carcinoma associated with smoking and alcohol consumption. The future lies in vaccination, but further studies will determine whether the rate of oropharyngeal carcinoma falls in women vaccinated against cervical cancer.     

Papillomavirus and head and neck cancer

Tobacco and alcohol consumption are the main risk factors for head and neck cancers. Papillomavirus (HPV) infection was recently associated with the development of malignant tumors of the oropharynx, according to molecular and biological arguments. We describe the oncogenic mechanisms of HPV infections, the epidemiological and clinical aspects of associated head and neck cancers, their prognosis, and issues of specific therapeutic strategies.     

紫杉醇与头颈部肿瘤

为了解紫杉醇治疗鼻咽癌、喉癌及其他头颈部肿瘤的疗效及作用机理，本文分析了近年来的文献27篇。紫杉醇通过稳定微管、阻断细胞的有丝分裂和增殖，从而显著地抑制肿瘤细胞的生长并促进细胞调亡，在头颈部肿瘤同期放化疗中能起到放疗增敏作用，单独或联合其他抗癌药物治疗亦有较佳的疗效。紫杉酵是一种具有良好抗癌活性的药物，随着研究的深入，将会在头颈部肿瘤的治疗中发挥更大的作用。     

Pepsin and Laryngeal and Hypopharyngeal Carcinomas

Laryngeal and hypopharyngeal carcinomas are common malignant tumors of the head and neck, and the incidence of both is increasing. Laryngopharyngeal reflux refers to the retrograde flow of gastric contents into the larynx, oropharynx, and/or nasopharynx. It remains controversial whether laryngopharyngeal reflux is a risk factor for laryngeal and hypopharyngeal cancers. The refluxing substances mainly include hydrochloric acid, pepsin, and occasionally bile acids and bile salts, as well as bacteria that colonize the gastrointestinal tract. Loss of epithelium in the mucous membrane of the larynx and hypopharynx is thought to be caused by pepsin. Here, we review the relationships between laryngopharyngeal reflux and both laryngeal and hypopharyngeal carcinomas, as well as the significance of pepsin, methods of clinical detection, and the mechanism of carcinogenesis.     

Subvocalization and reading rate differences between stuttering and nonstuttering children and adults

The hypothesis tested was that stutterers subvocalize more slowly than nonstutterers and that they need more time for the overt production of the fluent parts of their speech. We also investigated whether rate differences could only be observed for those words on which the stutterers expect to stutter. Fifty-nine school children (27 stutterers and 32 nonstutterers) and 19 adults (18 stutterers and 21 nonstutterers) performed a reading task in which a noun was presented together with its definite article. The presentation times of the reading material were controlled by the subjects. Half of the material had to be read silently, the other half orally. In oral reading, only the data from those trials without any indication of disfluencies were used. Dependent variables were presentation times, speech latency, and speech duration. The stutterers' silent presentation times were significantly longer than those of nonstutterers and this difference was significantly greater for children than for adults. In oral reading all stutterers, regardless of age, had longer presentation times, speech latencies, and article durations than the nonstutterers. Some nouns, however, were uttered significantly more rapidly by stutterers than by nonstutterers. These time differences were found to be independent of the stutterers' expectation to stutter. Our results indicate that a strictly motoric explanation of stuttering is inadequate. The data show that the stutterers and nonstutterers differ with respect to the temporal parameters not only during speech execution, but during speech planning as well.     

Child behavior and quality of life before and after tonsillectomy and adenoidectomy

OBJECTIVE: To determine the relationship between child behavior and quality of life before and after tonsillectomy and adenoidectomy by means of a standardized assessment of child behavior, the Child Behavior Checklist (CBCL), and a validated quality-of-life survey of pediatric obstructive sleep apnea, the OSA-18. DESIGN: Before-after study. SETTING: Hospital-based pediatric otolaryngology practice in a metropolitan area. PARTICIPANTS: Sixty-four children (mean [SD] age, 5.8 [3.1] years; 36 boys, 28 girls) who underwent tonsillectomy and adenoidectomy for treatment of sleep-disordered breathing or recurrent tonsillitis. INTERVENTION: Parents or caretakers completed the OSA-18 and the CBCL for ages 2 to 3 years or 4 to 18 years before surgery and 3 months postoperatively. MAIN OUTCOME MEASURES: The OSA-18 mean survey scores and change scores, and the CBCL total problem T scores and change in total problem T scores. RESULTS: The mean (SD) preoperative OSA-18 score was 3.9 (1.5) and change score was 2.3 (95% confidence interval, 1.9-2.7). The mean total problem score was 7.3 points lower after surgery (95% confidence interval, 4.9-9.7), indicating a significant decrease (P<.001, matched t test). The preoperative CBCL total problem score was consistent with abnormal behavior for 16 children (25%), but only 5 children (8%) scored in the abnormal range postoperatively (P =.03, log-likelihood ratio test). The OSA-18 preoperative mean survey score had fair to good correlation with the preoperative CBCL total problem T score (r = 0.50, P<.001, Pearson correlation), and the OSA-18 change score had fair to good correlation with the change in CBCL total problem T score (r = 0.54, P<.001, Pearson correlation). CONCLUSIONS: Behavioral and emotional difficulties are found in children with sleep-disordered breathing before treatment and improve after intervention. Scores on a standardized measure of assessment of behavior demonstrate significant correlation with scores on a validated quality-of-life instrument.     

Supraorbital and supratrochlear notches and foramina: anatomical variations and surgical relevance

The anatomy of the supraorbital and supratrochlear notches and foramina has been studied in 111 human skulls. Of 108 skulls, 49.07% had bilateral supraorbital notches, 25.93% had bilateral supraorbital foramina, and 25% had a notch on one side and a foramen on the other side. Of 101 skulls, 97.03% had bilateral supratrochlear notches, 0.99% had bilateral foramina, and 1.98% had a notch on one side and a foramen on the other side. The methods of study and clinical relevance are discussed, along with the varying nomenclature used in the literature for defining the supraorbital and supratrochlear structures. Knowledge of the anatomy of the region is important for those doing forehead and brow lift surgery in order to avoid injuring the neurovascular bundles passing through these notches and foramina.     

鼻窦解剖及其变异与鼻窦炎和手术的关系

目的 探讨鼻窦解剖及其变异对鼻窦炎和手术的治疗。方法 观察１００具颅骨、１０个尸头,复习７５０例鼻窦炎鼻窦冠状ＣＴ和１０００例内窥镜鼻窦手术记录,研究中鼻甲、钩突、上颌窦自然口和鼻囟门（含上颌窦骨性裂口）、前鼻颅底、筛蝶区域和鼻中隔的解剖学和影像解剖学,分析解剖、变异与鼻窦炎和手术的关系。结果 ①中鼻甲、钩突、前鼻颅底、筛蝶区域和鼻中隔均存在解剖变异;②中鼻甲、钩突和鼻中隔的变异在有鼻窦炎侧明显多     

Concomitant chemotherapy and split-course radiation for cure and preservation of speech and swallowing in head and neck cancer

To assess the ability of simultaneous cisplatin, 5-Fluorouracil, and radiation to substitute for surgery and radiation in advanced head and neck cancer, we have retrospectively selected from our phase II study a subgroup of 29 patients having primary disease requiring either more than a hemiglossec-tomy or a laryngectomy for control. Patients included 22 with stage IV and 7 with stage III disease, 12 tongue, 10 hypopharynx, and 7 larynx primaries. The treatment consisted of concurrent cisplatin, 5-Fluo-rouracil, and split-course radiation every other week for a total of 7 cycles within 13 weeks. With a median follow-up of 5 years, 86% of patients had preservation of speech and/or swallowing function. Median survival was 45 months, with 14 (48%) patients currently alive and disease free, 11 (38%) dead from their cancer, and 4 (14%) dead of other causes. The overall failure rate was 38%. Advanced-stage presence of N3 nodal disease and fewer than 7 cycles of chemotherapy received were significantly associated with increasing failure rates. This program of concomitant cisplatin, 5-Fluorouracil, and radiation produced control rates quite competitive with surgery and radiation and is appropriate for definitive testing in a randomized trial.     

Tobacco and otorhinolaryngology: Epic and disaster

More than 500 papers are retrieved from the PubMed database by the keywords “Tobacco” and “Otorhinolaryngology”, none of which, however, is devoted to the history of a plant that has a major impact on our specialty and practice. The present report describes and analyzes how tobacco conquered the world, the conflicts it triggered and the impact it has had in our field over the past centuries.