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Background: The authors sought to investigate patient preferences on physician and medical student attire in the outpatient otolaryngology setting. Methods: A prospective sample of 50 (23 males, 27 females) patients presenting to an otolaryngology clinic in a North American teaching hospital, Boston, MA, were included. Patients were seen by a researcher wearing a white coat and either (1) a shirt and tie or (2) surgical scrubs, then completed a Likert-style survey evaluating feelings of trust, comfort, and professionalism. Statistical significance was set at α = 0.05. Results: Most patients (82%, 41/50) believed that attire was important. Men and older patients were significantly more likely to believe attire was important (P =.01 and.005, respectively). Patients were significantly more comfortable when seen by a provider wearing a shirt and tie compared to scrubs (U = 109.5, P =.021); however, there was no difference in feelings of trust or professionalism (P =.5* and.6*, respectively). Conclusions: Physician attire is important for patients presenting to otolaryngology clinic. Patients favored a white coat with a shirt and tie. Level of Evidence: NA. [ABSTRACT FROM AUTHOR]

Introduction: Eagle's syndrome is a rare condition that refers to chronic recurrent pain in the oropharynx, face, and neck due to elongation of the styloid process or calcification of the stylohyoid ligament. It can be treated medically or surgically through a styloidectomy. In this paper, we review our experience with the two surgical approaches for the management of Eagle's syndrome. Materials and Methods: We conducted a retrospective chart review, which covered the period between 1997 and 2008. The review included seven patients with a long-standing diagnosis of Eagle's syndrome. Six patients underwent surgical intervention and one patient elected to observe her condition. Ethics Approval: The retrospective design of the study was approved by Boston Medical Center Institutional Review Board with no need for another consent other than the one obtained before surgical interventions. Results: Out of the seven patients identified, there were three men and four women. The median age and mean age at diagnosis were 44 years and 26.2 years, respectively. Neck pain and odynophagia were the most common symptoms reported. Three patients underwent styloidectomy through transoral approach and the three through transcervical approach. The average time to resolution of symptoms was 26.5 days. Conclusion: The review suggests a favorable role for surgery in the management of Eagle's syndrome with all the patients undergoing styloidectomy experiencing complete resolution of symptoms. Both surgical approaches provide the desired outcome; however, the choice of the surgical approach depends on the patient's wishes and the surgeon's experience. [ABSTRACT FROM AUTHOR]

Introduction: The majority of patients with advanced head and neck cancer receiving chemotherapy show partial response or frank resistance. Therefore, assessing the individuals' tumour reactivity to the eligible chemotherapeutic compounds carries the potential of personalizing the patient treatment and minimizing ineffective regimens which lead to excess toxicity and cost, treatment delays and possibly causing the tumour to be cross resistant to additional drugs. Aim: To determine the effectiveness of a phenotypic chemoresponse assay in predicting response to chemotherapy in a retrospective series of head and neck cancer patients whose tumour specimens had been tested with ChemoFx assay (Precision Theraputic Inc.). Materials and Methods: Twenty-two tumour specimens were submitted to Precision Theraputics Inc. for chemoresponse testing, all of which have been histologically confirmed as squamous cell carcinoma of the head and neck. Selection of treatment was at the discretion of the treating physician and the results of the assay were not used to determine the therapy. A portion of the patients' solid tumour was established in primary culture, then exposed to increasing doses of different chemotherapeutic agents. The resultant cell counts in the treated wells were used to indicate the tumours' response to the agent and based on the dose response score curve, the test was scored as "responsive," "intermediate response," or "non-responsive." Results: Of the 22 tumour samples submitted, 16 (72.7%) showed adequate cell yield in cultures and subsequently underwent in vitro chemoresponse assays and are reported in this study. Of the 16 cases reviewed, 5 were excluded due to inadequate follow up. A predictable response assay was either a good response to chemotherapy in patients whose tumour specimens showed sensitivity to the chemotherapeutic agents or failure in patients whose tumours showed either intermediate response or non responsiveness to the chemotherapeutic agent/ agents. Of the 11 patients reported in this study, nine showed a predictable chemoresponse assay (81.8% predictability of effective treatment). Three patients had a predictable good response and six who failed their chemotherapy regimen within six months of treatment and their chemoresponse assay showed an inadequate response to the chemotherapeutic agents they were treated with. At three years follow up, all patients who had a predictable poor response succumbed to their disease except one, whose test showed intermediate response. Conclusion: While the current report has its limitation, we conclude, based on our findings, that chemoresponse assays may be useful adjuncts in the guiding the selection of chemotherapeutic agents in patients with head and neck cancer. [ABSTRACT FROM AUTHOR]

Background: The authors sought to investigate patient preferences on physician and medical student attire in the outpatient otolaryngology setting., Methods: A prospective sample of 50 (23 males, 27 females) patients presenting to an otolaryngology clinic in a North American teaching hospital, Boston, MA, were included. Patients were seen by a researcher wearing a white coat and either (1) a shirt and tie or (2) surgical scrubs, then completed a Likert-style survey evaluating feelings of trust, comfort, and professionalism. Statistical significance was set at α = 0.05., Results: Most patients (82%, 41/50) believed that attire was important. Men and older patients were significantly more likely to believe attire was important ( P = .01 and .005, respectively). Patients were significantly more comfortable when seen by a provider wearing a shirt and tie compared to scrubs ( U = 109.5, P = .021); however, there was no difference in feelings of trust or professionalism ( P = .5* and .6*, respectively)., Conclusions: Physician attire is important for patients presenting to otolaryngology clinic. Patients favored a white coat with a shirt and tie. Level of Evidence: NA.